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Verified against CMS.gov · on April 2026 Plan ID: H8794-025 Cross-check on Medicare.gov →

Kaiser Permanente Dual Complete North P25 (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
917 Drugs Covered
1 States Served

Top Covered Drugs

Most popular medications covered by this plan, ordered by national search frequency. Click any drug to see exact copay, restrictions, and alternatives.

# Drug Name Type Tier 30-Day Copay
1 Diltiazem Hydrochloride Brand Tier 2 $0.00 Details
2 TAGRISSO osimertinib Brand Tier 5 $0.00 Details
3 Gentamicin Sulfate Brand Tier 2 $0.00 Details
4 RETEVMO selpercatinib Brand Tier 5 $0.00 Details
5 Tiagabine Hydrochloride Brand Tier 4 $0.00 Details
6 Xospata gilteritinib Brand Tier 5 $0.00 Details
7 Fluphenazine Hydrochloride Brand Tier 2 $0.00 Details
8 Clozapine Brand Tier 2 $0.00 Details
9 PredniSONE Brand Tier 1 $0.00 Details
10 ELIQUIS apixaban Brand Tier 3 $0.00 Details
11 ENTRESTO Sacubitril and Valsartan Brand Tier 3 $0.00 Details
12 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
13 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 4 $0.00 Details
14 Warfarin Sodium Brand Tier 1 $0.00 Details
15 Trifluoperazine Hydrochloride trifluoperazine hydrochloride Brand Tier 2 $0.00 Details
16 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
17 HYDROCODONE BITARTRATE AND ACETAMINOPHEN Brand Tier 2 $0.00 Details
18 Venclexta Venetoclax Brand Tier 5 $0.00 Details
19 Talzenna talazoparib Brand Tier 5 $0.00 Details
20 BOSULIF Bosutinib Brand Tier 5 $0.00 Details

Showing 20 of 917 covered drugs.

Compare this plan against others for your medications Enter your drugs and ZIP to see personalized out-of-pocket costs.
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States Served (1)

This plan is available to Medicare beneficiaries in the following states.

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