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The 2022 Medicare Advantage Plans in Kauai County HI.
2016 Medicare Advantage Plans in Kauai County Hawaii
There are 4 Medicare Advantage Plans available in Kauai County HI from 3 health insurance providers and 4 Special Needs Plans available. 3 Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3400 and the highest out of pocket is $6700.
The highest rated plan available in Kauai County received a 4 overall star rating from CMS and the lowest rated plan is 4 stars.
(Click the Plan Name for More Details)
|Type||Gap|| Max Out
|Return to Counties In Hawaii|
|Akamai Advantage Standard (PPO)
|$153.00||$360.00||Local PPO||No||$6,700||Browse |
|Akamai Advantage Standard Plus (PPO)
|$196.00||$0.00||Local PPO||Yes||$3,400||Browse |
|Humana Gold Plus H0028-004 (HMO)
|$0.00||$0.00||Local HMO||Yes||$4,900||Browse |
|HumanaChoice H6609-137 (PPO)
|$39.00||$0.00||Local PPO||Yes||$4,900||Browse |
* Plan Type Indicates plan does not offer Medicare Part D drug coverage.
Medicare Special Needs Plans in Kauai county Hawaii
|'Ohana Liberty (HMO SNP)
|Akamai Advantage Dual Care (PPO SNP)
|AlohaCare Advantage Plus (HMO SNP)
|UnitedHealthcare Dual Complete RP (Regional PPO SNP)
Plan Type Is the type of organization offering the Medicare Plans.
- HMO - Health Maintenance Organization
- PPO - Preferred Provider Organization
- PDP - Prescription Drug Plan
- SNP - Special Needs Plan
- POS - Point of Service
- PFFS - Private Fee For Service
Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your plan for details.
Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage plans; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.Benefit Type
(EA) Enhanced Alternative plans may offer additional gap coverage which is calculated as the percentage of “generic” formulary products with coverage above standard "generic" coverage gap cost-sharing benefit and/or the percentage of “brand” formulary products covered in addition to the coverage gap discount for applicable drugs.
In 2016 once you and your plan provider have spent $3310 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") Once you reach the coverage gap you will pay 45% of the plans cost for covered brand-name prescription drugs and 58% on generic drugs unless your plan offers additional coverage.
Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable
Plans as of September 9, 2015.
Plans are subject to change as contracts are finalized.
Includes 2016 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded. For 2016, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.