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HMSA Akamai Advantage Standard (PPO)

H3832 - 007 - 0
3.5 out of 5 stars (3.5 / 5)

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

This page features plan details for 2025 HMSA Akamai Advantage Standard (PPO) H3832 – 007 – 0 available in Hawaii, Kalawao, Kauai and Maui counties.

Locations

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

Insurer:HMSA Akamai Advantage
Health Plan Deductible:$0
MOOP:$10,000 In and Out-of-network
$6,700 In-network
Drugs Covered:Yes

Ready to sign up for HMSA Akamai Advantage Standard (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 (PPO) qualifies for a monthly Medicare Give Back Benefit of $6.00.

Premium Reduction:$6.00

Premium Breakdown

HMSA Akamai Advantage Standard (PPO) has a monthly premium of $0.00. 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 $0.00 $0.00 $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 (PPO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $400.00
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
$0.00$0.00

Initial Coverage Phase

After you pay your $400.00 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 (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

  • 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 radiology services (e.g., MRI)
    • In-Network: 25% coinsurance (Authorization Required)
  • Lab services
    • In-Network: $0 copay (Authorization Required)
  • Outpatient x-rays
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Lab services
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Outpatient x-rays
    • In-Network: 20% coinsurance (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Diagnostic tests and procedures
    • In-Network: 20% coinsurance (Authorization Required)
    • Out-of-Network: 40% coinsurance (Authorization Required)

Doctor visits

  • Primary
    • In-Network: $0 copay
    • Out-of-Network: $40 copay per visit
  • Specialist
    • In-Network: $50 copay per visit
    • Out-of-Network: $60 copay per visit

Emergency care/Urgent care

  • Urgent care
    • $50 copay per visit (always covered)
  • Emergency
    • $100 copay per visit (always covered)

Foot care (podiatry services)

  • Routine foot care
    • Not covered
  • Foot exams and treatment
    • In-Network: $50 copay
    • Out-of-Network: 40% coinsurance

Ground ambulance

    • In-Network: $250 copay
    • Out-of-Network: $250 copay

Health plan deductible

    • $0

Hearing

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

Inpatient hospital coverage

    • In-Network: $370 per day for days 1 through 6
      $50 per day for days 7 through 60
      $0 per day for days 61 through 90 (Authorization Required)
    • Out-of-Network: $400 per day for days 1 through 14
      $0 per day for days 15 through 90 (Authorization Required)

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

    • $10,000 In and Out-of-network
      $6,700 In-network

Medical equipment/supplies

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

Medicare Part B drugs

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

Mental health services

  • Outpatient group therapy visit
    • In-Network: $40 copay
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $40 copay
    • Out-of-Network: 40% coinsurance
  • Inpatient hospital – psychiatric
    • In-Network: $320 per day for days 1 through 6
      $0 per day for days 7 through 90 (Authorization Required)
  • Outpatient individual therapy visit
    • In-Network: $40 copay
  • Inpatient hospital – psychiatric
    • Out-of-Network: $400 per day for days 1 through 14
      $0 per day for days 15 through 90 (Authorization Required)
  • Outpatient group therapy visit
    • Out-of-Network: 40% coinsurance
  • Outpatient individual therapy visit
    • Out-of-Network: 40% coinsurance
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: $40 copay
    • 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

  • Physical therapy and speech and language therapy visit
    • In-Network: $35 copay (Authorization Required)
  • Occupational therapy visit
    • In-Network: $35 copay (Authorization Required)
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • Out-of-Network: 40% coinsurance (Authorization Required)

Skilled Nursing Facility

    • In-Network: $0 per day for days 1 through 20
      $200 per day for days 21 through 60
      $0 per day for days 61 through 100 (Authorization Required)
    • Out-of-Network: $200 per day for days 1 through 50
      $0 per day for days 51 through 100 (Authorization Required)

Transportation

    • Not covered

Vision

  • Eyeglasses (frames and lenses)
    • In-Network: $0 copay (Limits Apply)
  • Other
    • Not covered
  • Routine eye exam
    • Out-of-Network: 40% coinsurance (Limits Apply)
  • Eyeglass frames
    • Not covered
  • Eyeglass lenses
    • Not covered
  • Eyeglasses (frames and lenses)
    • Out-of-Network: $0 copay (Limits Apply)
  • Contact lenses
    • In-Network: $0 copay (Limits Apply)
    • Out-of-Network: $0 copay (Limits Apply)
  • Routine eye exam
    • In-Network: $10 copay (Limits Apply)
  • Upgrades
    • Not covered

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

    • Covered (Authorization Required)

Ready to sign up for HMSA Akamai Advantage Standard (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

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All plan-related information on this site is from CMS.gov and Medicare.gov. We only use data released publicly each year. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Contact a plan for a Summary of Benefits.

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