HMSA Akamai Advantage Dual Care (PPO D-SNP) H8481-001 • 2027 • Maui County, HI
- Monthly Premium
- $17.10Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Basic, $700.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Maui County, HI
- Local Enrollment
- 415 beneficiaries in Maui County
Introduction
HMSA Akamai Advantage Dual Care is a Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP) offered by HMSA Akamai Advantage Dual Care. The plan uses a Preferred Provider Organization (PPO) provider network and includes Medicare Part D prescription drug coverage. For the 2027 plan year, it has a $17.10 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. CMS Plan ID H8481-001 identifies this plan. The 2027 Part D prescription drug deductible is $700.00.
This plan is available to eligible residents of Maui County, Hawaii. CMS reports 415 beneficiaries enrolled in this plan in Maui County. For assistance with this plan, new members can call (800)693-4672 (TTY 711).
Eligibility
HMSA Akamai Advantage Dual Care is a Medicare D-SNP plan for dual-eligible beneficiaries (Medicare and Medicaid).
- Special Needs Plan Type
- Dual-Eligible Special Needs Plan (D-SNP)
- Medicare Requirement
- Medicare Part A and Part B
- Special Needs Requirement
- Must qualify for Medicaid
- Service Area Requirement
- Must live in the plan's service area
- Prescription Drug Coverage
- Medicare Part D prescription drug coverage is included.
Compare Similar Plans in Maui County
Compare this plan with the two most-enrolled PPO D-SNP plans available in Maui County, Hawaii. Enrollment is based on CMS local enrollment data.
| Plan Detail | HMSA Akamai Advantage Dual Care | UHC Dual Complete HI-Y1 | UHC Dual Complete HI-YL |
|---|---|---|---|
| CMS Plan ID | H8481-001-0 |
H6824-002-0 |
H6824-003-0 |
| Local Enrollment | 415 | 872 | 0 |
| Monthly Premium | $17.10 | $20.40 | $33.60 |
| Medical Deductible | $0.00 | $0.00 | $0.00 |
| Maximum Out-of-Pocket | $9,850.00 | $9,850.00 | $9,850.00 |
| Part B Giveback | Not offered | Not offered | Not offered |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $0 copay | $0 copay | $0 copay |
| Part D Deductible | $700.00 | $700.00 | $700.00 |
| CMS Star Rating | Not yet rated | Not yet rated | Not yet rated |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | Not covered | Not covered |
| Hearing | Not covered | Not covered | Not covered |
Plan Benefits
HMSA Akamai Advantage Dual Care has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H8481-001.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H8481-001-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
Out-of-network: $0 copay - Specialist
- In-network: $0 copay
Out-of-network: $0 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
Out-of-network: $0 copay - Telehealth benefit
- In-network: $0 copay
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0 copay
Out-of-network: $0 copay - Lab services
- In-network: $0 copay
Out-of-network: $0 copay - Outpatient x-rays
- In-network: $0 copay
Out-of-network: $0 copay - Diagnostic tests and procedures
- In-network: $0 copay
Out-of-network: $0 copay
Emergency and Urgent Care Services
- Emergency room care
- $0 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $0 copay
- Inpatient hospital care
- In-network:
Tier 1
$0 per day for days 1-60
$0 per day for days 61-90
$0 per day for days 91-150
Out-of-network:
$0 per day for days 1-60
$0 per day for days 61-90
$0 per day for days 91-150 - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$0 per day for days 21-100
Out-of-network: - Ground ambulance
- In-network: $0 copay
Out-of-network: $0 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $0 copay
Out-of-network: $0 copay - Outpatient group therapy
- In-network: $0 copay
Out-of-network: $0 copay - Inpatient psychiatric hospital care
- In-network:
Tier 1
$0 per day for days 1-60
$0 per day for days 61-90
$0 per day for days 91-150
Out-of-network:
$0 per day for days 1-60
$0 per day for days 61-90
$0 per day for days 91-150
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $0 copay
Out-of-network: $0 copay - Occupational therapy
- In-network: $0 copay
Out-of-network: $0 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
Out-of-network: $0 copay - Durable medical equipment
- In-network: $0 copay
Out-of-network: $0 copay - Prosthetics
- In-network: $0 copay
Out-of-network: $0 copay
Medicare Part B Drugs
- Chemotherapy
- In-network: $0 copay
Out-of-network: $0 copay - Other Part B drugs (Medicare-covered)
- In-network: $0 copay
Out-of-network: $0 copay
Dental Services
- Oral exam
- In-network: $0 copay
Out-of-network: 30% coinsurance - Dental x-rays
- In-network: $0 copay
Out-of-network: 30% coinsurance - Cleaning
- In-network: $0 copay
Out-of-network: 30% coinsurance - Periodontics
- In-network: $0 copay
Out-of-network: 30% coinsurance - Endodontics
- In-network: $0 copay
Out-of-network: 30% coinsurance - Restorative services
- In-network: $0 copay
Out-of-network: 30% coinsurance - Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: $0 copay
Out-of-network: 30% coinsurance
Vision Services
- Routine eye exam
- In-network: $0 copay
Out-of-network: 30% coinsurance - Contact lenses
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Eyeglass frames only
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Eyeglass lenses only
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Eyeglasses (frames & lenses)
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance - Upgrades
- In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Hearing Services
- Hearing exam
- Not covered
- Fitting/evaluation
- Not covered
- Prescription hearing aids
- Not covered
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- In-network: $0 copay
Out-of-network: $0 copay - Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by HMSA Akamai Advantage Dual Care as a Part B benefit.
Prescription Drug Coverage
HMSA Akamai Advantage Dual Care includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $17.10 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $17.10 |
| Low-Income Premium Subsidy: | $33.59 |
| Low-Income Premium Subsidy Paid by CMS: | $17.10 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $700.00 annual Part D deductible. You'll pay this deductible at the pharmacy before HMSA Akamai Advantage Dual Care starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, HMSA Akamai Advantage Dual Care may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Brand-name drugs | 25% coinsurance | Not available |
| Generic drugs | 25% coinsurance | Not available |
| Preferred Generic | Not available | $0.00 copay |
| Generic | Not available | $0.00 copay |
| Preferred Brand | Not available | 25% coinsurance |
| Non-Preferred Drug | Not available | 30% coinsurance |
| Specialty Tier | Not available | 25% coinsurance |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H8481)
CMS star ratings reflect how well a Medicare plan performs across key quality measures, such as managing chronic conditions, member satisfaction, and customer service. Ratings range from 1 to 5 stars and are updated each year by Medicare.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | Plan too new to be measured |
| Managing Chronic (Long Term) Conditions | Plan too new to be measured |
| Member Experience with Health Plan | Plan too new to be measured |
| Complaints and Changes in Plans Performance | Plan too new to be measured |
| Health Plan Customer Service | Plan too new to be measured |
| Drug Plan Customer Service | Plan too new to be measured |
| Complaints and Changes in the Drug Plan | Plan too new to be measured |
| Member Experience with the Drug Plan | Plan too new to be measured |
| Drug Safety and Accuracy of Drug Pricing | Plan too new to be measured |
Contact Information for HMSA Akamai Advantage Dual Care
- Website
- HMSA Akamai Advantage Dual Care Plan Page
- Providers
- HMSA Akamai Advantage Dual Care Providers Page
- Formulary
- HMSA Akamai Advantage Dual Care Formulary Page
- Pharmacy
- HMSA Akamai Advantage Dual Care Pharmacy Page
- New Member Health Plan Help
- (800)693-4672
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (800)693-4672
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | CY2027 Landscape (202609.1) |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2027 Star Ratings Data Tables |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | PBP Benefits-2027 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-09 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| HMSA Akamai Advantage Dual Care (official source) | http://www.hmsa.com/advantage | October 4, 2026 |
| CMS.gov | Dual Eligible Special Needs Plans (D-SNPs) | April 28, 2026 |
| Medicare.gov | Compare types of Medicare Advantage Plans | April 28, 2026 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | April 28, 2026 |
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