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Verified against CMS.gov · on April 2026 Plan ID: H2172-016 Cross-check on Medicare.gov →

Kaiser Permanente Dual Complete Plan 1 MD (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$210.00 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 BOSULIF Bosutinib Brand Tier 5 0.3% coinsurance Details
2 Methotrexate Brand Tier 2 0.0% coinsurance Details
3 Lenalidomide Brand Tier 5 0.3% coinsurance Details
4 NITROGLYCERIN nitroglycerin Brand Tier 4 0.3% coinsurance Details
5 Midodrine Hydrochloride midodrine hydrochloride Brand Tier 2 0.0% coinsurance Details
6 Propranolol Hydrochloride propranolol hydrochloride Brand Tier 1 0.0% coinsurance Details
7 Diazepam Brand Tier 2 0.0% coinsurance Details
8 Calcipotriene Brand Tier 2 0.0% coinsurance Details
9 Cefuroxime Brand Tier 2 0.0% coinsurance Details
10 Sulfasalazine Brand Tier 2 0.0% coinsurance Details
11 Clarithromycin Brand Tier 2 0.0% coinsurance Details
12 ISENTRESS RALTEGRAVIR Brand Tier 5 0.3% coinsurance Details
13 Scopolamine scopolamine Brand Tier 4 0.3% coinsurance Details
14 Amoxicillin Brand Tier 2 0.0% coinsurance Details
15 Estradiol Brand Tier 1 0.0% coinsurance Details
16 Fludrocortisone Acetate FLUDROCORTISONE ACETATE Brand Tier 2 0.0% coinsurance Details
17 Medroxyprogesterone Acetate Brand Tier 2 0.0% coinsurance Details
18 Augtyro repotrectinib Brand Tier 5 0.3% coinsurance Details
19 Risperidone Brand Tier 4 0.3% coinsurance Details
20 Venlafaxine Hydrochloride Brand Tier 2 0.0% coinsurance Details

Showing 20 of 917 covered drugs.

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States Served (1)

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

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