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Extra Help LIS Premium Summary Chart 2027

Low-Income Subsidy tables for 2027

Monthly premium

Premium Subsidy Complete Complete Plus Select Plus Standard Standard Plus Dual Care
100% $55 $206.40 $11.40 $50 $206.40 $0

HMSA Akamai Advantage (PPO) LIS premium summary

HMSA Akamai Advantage (HMO) LIS premium summary

HMSA Akamai Advantage (PPO D-SNP) LIS premium summary

Out-of-pocket drug costs

Subsidy LevelsDeductibleCopayment*
Level 1$0$5.80/$14.40
Level 2$0$1.65/$5
Level 3$0$0

*Copayment amounts listed: Members will pay the lesser of plan copayment or their respective LIS copayment. When two copayments are listed in the chart, the first copayment corresponds to generic/preferred multi-source drugs and the second copayment corresponds to other drugs.

HMSA Disclaimer

  • HMSA Akamai Advantage® is a PPO plan with a Medicare contract. Enrollment in HMSA Akamai Advantage depends on contract renewal.
  • HMSA Akamai Advantage® Select Plus is an HMO plan with a Medicare contract. Enrollment in HMSA Akamai Advantage Select Plus depends on contract renewal.
  • HMSA Akamai Advantage® Dual Care is a PPO D-SNP plan with a Medicare contract and is a state of Hawaii Medicaid Managed Care Program. Enrollment in HMSA Akamai Advantage Dual Care depends on contract renewal.