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HMSA Akamai Advantage Standard Plus (PPO)

H3832 - 008 - 0
3.5 out of 5 stars (3.5 / 5)

HMSA Akamai Advantage Standard Plus (PPO) is a Medicare Advantage Plan by HMSA Akamai Advantage.

This page features plan details for 2025 HMSA Akamai Advantage Standard Plus (PPO) H3832 – 008 – 0 available in Hawaii, Kalawao, Kauai and Maui counties.

Locations

HMSA Akamai Advantage Standard Plus (PPO) is offered in the following locations.

Hawaii
Hawaii County, Hawaii
Kalawao County, Hawaii

Click to see more locations

Plan Overview

HMSA Akamai Advantage Standard Plus (PPO) offers the following coverage and cost-sharing.

Insurer:HMSA Akamai Advantage
Health Plan Deductible:$0
MOOP:$5,750 In and Out-of-network
$3,850 In-network
Drugs Covered:Yes

Ready to sign up for HMSA Akamai Advantage Standard Plus (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Medicare Part B Give Back Benefit

The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans. 

HMSA Akamai Advantage Standard Plus (PPO) qualifies for a monthly Medicare Give Back Benefit of $6.00.

Premium Reduction:$6.00

Premium Breakdown

HMSA Akamai Advantage Standard Plus (PPO) has a monthly premium of $125.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.
Part B Part C Part D Part B Give Back Total
$185.00 $103.00 $22.00 $6.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.
  • You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

Drug Info

HMSA Akamai Advantage Standard Plus (PPO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $0.00
Drug Out-Of-Pocket maximum: $2,000.00
Drug Benefit Type: Enhanced Alternative

Part D Premium Reduction

The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.

The table below shows how the LIS impacts the Part D premium of this plan.

Part DLIS Full
$22.00$0.00

Initial Coverage Phase

After you pay your $0.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $2,000.00. Once you reach that amount, you will enter the next coverage phase.

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $2,000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. Please note, that this plan has a Enhanced Alternative benefit type.

Additional Benefits

HMSA Akamai Advantage Standard Plus (PPO) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

    • In-Network: Yes, contact plan for further details

Comprehensive Dental

  • Endodontics
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: 40% Coins – No Copay
  • Oral and Maxillofacial Surgery
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: 40% Coins – No Copay
  • Periodontics
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: 40% Coins – No Copay
  • Restorative Services
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: 40% Coins – No Copay

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: 40% Coins – No Copay
  • Fluoride Treatment
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: 40% Coins – No Copay
  • Oral Exams
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: 40% Coins – No Copay
  • Other Preventive Dental Services
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: 40% Coins – No Copay
  • Prophylaxis (cleaning)
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: 40% Coins – No Copay

Diagnostic procedures/lab services/imaging

  • Diagnostic tests and procedures
    • In-Network: 20% coinsurance (Authorization Required)
  • Lab services
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Diagnostic tests and procedures
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Lab services
    • In-Network: $0 copay (Authorization Required)
  • Outpatient x-rays
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • In-Network: $100 copay or 20% coinsurance (Authorization Required)
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Outpatient x-rays
    • In-Network: 20% coinsurance (Authorization Required)

Doctor visits

  • Primary
    • Out-of-Network: $30 copay per visit
  • Specialist
    • Out-of-Network: $50 copay per visit
    • In-Network: $40 copay per visit
  • Primary
    • In-Network: $0 copay

Emergency care/Urgent care

  • Emergency
    • $100 copay per visit (always covered)
  • Urgent care
    • $40 copay per visit (always covered)

Foot care (podiatry services)

  • Routine foot care
    • Not covered
  • Foot exams and treatment
    • In-Network: $40 copay
    • Out-of-Network: 40% coinsurance

Ground ambulance

    • In-Network: $225 copay
    • Out-of-Network: $225 copay

Health plan deductible

    • $0

Hearing

  • Fitting/evaluation
    • Out-of-Network: 40% coinsurance
  • Hearing aids
    • Out-of-Network: 40% coinsurance (Limits Apply)
  • Medicare-Covered Hearing Exam
    • In-Network: $0 copay
  • Hearing aids OTC
    • Not covered
  • Medicare-Covered Hearing Exam
    • Out-of-Network: 40% coinsurance
  • Fitting/evaluation
    • In-Network: $0 copay
  • Hearing aids
    • In-Network: $195-1,395 copay (Limits Apply)

Inpatient hospital coverage

    • Out-of-Network: $375 per day for days 1 through 11
      $0 per day for days 12 through 90
      $0 per day for days 91 and beyond (Authorization Required)
    • In-Network: $350 per day for days 1 through 5
      $0 per day for days 6 through 90
      $0 per day for days 91 and beyond (Authorization Required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

    • $5,750 In and Out-of-network
      $3,850 In-network

Medical equipment/supplies

  • Diabetes supplies
    • In-Network: $0 copay per item
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • In-Network: 20% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • In-Network: 20% coinsurance per item (Authorization Required)
  • Diabetes supplies
    • Out-of-Network: 40% coinsurance per item
  • Prosthetics (e.g., braces, artificial limbs)
    • Out-of-Network: 40% coinsurance per item (Authorization Required)
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • Out-of-Network: 40% coinsurance per item (Authorization Required)

Medicare Part B drugs

  • Chemotherapy
    • In-Network: 0-20% coinsurance (Authorization Required)
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Other Part B drugs
    • Out-of-Network: 40% coinsurance (Authorization Required)
    • In-Network: 0-20% coinsurance (Authorization Required)

Mental health services

  • Outpatient individual therapy visit
    • In-Network: $40 copay
    • Out-of-Network: 40% coinsurance
  • Outpatient individual therapy visit with a psychiatrist
    • Out-of-Network: 40% coinsurance
  • Inpatient hospital – psychiatric
    • Out-of-Network: $375 per day for days 1 through 11
      $0 per day for days 12 through 90 (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: $40 copay
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $40 copay
  • Inpatient hospital – psychiatric
    • In-Network: $320 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)
  • Outpatient group therapy visit
    • In-Network: $40 copay
    • Out-of-Network: 40% coinsurance
  • Outpatient group therapy visit with a psychiatrist
    • Out-of-Network: 40% coinsurance

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • In-Network: 0-20% coinsurance per visit (Authorization Required)
    • Out-of-Network: 0-40% coinsurance per visit (Authorization Required)

Preventive care

    • In-Network: $0 copay (Authorization Required)
    • Out-of-Network: $0 copay (Authorization Required)

Rehabilitation services

  • Occupational therapy visit
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • In-Network: $30 copay (Authorization Required)
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Occupational therapy visit
    • In-Network: $30 copay (Authorization Required)

Skilled Nursing Facility

    • In-Network: $20 per day for days 1 through 20
      $190 per day for days 21 through 40
      $0 per day for days 41 through 100 (Authorization Required)
    • Out-of-Network: $200 per day for days 1 through 30
      $0 per day for days 31 through 100 (Authorization Required)

Transportation

    • Not covered

Vision

  • Contact lenses
    • Out-of-Network: $0 copay (Limits Apply)
  • Upgrades
    • Not covered
  • Contact lenses
    • In-Network: $0 copay (Limits Apply)
  • Routine eye exam
    • Out-of-Network: 40% coinsurance (Limits Apply)
  • Eyeglass frames
    • Not covered
  • Eyeglass lenses
    • Not covered
  • Eyeglasses (frames and lenses)
    • In-Network: $0 copay (Limits Apply)
  • Other
    • Not covered
  • Eyeglasses (frames and lenses)
    • Out-of-Network: $0 copay (Limits Apply)
  • Routine eye exam
    • In-Network: $0 copay (Limits Apply)

Wellness programs (e.g., fitness, nursing hotline)

    • Covered (Authorization Required)

Ready to sign up for HMSA Akamai Advantage Standard Plus (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Need more information on HMSA Akamai Advantage Standard Plus (PPO)? See 2025 HMSA Akamai Advantage Standard Plus (PPO) at MedicareAdvantageRX.com.

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