Compare Medicare Advantage Plans in Kauai County, HI
There are 13 Medicare Advantage plans available in Kauai County, Hawaii for 2023. See Plans
Kauai County MA Plans By The Numbers
- 4 to 5-Star Plan Availability: 54%
- Average premium: $18.40/month
- Average out-of-pocket limit: $5,923/year
- Average Part D deductible: $145.63/year
- Plan types available: PPO, HMO, MSA, and SNP
- New or Unrated Plans: 4
4 and 5-Star Medicare Advantage Plans available in Kauai County, HI
Here are the top-rated Medicare Advantage plans in Kauai County.
| CMS Star Rating | Plan Name | Monthly Premium |
Part D Deductible | Out of Pocket Max |
|---|---|---|---|---|
4.5 out of 5 |
Humana Honor (PPO H5216-234) | $0 | N/A | $7,550 |
4.5 out of 5 |
HumanaChoice H5216-232 (PPO H5216-232) | $49 | $0 | $5,350 |
4.5 out of 5 |
HumanaChoice H5216-233 (PPO H5216-233) | $0 | $100 | $5,900 |
4.5 out of 5 |
HumanaChoice H5216-313 (PPO H5216-313) | $24 | $160 | $5,400 |
4.0 out of 5 |
AARP Medicare Advantage Choice (PPO H2228-068) | $28 | $0 | $5,700 |
4.0 out of 5 |
AARP Medicare Advantage Patriot (PPO H2228-025) | $0 | N/A | $6,700 |
4.0 out of 5 |
Humana Gold Plus H0028-048 (HMO H0028-048) | $0 | $0 | $5,850 |
3.5-Star and Below Medicare Advantage Plans available in Kauai County, HI
These are the Medicare Advantage plans in Kauai County rated 3.5 stars or lower by Medicare.
| Plan Name | Monthly Premium |
Part D Deductible | Out of Pocket Max | CMS Star Rating |
|---|---|---|---|---|
3.5 out of 5 |
HMSA Akamai Advantage Standard (PPO H3832-007) | $0 | $400 | $6,700 |
3.5 out of 5 |
HMSA Akamai Advantage Standard Plus (PPO H3832-008) | $124 | $0 | $3,450 |
0.0 out of 5 |
Lasso Healthcare Growth (MSA H1924-001) | $0 | N/A | * |
0.0 out of 5 |
Lasso Healthcare Growth Plus (MSA H1924-004) | $0 | N/A | * |
0.0 out of 5 |
Wellcare 'Ohana Assist Open (PPO H6605-003) | $14 | $505 | $5,000 |
0.0 out of 5 |
Wellcare 'Ohana Patriot Giveback Open (PPO H6605-002) | $0 | N/A | $7,550 |
NOTE: Plans with a 0.0 rating are new and have not yet been rated by Medicare.
Kauai County, HI
Medicare Advantage Information
Medicare Advantage (MA) plans are a private insurance option for those who have Original Medicare. Kauai County has plan_count} MA plans available for 2023 (except Special Needs Plans). Medicare-approved companies must follow the Medicare rules to be eligible for coverage. MA plans (also known as Medicare Part C) may offer additional benefits that are not offered by Original Medicare.
Some Medicare Advantage plans offer prescription medication coverage (i.e. a Part D plan). These plans are also known as Medicare Advantage Prescription Drug Plans or MAPDs and offer comprehensive coverage to people who wish to lower their healthcare costs.
Medicare Advantage Plan Types
The Medicare Advantage program allows 7 types of private insurance plans. However, all plans are not available in every area. Beneficiaries in Kauai County can choose between 3 of the 7 available plans.
| Plan Type | Description |
|---|---|
| HMO | Health Maintenance Organization (HMO) members usually receive services through the plan’s local network of providers. Referrals are typically required to see a specialist and other providers. However, plans allow out-of-network care for emergencies and out-of-area dialysis. Prescription drug coverage is often included in HMO plans, and many plans include some coverage for dental, vison, and hearing. |
| PPO | Preferred Provider Organization (PPO) members can usually use in-network and out-of-network providers for care, including hospitalization. However, visits to non-network providers could cost significantly more. PPO plans often include prescription drug coverage and other benefits, and referrals are typically not required for specialist visits. |
| MSA | Medicare Medical Savings Account (MSA) plans are private companies that the Medicare program pays to manage a beneficiary's Medicare benefits. As with all types of Medicare Advantage plans, MSA plans must offer the same basic benefits included in Medicare Part A and Part B. However, benefits may have different rules, restrictions, and costs. Unlike other Medicare Advantage plans, MSAs have a high deductible health plan (HDHP) and a government-funded bank account for paying your medical costs. |
| SNP |
Special Needs Plans (SNPs) are highly specialized and you must be qualified to join. For this reason, All Medicare organizes Medicare Advantage Special Needs plans for Kauai County, Hawaii residents in their own directory. |
Medicare Advantage without Part D
Some beneficiaries may also qualify to join a Medicare Part D plan, also known as a PDP. Hawaii Part D plans can be used with Original Medicare or Medicare Advantage plans that do not include Part D benefits.
Original Medicare and Medigap vs. Medicare Advantage
Medicare Advantage is just one of the options available in Kauai County. Some people believe these plans are too expensive or don't like their restrictions. Original Medicare and a Medicare Supplement policy (aka, Medigap) are the best options for these people.
If you don't know about Medicare Supplements and how they protect you from the high out-of-pocket costs in Original Medicare, take a look at our Medicare Supplement directory. You can compare plans, and costs, and even get a list of carriers in Hawaii. All Medicare Supplements are standardized, so you can easily choose a plan based on coverage and price.
Medicare Advantage Plan Availability
The MA and MAPD plans listed on this page are available to individuals enrolled in both Medicare Part A and Part B who reside in Anahola, Eleele, Hanalei, Hanapepe, Kalaheo, Kapaa, Kekaha, Kilauea, Koloa, Lihue, Princeville, Waimea, and all other areas of Kauai County, Hawaii.
Individuals who are institutionalized, have a severe chronic illness, or have special financial needs are encouraged to look into the 2023 Medicare SNP Plans in Kauai County, Hawaii.
The 2023 Medicare Part C plan information for Kauai County, Hawaii was last updated by the All Medicare team on .