Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Kaiser Permanente Medicare Advantage Standard DC, 2027
H2172Contract020Plan
HMO-POS · 1 county in District of Columbia
Run by Kaiser Fdtn Hlth Plan of the Mid-Atlantic States (contract H2172), sold as Kaiser Permanente, owned by Kaiser Foundation Health Plan, Inc.
Kaiser Permanente Medicare Advantage Standard DC (H2172-020) costs $38 a month in 2027, up $2 from 2026, with an in-network out-of-pocket limit of $7,400.
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Monthly premium | $36 | $38 | ▲up $2 |
| Specialist visit | $35 copay | $40 copay | ▲up $5 |
| Hospital stay, in network | $350 a day for days 1–5, then $0 a day for days 6–90 | $375 a day for days 1–6, then $0 a day for days 7–90 | ▲up $125for a 5-day stay |
| Skilled nursing facility, in network | $0 a day for days 1–20, then $218 a day for days 21–100 | $0 a day for days 1–20, then $221 a day for days 21–100 | ▲up $30for a 30-day stay |
| Eyewear, yearly limit | $125 a year | $250 a year | ▲up $125 |
| 17 lines do not change | |||
| In-network out-of-pocket limit | $7,400 | $7,400 | no change |
| Drug deductible | $0 | $0 | no change |
| Part B premium reduction, monthly | none | none | no change |
| Primary care visit | $0 copay | $0 copay | no change |
| Emergency room | $115 copay | $115 copay | no change |
| Medical deductible, in network | none | none | no change |
| Ground ambulance, in network | $275 copay | $275 copay | no change |
| Comprehensive dental, yearly limit | $1,000 a year | $1,000 a year | no change |
| Hearing aids, yearly limit for both ears | $333.33 a year | $333.33 a year | no change |
| Over-the-counter items, yearly | $200 a year | $200 a year | no change |
| Counties served | 1 | 1 | no change |
| Drug tier 1, preferred generic | $10 | $10 | no change |
| Drug tier 2, generic | $20 | $20 | no change |
| Drug tier 3, preferred brand | $47 | $47 | no change |
| Drug tier 4, non-preferred drug | $100 | $100 | no change |
| Drug tier 5, specialty tier | 29% of the cost | 29% of the cost | no change |
| Drug tier 6, vaccines | $0 | $0 | no change |
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.
What will prescriptions cost?
| Tier | What the tier holds | 2026, standard pharmacy | 2027, standard pharmacy | 2027, preferred pharmacy |
|---|---|---|---|---|
| Tier 1 | Preferred Generic | $10 | $10 | $0 |
| Tier 2 | Generic | $20 | $20 | $6 |
| Tier 3 | Preferred Brand | $47 | $47 | $45 |
| Tier 4 | Non-Preferred Drug | $100 | $100 | $100 |
| Tier 5 | Specialty Tier | 29% of the cost | 29% of the cost | 29% of the cost |
| Tier 6 | Vaccines | $0 | $0 | $0 |
Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.
How does it compare with plans sold where it is?
In the counties it serves, 11 plans open to everyone are sold for 2027, this one included. Against the others, 8 plans have a lower out-of-pocket limit, 2 a higher one. On the premium, 5 plans have a lower premium, 5 a higher one.
Out-of-pocket limits of the 11 plans open to everyone
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Where is it sold, and what does it cost there?
The premium and the out-of-pocket limit are the same in all 1 county: $38 a month and $7,400.
District of Columbia
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Who runs this plan?
- Plan ID
- H2172-020
- Legal name of the contract
- Kaiser Fdtn Hlth Plan of the Mid-Atlantic States
- Sold as
- Kaiser Permanente
- Parent company
- Kaiser Foundation Health Plan, Inc.
- Plan type
- HMO-POS
- 2026 star rating of the contract
- 4.5 of 5 overall; health plan 4 of 5, drug plan 5 of 5
- Members, September 2026
- 1,638
- Plan website, as filed with CMS
- kp.org/medicare
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.
What else should you check?
- Other 2027 plans in District of Columbia, DCWhere most of its members live; premiums and limits side by side
- Every Kaiser Permanente plan for 2027Its contracts, counties and plans that end
- The other 19 plans of contract H2172Same company, same contract
- Is your prescription covered?Coverage share and tier for 2,259 drugs
Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.