Alohacare Advantage and Advantage Plus Review

Alohacare offers Medicare health insurance programs for residence of Hawaii.  Alohacare Advantage and Alohacare Advantage Plus are Medicare Advantage HMO plans available in Hawaii, Honolulu, Kalawao, Kauai, and Maui counties in Hawaii.  Advantage Plus is an HMO-SNP, and is only available to individuals with Medicare and Medicaid benefits.  The coverage does include Part D drug coverage as well as health benefits.  In addition they offer nurses to help you with your healthcare.  Below is a review of the benefits they offer:

Alohacare Advantage

  • Premium – $0
  • Deductible – $0
  • $3,400 out-of-pocket limit
  • Network – Must go to in-network doctors and hospitals to receive benefits
  • Referrals – Required
  • Inpatient hospital – $220/day Days 1-10
  • Doctors Visits – $2 = Primary Care; $20 = Specialist
  • Outpatient Surgery – %25
  • Labs – 0%
  • X-rays and Diagnostic Procedures and tests – 0% – 25%
  • Part D Drug Coverage Included – Tier 1 – $4; Tier 2 – $7; Tier 3 – $40; Tier 4 – $80; Tier 5 – 33%

Alohacare Advantage Plus

  • Premium – $0
  • Deductible – $0
  • $6,700 out-of-pocket limit depending on your level of Medicaid you may have no out-of-pocket costs
  • Network – Must go to in-network doctors and hospitals to receive benefits
  • Referrals – Required
  • Inpatient hospital – $0
  • Doctors Visits – $0
  • Outpatient Surgery – $0
  • Emergency room/Ambulance – $0
  • Part D Drug Coverage Included – You pay between $0 and $6.50 per prescription based on your level of assistance

Extra Benefits Included With Alohacare Advantage

  • Dental – No preventative dental
  • Hearing – Routine hearing exams – $30 co-pay and hearing aids covered up to $500
  • Vision – $25 co-pay for an eye exam up to $100 limit on glasses

Extra Benefits Included With Alohacare Advantage Plus

  • Dental – Routine dental care not covered
  • Hearing – $Routine hearing tests not covered
  • Vision – Routine vision services not covered
  • Acupuncture – $0 co-pay for up to twelve visits

Since these plans are HMO’s you will have to use providers and facilities that are in the plan’s network, and you will not be covered for any services received outside the network.  You want to make sure your providers are in network by visiting their website.   You may also visit for more information regarding this plan.

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