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Oahu Plans for 2026

Quality care you can count on from doctors you know and trust.

We’ve got you covered no matter where you are in life.

  • $0 primary care provider visits and lab services.
  • $0 dental cleanings, exams, X-rays, fillings, and more.
  • $0 preferred generic prescription drugs.
  • $300 annually toward eyeglasses and contact lenses.
  • $0 routine hearing exam and hearing aids starting at $195 per aid.
  • Local customer service.
  • Benefits for travel and more that go beyond Original Medicare.
 wcagcolheader HMSA Akamai Advantage Complete (PPO) HMSA Akamai Advantage Complete Plus (PPO)

Monthly premium
The amount you pay each month.
You must continue to pay your Medicare Part B premium.

Extra Help, or Low Income Subsidy, can help pay for prescription drugs and monthly premiums. Find out more.

 $20 $160
In-network maximum out-of-pocket
The most you pay each year for Medicare-covered medical services from in-network providers.		 $7,700 $5,100
2026 Star Rating 3.5 out of 5 stars

3.5 out of 5 Star Rating (H3832).
English [PDF]

Provider Directory
Medical Benefits*
  You Pay You Pay
Annual medical deductible $0 $0
Inpatient hospital care*

Days 1 to 5:
$475/day

Days 6 to 60:
$50/day

Days 61 to 90:
$0/day

Days 1 to 4:
$450/day

Days 5 to 90:
$0/day

Additional Days:
$0/day
Skilled nursing facility*

Days 1 to 20:
$0/day

Days 21 to 60:
$218/day

Days 61 to 100:
$0/day

Days 1 to 20:
$10/day

Days 21 to 40:
$210/day

Days 41 to 100:
$0/day
Outpatient hospital and ambulatory surgical center services* 20% 20%
Primary care provider office visit $0 $0
Specialty care provider office visit $55 $35
Annual wellness visit $0 $0
Ambulance, includes ground and air ambulance $350 $300
Emergency care $115 $115
Urgent care $40 $35
Worldwide coverage for emergency and urgent care services  10% 10%
Diagnostic services, labs, and imaging* $0 or 20% depending on the service $0, $50, or 20% depending on the service
Medicare Part B drugs* Up to 20% Up to 20%
Medicare Part B insulin drugs* $35 $35
Medical equipment and supplies* 20% 20%
Supplemental Dental Benefits

Diagnostic and preventive dental services:

  • Two oral exams every calendar year
  • Two cleanings every calendar year
  • One set of bitewing X-rays every calendar year
  • One set of full mouth X-rays or panoramic X-ray every five calendar years
  • Two fluoride treatments every calendar year
 $0 $0

Comprehensive dental services:

  • Four extractions every calendar year
  • Two fillings every calendar year
 $0 $0

Comprehensive dental services:

  • One root canal every calendar year
  • One crown following a root canal on the same tooth every calendar year
 Not covered $0
Dental Provider Directory  Dental Provider Directory
English [PDF] | Chinese [PDF] | Ilocano [PDF] | Korean [PDF] | Vietnamese [PDF]
Supplemental Vision Benefits
  You Pay You Pay
Routine eye exam (once a calendar year) $10 $0
Contact lenses and eyeglasses (frames and lenses) $0
Plan pays up to $300 every calendar year 		 $0
Plan pays up to $300 every calendar year 
Vision Provider Directory Routine Vision Directory [PDF]
Supplemental Hearing Benefits
Supplemental Hearing Benefits For more information, visit TruHearing or see our Frequently Asked Questions [PDF].
Routine hearing exam (one every calendar year) $0 $0
Hearing aids (one aid per ear every calendar year)
  • Basic aid
    $195
  • Standard aid
    $595
  • Advanced aid
    $995
  • Premium aid
    $1,395
  • Basic aid
    $195
  • Standard aid
    $595
  • Advanced aid
    $995
  • Premium aid
    $1,395
Other Supplemental Benefits and Programs
Telehealth services
Includes HMSA’s Online Care.		 $0 $0
Health education
Learn more		 $0 $0
Health coaching
Learn more		 $0 $0
Drug Benefits
  You Pay You Pay

Annual drug deductible

Extra Help, or Low Income Subsidy, can help pay for prescription drugs and monthly premiums. Find out more.

 $300
Does not apply to tier 1 drugs, insulin and most Part D vaccines		 $200
Does not apply to tier 1 drugs, insulin, and most Part D vaccines
Initial coverage stage
Until you’ve paid $2,100 out of pocket for Part D drugs.
30-day supply from retail pharmacies
Tier 1 - Preferred Generic
 $0 $0
Tier 2 - Generic
 $11 $11
Tier 3 - Preferred Brand
 20% 20%
Tier 3 - Preferred Brand Insulin
 Lesser of $35 and 20% Lesser of $35 and 20%
Tier 4 - Non-Preferred Drug
 30% 30%
Tier 5 - Specialty
 29% 29%
Tier 5 - Specialty Insulin
 Lesser of $35 and 25% Lesser of $35 and 25%
100-day supply from mail-order pharmacy
Tier 1 - Preferred Generic
 $0 $0
Tier 2 - Generic
 $11 $11
Tier 3 - Preferred Brand
 20% 20%
Tier 3 - Preferred Brand Insulin
 Lesser of $105 and 20% Lesser of $105 and 20%
Tier 4 - Non-Preferred Drug
 30% 30%
Tier 5 - Specialty
 29% 29%
Tier 5 - Specialty Insulin
 Lesser of $105 and 25% Lesser of $105 and 25%
Catastrophic coverage stage
After you’ve paid $2,100 out of pocket for Part D drugs.		 $0
Most Part D vaccines $0
Pharmacy Find a pharmacy
Prescription Drugs List (Formulary)
See if your prescription drugs are covered and search for lower-cost alternatives.
Resources and Plan Materials
Summary of Benefits Summary of Benefits [PDF]  Summary of Benefits [PDF] 
Annual Notice of Changes Annual Notice of Changes [PDF] Annual Notice of Changes [PDF] 
Evidence of Coverage
Member Resources Learn more Learn more

HMSA Disclaimer

  • This plan information is effective Jan. 1, 2026.
  • Medicare beneficiaries may also enroll in HMSA Akamai Advantage through the CMS Medicare Online Enrollment Center at medicare.gov.
  • Every year, Medicare evaluates plans based on a 5-star rating system.
  • Benefit amounts listed are based on using HMSA participating providers.
  • HMSA Akamai Advantage® is a PPO plan with a Medicare contract. Enrollment in HMSA Akamai Advantage depends on contract renewal.

* For some services, your doctor or other network provider may request prior authorization. Please contact us for more information.