HMSA Akamai Advantage Dual Care Plan for 2019

Are you eligible for both Medicare and Medicaid (Hawaii QUEST Integration)? You may qualify for HMSA Akamai Advantage Dual Care (PPO SNP). This plan offers you a choice of doctors and a care coordinator who'll help you get the care and support you need.

We can help

Not sure if you qualify for HMSA Akamai Advantage Dual Care? Visit an HMSA Center or office near you, or call us 8 a.m. to 8 p.m., seven days a week.

Here's a short description of the 2019 plan benefits and amount you'd pay. There may be some exceptions, so check your Summary of Benefits or Evidence of Coverage for plan details. Costs may be different, depending on how much you receive in Extra Help for prescription drugs. Please contact us if you have questions.

To be enrolled in a Dual Eligible Special Needs Plan, you must be eligible for your state's Medicaid program.

  HMSA Akamai Advantage Dual Care
Monthly premium
(The amount you pay each month.)
You must continue to pay your Part B premium (if Medicaid or another source doesn’t already pay for it).
In-network out-of-pocket maximum
(The most you pay each year for Medicare-covered services from in-network providers.)
2019 Star Rating 4.5 out of 5 stars

4.5 out of 5 Star Rating (H3832).

Provider directory
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Medical Benefits*
  You Pay
Annual deductible $0
Inpatient hospital care $0 up to 90 days
Skilled nursing facility $0 up to 100 days
Primary care provider office visit $0
Specialty care provider office visit $0
Annual wellness visit $0
Outpatient surgery $0
Ambulance service $0
Emergency care $0
Urgent care $0
Preventive care $0
Medical equipment and supplies $0
Outpatient X-rays $0
Chemotherapy and other Part B drugs $0
Drug Benefits
  You Pay
Annual deductible If you qualify for a low-income subsidy, you pay $0. If you don't qualify for a low-income subsidy, you pay a $415 deductible for your drugs.
30-day supply from retail pharmacy
Generic $0, $1.25, $3.40
All other drugs $0, $3.80, $8.50
Pharmacy Find a pharmacy
Prescription Drugs List (Formulary)
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Dental Benefits
Plan pays up to $2,500/year
  You Pay
Oral exams $0 for 2 exams/calendar year
Cleanings $0 for 2 cleanings/calendar year
X-rays $0 for 1 set of X-rays/calendar year
Filling $0 for 1 filling per tooth surface/calendar year
Root canal $0 for 1 root canal per tooth/calendar year
Supplemental Dental Provider Directory
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Wellness Benefits
HMSA’s Online Care $0
Health Education Available
Resources and Plan Materials
Summary of Benefits Download
Evidence of Coverage Download
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Member Resources Learn more

HMSA Disclaimer

  • This plan information is effective January 1, 2019.
  • This information is not a complete description of benefits. Contact the plan for more information.
  • Every year, Medicare evaluates plans based on a 5-star rating system.
  • HMSA Akamai Advantage is a PPO plan with a Medicare contract. Enrollment in HMSA Akamai Advantage depends on contract renewal.
  • Out-of-network/non-contracted providers are under no obligation to treat HMSA Akamai Advantage members except in emergency situations. To see if we’ll help pay for an out-of-network service, you or your provider can ask us for a pre-service organization determination before you receive the service. Please call Customer Relations or see your Evidence of Coverage for more information, including the share of your costs for out-of-network services.
  • To enroll in this plan, you must be eligible for Medicare and full Medicaid benefits.
  • Premium, copayments, coinsurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for details.
  • You must continue to pay your part B premiums unless Medicaid or another third party pays your Part B premium.

* Because you get Medicaid assistance, you pay nothing for your premium or covered services as long as you follow the plans' rules for getting care.

You’re eligible to enroll in HMSA Akamai Advantage Dual Care if you:

  • Are entitled to Part A (hospital insurance), Part B (medical insurance), and a Medicaid plan that meets eligibility requirements. Only people who are Qualified Medicare Beneficiaries or Qualified Medicare Beneficiaries Plus meet eligibility requirements for HMSA Akamai Advantage Dual Care.
  • Pay your Part B premium (if Medicaid or another source doesn’t already pay for it).
  • Enrolled in QUEST Integration.
  • Are a U.S. citizen or lawfully present in the United States.
  • Are a permanent resident of the state of Hawaii.

People with ESRD are not eligible for enrollment in this plan. Some exceptions may be applicable, please speak with a sales agent to determine eligibility.


Mahalo for your interest in HMSA Akamai Advantage

A sales representative will help you enroll. Call us today, 8 a.m. to 8 p.m.:

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