Being A Member
Important information about being an AlohaCare Advantage (HMO D-SNP) or AlohaCare Advantage Plus (HMO D-SNP) member.
AlohaCare Advantage (HMO D-SNP) and AlohaCare Advantage Plus (HMO-DSNP) are plans that are specifically designed to meet the special needs of individuals who are currently enrolled in Medicare and have full benefit Medicaid coverage.
- Monthly Premium – You pay nothing.
- Deductible – This plan does not have a deductible.
- Cost Sharing – You will have no cost sharing responsibility for Medicare-covered Part A and B services, based on your level of Medicaid eligibility. You will be responsible for your Part D copayments.
Our plans are available to Medicare beneficiaries who live in our service area. Our service area includes the counties of: O`ahu, Maui, Hawai`i, Kaua`i, and Kalawao.
To enroll into AlohaCare Advantage Plus (HMO D-SNP):
- You must be a resident of Hawai`i
- You have full benefit Medicaid coverage and are enrolled in AlohaCare's QUEST Integration health plan
- You must have Medicare Parts A and B
- You must continue to pay for your Medicare Part B premium. The State pays the Part B premium for full-dual members who are eligible for AlohaCare Advantage Plus (HMO SNP).
To enroll into AlohaCare Advantage (HMO D-SNP):
- You must be a resident of Hawai`i
- You have full benefit Medicaid coverage and are enrolled in a different QUEST Integration health plan
- You must have Medicare Parts A and B
- You must continue to pay for your Medicare Part B premium. The State pays the Part B premium for full-dual members who are eligible for AlohaCare Advantage Plus (HMO SNP).
You may enroll online or by printing the enrollment form and mailing it to:
AlohaCare
ATTN: Enrollment
1357 Kapiolani Blvd., Suite G101
Honolulu, HI 96814
For more information, call 808-973-6395 or toll-free at 1-866-973-6395. TTY/TDD users call 1-877-447-5990. Medicare beneficiaries may also enroll in AlohaCare Advantage Plus through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov . By clicking on the link, you will be leaving the AlohaCare website.
It is important that you know your rights and responsibilities as a member of AlohaCare Advantage and AlohaCare Advantage Plus.
Your rights as a member of the plan
- We must provide information in a way that works for you (in languages other than English, in Braille, in large print, or other alternate formats, etc.)
- We must treat you with fairness and respect at all times
- We must ensure that you get timely access to your covered services and drugs
- We must protect the privacy of your personal health information
- We must give you information about the plan, its network of providers, and your covered services
- We must support your right to make decisions about your care
- You have the right to make complaints and to ask us to reconsider decisions we have made
Your responsibilities as a member of the plan
- Get familiar with your covered services and the rules you must follow to get these covered services.
- If you have any other health insurance coverage or prescription drug coverage in addition to our plan, you are required to tell us.
- Tell your doctor and other health care providers that you are enrolled in our plan.
- Help your doctors and other providers help you by giving them information, asking questions, and following through on your care.
- Be considerate.
- Pay what you owe.
- Tell us if you move.
- Call Customer Service for help if you have questions or concerns
AlohaCare keeps all of your personal information private. You can request to release your protected health information to another person that you designate.
Ending your membership with AlohaCare Advantage or AlohaCare Advantage Plus may be voluntary (your own choice) or involuntary (not your own choice). You might leave our plan because you have decided that you want to leave. There are also limited situations where we are required to end your membership. For example, if you move permanently out of the geographic service area we cover. We cannot ask you to leave our plan because of your health.
If you leave our plan, it may take some time for your membership to end. While you are waiting for your membership to end, you are still a member and must continue to get your care and/or prescription drugs as usual through our plan.
You have the right to make a complaint if we end your membership in our plan. If we end your membership in our plan we will tell you our reasons in writing and explain how you may file a complaint against us if you want to. Visit our Grievance and Appeals section on how to submit a complaint.
For more information on your rights and responsibilities upon disenrollment, contact us at 973-6395 or toll-free at 1-866-973-6395. TTY/TDD users call 1-877-447-5990.
Below is a list of resources that you may find helpful. By clicking on any of the links, you will be leaving the AlohaCare website.
AlohaCare Advantage (HMO D-SNP) and AlohaCare Advantage Plus (HMO D-SNP) are HMOs with a Medicare contract and a contract with the Hawai`i Medicaid program. Enrollment in AlohaCare Advantage (HMO D-SNP) or AlohaCare Advantage Plus (HMO D-SNP) depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B Premium. The State pays the Part B premium for full-dual members who are eligible for AlohaCare Advantage (HMO D-SNP) and AlohaCare Advantage Plus (HMO D-SNP). This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help that you receive. Please contact the plan for further details.
Nondiscrimination
AlohaCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
PAKDAAR: Nu saritaem ti Ilocano, ti serbisyo para ti baddang ti lengguahe nga awanan bayadna, ket sidadaan para kenyam. Awagan ti 1-808-973-6395 (TTY: 1-877-447-5990).
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-808-973-6395 (TTY: 1-877-447-5990).
H5969_WEB40062301