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Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP)

Maryland Medicare-Medicaid Dual Eligible D-SNP Plan (2026 Plan)

Monthly Premium

Your Cost
$0
by Kaiser Permanente

Additional Coverage

HearingVisionDental

Overall Government Star Rating

 4.5
out of 5 stars

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Plan Overview

Plan Name
Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP)
Insurance Carrier
Kaiser Permanente
Plan Type
Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP)
Network Type
HMO

Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) is a Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP), which is available in Maryland and offered by the health insurance company Kaiser Permanente. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Cost Summary

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$9,250
Primary doctor visit
$0 copay
Specialist visit
$30 copay
ER visit
$115 copay
Ambulance
$290 copay

Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $9,250 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) are defined below.

Additional Benefits and Coverage

Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Not covered
Home and bathroom safety devices
Not covered
Meals for short duration
Not covered
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Comparing the Quality Score of Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) to Other Plans in Maryland

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2026, Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) received an overall government quality rating of 4.5 stars out of 5 stars.

Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) performed better than Maryland’s State average overall quality score of 3.7 stars.

This Plan’s 5-star Gov’t Quality Score
Maryland State Average Score
Overall Government 5 Star Quality Rating
 4.5
 3.7
Summary rating of health plan quality
 4
 3.7
Staying healthy: screenings, tests, & vaccines
 4
 3.8
Managing chronic (long term) conditions
 5
 3.6
Member experience with health plan
 3
 3.3
Member complaints & changes in the health plan's performance
 4
 3.9
Health plan customer service
 4
 4.1
Summary rating of drug plan quality
 5
 3.7
Drug plan customer service
 4
 4.5
Member complaints & changes in the drug plan's performance
 4
 3.7
Member experience with the drug plan
 5
 3.7
Drug safety & accuracy of drug pricing
 5
 3.5

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) received 4 stars for its health plan quality score which is better than the Maryland State average health plan quality score of 3.7 stars.

Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) received 5 stars for its drug plan quality score which is better than the Maryland State average drug plan quality score of 3.7 stars.

Plan Benefits and Coverage Details

Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$9,250 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes
Doctor Lookup Link
http://kp.org/directory
Plan Link
http://kp.org/medicare

Medical Benefits

Doctor Services

Primary doctor visit
In-network: $0 copay
Out-of-network: $0 copay
Specialist visit
In-network: $30 copay
Out-of-network: $30 copay

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $0 copay
Out-of-network: $0 copay
Lab services
In-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI)
In-network: $25-$250 copay
Out-of-network: $25-$250 copay
Outpatient x-rays
In-network: $25 copay
Out-of-network: $25 copay
Emergency care
$115 copay
Urgent care
$30 copay

Hospital Services

Inpatient hospital coverage
Tier 1
$375 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Outpatient hospital coverage
In-network: $0-$350 copay
Out-of-network: $0-$350 copay

Skilled nursing facility

Skilled nursing facility
Tier 1
$0 per day for days 1-20
$218 per day for days 21-100

Preventive services

Preventive services
In-network: $0 copay
Out-of-network: $0 copay

Ambulance

Ground ambulance
In-network: $290 copay
Out-of-network: $290 copay

Therapy services

Occupational therapy visit
In-network: $30 copay
Out-of-network: $30 copay
Physical therapy & speech & language therapy visit
In-network: $30 copay
Out-of-network: $30 copay

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $0 copay
Out-of-network: $0 copay
Outpatient individual therapy with a psychiatrist
In-network: $15 copay
Out-of-network: $15 copay
Outpatient group therapy visit
In-network: $0 copay
Out-of-network: $0 copay
Outpatient individual therapy visit
In-network: $15 copay
Out-of-network: $15 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Diabetes supplies
In-network: 0% coinsurance
Out-of-network: 0% coinsurance

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseCatastrophic coverage phase
Preferred Generic25% coinsurance$0 copay
Generic25% coinsurance$0 copay
Preferred Brand25% coinsurance$0 copay
Non-Preferred Drug25% coinsurance$0 copay
Specialty Tier25% coinsurance$0 copay

Part B Drugs

Chemotherapy drugs
In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Other Part B drugs
In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Extra Benefits

Hearing

Hearing exam
Not covered
Fitting/evaluation
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - prescription
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - over the counter
Not covered

Preventive Dental

Oral exam
In-network: $0-$30 copay
Out-of-network: $0-$30 copay
Cleaning
In-network: $0-$30 copay
Out-of-network: $0-$30 copay
Fluoride treatment
In-network: $0-$30 copay
Out-of-network: $0-$30 copay
Dental x-rays
In-network: $0-$30 copay
Out-of-network: $0-$30 copay

Comprehensive dental

Restorative services
In-network: $0 copay
Out-of-network: $0 copay
Endodontics
In-network: $0 copay
Out-of-network: $0 copay
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, fixed
In-network: $0 copay
Out-of-network: $0 copay
Maxillofacial prosthetics
Not covered
Implant services
Not covered
Oral and maxillofacial surgery
In-network: $0-$30 copay
Out-of-network: $0-$30 copay
Orthodontics
Not covered
Adjunctive general services
In-network: $0 copay
Out-of-network: $0 copay

Vision

Routine eye exam
In-network: $0-$30 copay
Out-of-network: $0-$30 copay
Contact lenses
In-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass frames (only)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass lenses (only)
In-network: $0 copay
Out-of-network: $0 copay
Upgrades
Not covered

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