Get more benefits with HMSA Akamai Advantage® Dual Care (PPO D-SNP).
A Medicare plan that works with HMSA QUEST (Medicaid).
With HMSA Akamai Advantage® Dual Care (PPO D-SNP), you’ll have one health plan to coordinate your Medicare and Medicaid benefits at no cost.
- $133 a month for over-the-counter health products, food and utilities.
- $0 dental cleanings, exams, X-rays, fillings, and more with no calendar year maximum or waiting period.
- $300 annually toward eyeglasses and contact lenses.
- Silver&Fit® fitness center membership and home fitness program.
- $0 copayment for eligible prescription drugs.
- Care you need from providers you choose.
- Benefits that go beyond Original Medicare.
With this plan, you’ll also have one HMSA membership card for Medicare and Medicaid. And you’ll get a health coordinator who can help you with your health care.
| wcagcolheader | HMSA Akamai Advantage Dual Care (PPO D-SNP) |
|---|---|
| Monthly premium The amount you pay each month. You must continue to pay your Part B premium if Medicaid or another source doesn’t already pay for it. |
$0 |
| Part B premium reduction The amount the plan will pay towards your Part B monthly premium. |
$3/month |
| In-network out-of-pocket maximum The most you pay each year for Medicare-covered services from in-network providers. |
$9,350 |
| 2025 Star Rating | 
3.5 out of 5 Star Rating (H3832). |
|
Provider directory |
|
| Medical Benefits** | |
| You Pay | |
| Annual deductible | $0 |
| Inpatient hospital care* | $0 up to 90 days |
| Skilled nursing facility* | $0 up to 180 days |
| Primary care provider office visit | $0 |
| Specialty care provider office visit | $0 |
| Annual wellness visit | $0 |
| Outpatient hospital facility and ambulatory surgical center services* | $0 |
| Ambulance service, includes ground and air | $0 |
| Emergency care | $0 |
| Urgent care | $0 |
| Diagnostic tests and procedures, lab services, and outpatient X-rays* | $0 |
| Medicare Part B drugs* | $0 |
| Medicare Part B insulin drugs* | $0 |
| Medical equipment and supplies* | $0 |
| Supplemental Vision Benefits | |
| You Pay | |
| Routine eye exam (once a calendar year) | $0 |
| Contact lenses and eyeglasses (frames and lenses) | $0 Plan pays up to $300 every calendar year. |
| Supplemental Dental Benefits | |
Diagnostic and preventive dental services:
|
$0 |
Comprehensive dental services:
|
$0 |
| Dental Provider Directory | Dental Provider Directory English [PDF] | Chinese [PDF] | Ilocano [PDF] | Korean [PDF] | Vietnamese [PDF] |
| Other Supplemental Benefits | |
| Over-the-counter (OTC) Health Products, Food, and Home Utilities Allowance You’ll receive an HMSA Extra Benefits debit card with an allowance for over-the-counter health products, healthy foods, and home utilities. You can purchase covered products at select retail stores or through mail order delivery at HMSAExtraBenefits.com or by calling 1-800-790-6019. For more information, visit hmsa.com/ExtraBenefitsDSNP. |
$0 Plan pays $133 a month |
| Over-the-counter (OTC) and Healthy Foods Product Catalog | Over-the-counter (OTC) and Healthy Foods Product Catalog [PDF] |
| Fitness — Silver&Fit Healthy Aging and Exercise Program A membership to a participating fitness center, one home fitness kit per year, Well-Being Coaching and more. |
Fitness Center Membership $0/month for standard fitness center, $30-$250/month for premium fitness center Home Fitness Kit $0 1 Home Fitness Kit per calendar year Well-Being Coaching $0 Digital Workout Videos $0 |
| Telehealth services Includes HMSA’s Online Care |
$0 |
| Health education Learn more about our Health Education workshops |
$0 |
| Drug Benefits | |
| You Pay | |
| Annual deductible | $0 |
| 30-day supply from retail pharmacy | |
| All drugs | $0 |
| 100-day supply from mail-order pharmacy | |
| All drugs | $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 English [PDF] | Chinese [PDF] | Ilocano [PDF] | Korean [PDF] | Vietnamese [PDF] |
| Annual Notice of Changes | Annual Notice of Changes English [PDF] | Chinese [PDF] | Ilocano [PDF] | Korean [PDF] | Vietnamese [PDF] |
| Evidence of Coverage |
|
| Member Resources | Learn more |
This is a short description of the 2025 plan benefits and amount you’d pay. There may be some exceptions, so check your Summary of Benefits or Evidence of Coverage for plan details. Costs may be different, depending on how much you receive in Extra Help for prescription drugs. Please contact us if you have questions.
* For some services, your doctor or other network provider may request prior authorization. Please contact us for more information.
** Because you get Medicaid assistance, you pay nothing for your premium or covered services as long as you follow the plans’ rules for getting care.