Dual Care Plan for 2024

Get more benefits with HMSA Akamai Advantage® Dual Care (PPO SNP).

A Medicare plan that works with Medicaid (QUEST Integration).

HMSA can help you live your best life.

  • $0 copayment for eligible prescription drugs.
  • $300 annually toward eyeglasses and contact lenses. IMPROVED
  • Silver&Fit® fitness center membership and home fitness program.
  • $270 allowance every quarter for over-the-counter health and wellness products. IMPROVED
  • Friendly, local customer service.
  • Care you need from providers you choose.
  • Convenience of telehealth, including HMSA’s Online Care®, at no cost.
  • Support from health coordinators.
  • Benefits that go beyond Original Medicare.

HMSA is here with you.

 wcagcolheaderHMSA Akamai Advantage Dual Care (PPO 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
In-network out-of-pocket maximum
(The most you pay each year for Medicare-covered services from in-network providers.)
$8,850
2024 Star Rating4 out of 5 stars

4 out of 5 Star Rating (H3832 [PDF]).

Provider directory
Medical Benefits**
 You Pay
Annual deductible$0
Inpatient hospital care*$0 up to 90 days
Skilled nursing facility*$0 up to 100 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$0/1 exam per calendar year
Contact lenses and eyeglasses (frames and lenses)$0
Plan pays up to $300 every calendar year.
Other Supplemental Benefits
Over-the-Counter (OTC) Health Products
Over-the-counter health and wellness products available at select retail stores or through mail order delivery online at HMSAExtraBenefits.com or by calling 1-800-790-6019.

For more information, visit zurisjewels.com/ExtraBenefits.
$0
Plan pays $270 per quarter
Over-the-Counter (OTC) Health Products CatalogOver-the-Counter (OTC) Health Products Catalog [PDF]
Fitness — Silver&Fit Healthy Aging and Exercise Program
A membership to a participating fitness center, one home fitness kit per year, Healthy Aging Coaching sessions and more.
Fitness Center Membership
$0/month for standard fitness center,
$30-$200/month for premium fitness center

Home Fitness Kit
$0
1 Home Fitness Kit per calendar year

Healthy Aging Coaching
$0

Digital Workout Videos
$0
Health education$0
Learn more about our Health Education workshops
Telehealth services
includes HMSA’s Online Care
$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
PharmacyFind 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 BenefitsSummary of Benefits [PDF]
Annual Notice of ChangesAnnual Notice of Changes [PDF]
Evidence of Coverage
Member ResourcesLearn more

This is a short description of the 2024 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.

HMSA Disclaimer

  • This plan information is effective Jan. 1, 2024.
  • Every year, Medicare evaluates plans based on a 5-star rating system.
  • HMSA Akamai Advantage® is a PPO plan with a Medicare contract. Enrollment in HMSA Akamai Advantage depends on contract renewal.
  • Benefit amounts listed are based on using HMSA participating providers.
  • Out-of-network/non-contracted providers are under no obligation to treat HMSA Akamai Advantage members except in emergency situations. To see if we’ll help pay for an out-of-network service, you or your provider can ask us for a pre-service organization determination before you receive the service. Please call Customer Relations or see your Evidence of Coverage for more information, including the share of your costs for out-of-network services.
  • To enroll in this plan, you must be eligible for Medicare and full Medicaid benefits.
  • You must continue to pay your part B premiums unless Medicaid or another third party pays your Part B premium.