2014 Akamai Advantage Select

If you rarely see a doctor but would still like to have coverage just in case something goes wrong, Akamai Advantage Select (PPO) will offer you just that. It also comes with many preventive health services to help you stay healthy, routine vision coverage, and discounts for dental and hearing services.

Plan Features

In-network out-of-pocket maximum: $3,400

Request Akamai Advantage Info Kit

If you'd like an Akamai Advantage information kit, please fill out the form below. Information kits take about five business days to get to you.
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We're glad you're interested in learning more about the many benefits HMSA Akamai Advantage has to offer you. If you don't get an information kit in seven days or would like to get your questions answered now, please call us.


Hours Available
You can call from 8 a.m to 8 p.m., seven days a week

Medical

Medical benefits * You pay
Annual deductible $0
Inpatient hospital care $250/day (days 1-7)
$0/day (days 8-90)
$0 for additional days
Skilled nursing facility $50/day (days 1-20)
$150/day (days 21-52)
$0/day (days 53-100)
Primary care provider office visit $10
Specialty care provider office visit $23
Annual wellness visit $0
Outpatient services/surgery¹ 20%
Ambulance service $200
Emergency room $65
Worldwide coverage for emergency physician and outpatient services 10%
Durable medical equipment 20%
Diagnostic X-rays $25
Kidney dialysis 20%
Part B drugs 20%

*All plan benefits listed above are based on in-network services.
With the exception of emergency or urgent care, it may cost more to get care from out- of-network providers.

1 - Physician visit copayment may apply.

Vision

Vision benefits You pay
Routine eye exam $23/1 exam a year
Eyewear (supplemental) $0 for frames, lenses, and contacts. Every two years, up to $100.

Benefits listed above are based on in-network services.
With the exception of emergency or urgent care, it may cost more to get care from out- of-network providers.

Drug

Drug benefits You pay
Annual deductible $0
Initial coverage stage
Until total drug costs reach $2,850
30-day supply from retail pharmacies
Tier 1 – Generic $6
Tier 2 – Preferred brand $45
Tier 3 – Non-preferred brand $95
Tier 4 – Specialty 33%
90-day from mail-order pharmacy
Tier 1 – Generic $6
Tier 2 - Preferred brand $90
Tier 3 – Non-preferred brand $190
Coverage gap
Until your yearly out-of-pocket drug costs reach $4,550
47.5% of the drug cost for brand drugs;
72% of the drug cost for generic drugs.
Additional gap coverage for some Tier 1 drugs
30-day supply from retail pharmacy $6
90-day supply from mail-order pharmacy $6
Catastrophic coverage
After your yearly out-of-pocket drug costs reach $4,550
The greater of 5% or $2.55 for generic drugs (including brand drugs treated as generic) and $6.35 for other drugs.

*You must use in-network pharmacies to access your prescription drug benefit except under special circumstances. Quantity limits and restrictions may apply.

Discounts

Dental discounts: HMSA provides special discounts on dental services to help you keep those pearly whites bright and shiny. Savings on services include:

  • Dental exams
  • X-rays
  • Cleanings
  • Root canals
  • And more!

HMSA365: Get more out of your HMSA membership every day of the year. HMSA365 helps members save on products, services, and memberships such as:

  • Lifeline®
  • Hearing aids
  • Oahu Fresh
  • Fitness centers
  • And more!

CVS ExtraCare Health Card: Save 20% on thousands of CVS/pharmacy Brand health-related items purchased at Longs Drugs or CVS/pharmacy or on www.cvs.com. Discounted items include:

  • First-aid supplies
  • Vitamins
  • Allergy, cough, and cold drugs
  • Eye care
  • And more!

The products and services described above are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the HMSA grievance process.

You’re eligible to enroll in Akamai Advantage if:

  • You have Medicare Parts A and B and continue to pay your Part B premium.
  • Some people with end-stage renal disease (ESRD) may not be eligible for Akamai Advantage. Please call us for more information.

To enroll in Akamai Advantage Select (PPO), you must live in the City and County of Honolulu.

Open enrollment is October 15 through December 7

Call us for information.


Attend a Seminar

Want to learn more about Medicare and HMSA Akamai Advantage? Join us for a free seminar and get your questions answered.

Seminar schedule


HMSA Disclaimer

  • This plan information is effective January 1, 2014. Benefits, formulary, provider network, premium, and/or copayments/coinsurance may change on January 1 of each year.
  • Limitations, copayments, and restrictions may apply.
  • This benefit information is a brief summary, not a complete description of benefits. For more information, contact the plan.
  • Medicare beneficiaries may also enroll in Akamai Advantage through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare evaluates plans based on 5-Star Rating system. Star Ratings are calculated each year and may change from one year to the next.
  • Akamai Advantage is a PPO plan with a Medicare contract. Enrollment in Akamai Advantage depends on contract renewal.
  • CVS Caremark provides pharmacy benefit management services and manages HMSA’s drug formulary for HMSA’s commercial, Medicare, and QUEST programs. CVS Caremark is an independent company.