Medicare Plans in
Kauai County, HI
15 Medicare Advantage Plans Found in Kauai County. See Plans
Kauai County, HI
Medicare Information
For Kauai County’s Medicare beneficiaries, private plans like Medicare Advantage plans offer an alternative to Original Medicare, and Part D plans (PDP) can work alongside your Original Medicare benefits.
Currently, 15 private Medicare plans are available in Kauai County, and coverage is provided through Medicare-approved private companies, following rules set by Medicare.
MA plans, which are also referred to as Medicare Part C, may offer additional benefits that aren't available through Original Medicare.
Part D plans, also referred to as PDPs, cover retail prescription drugs.
Some Medicare Part C plans include coverage for prescription medications. Known as Medicare Advantage Prescription Drug plans, or MAPDs, these plans offer comprehensive coverage for seniors who want to minimize their out-of-pocket costs.
Learn more about some of the Medicare plans in Kauai County, Hawaii, including average costs, out-of-pocket expenses and what’s involved in obtaining prescription drug coverage.
The following is HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files as well as carrier-provided plan data supplied by SunFire Inc.
Average Cost of Medicare
Plans in Kauai County
| Average Cost of Medicare Advantage Plans in Kauai County, Hawaii | |
|---|---|
| Average Monthly Premium | $27.36 |
| Average in-network out-of-pocket spending limit | $7,146.67 |
| Average drug deductible in 2024 (weighted) | $281.00 |
| Percentage of plans rated 4 stars or higher | 53.3% |
| Average Cost of Medicare Advantage Plans in Kauai County, Hawaii |
|---|
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Average Monthly Premium $27.36 |
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Average in-network out-of-pocket spending limit $7,146.67 |
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Average drug deductible in 2021 (weighted) $281.00 |
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Percentage of plans rated 4 stars or higher 53.3% |
Learn More About Medicare
Prescription Drug Plans
| Plan Type | Description |
|---|---|
| HMO | HMO enrollees typically receive services through in-network providers and must obtain referrals for visits to specialists. However, most plans permit out-of-network care in emergencies or out-of-area dialysis. HMO plans often include prescription drug coverage. |
| PPO | Members of PPO plans can typically go in or out of network for care, including hospitalization, although visits to non-network providers may cost considerably more. Referrals are usually not needed for visits to specialists, and many PPO plans include prescription drug coverage. |
| PFFS | Private fee-for-service plans determine how much a doctor or facility will be paid for services, and members may seek care from any in or out-of-network provider that agrees to the plan's terms. Some PFFS plans include prescription drug coverage. Otherwise, members may seek coverage for medications through standalone Medicare drug plans, which are also known as Part D plans. |
| SNP | Special Needs Plans are designed for individuals with specific conditions or medical characteristics. Benefits such as providers and drug formularies are tailored to members' unique needs, and most care is provided by in-network physicians and facilities. SNPs are required to provide prescription drug coverage. |
| Plan Type and Description |
|---|
|
HMO enrollees typically receive services through in-network providers and must obtain referrals for visits to specialists. However, most plans permit out-of-network care in emergencies or out-of-area dialysis. HMO plans often include prescription drug coverage.
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Members of PPO plans can typically go in or out of network for care, including hospitalization, although visits to non-network providers may cost considerably more. Referrals are usually not needed for visits to specialists, and many PPO plans include prescription drug coverage.
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Private fee-for-service plans determine how much a doctor or facility will be paid for services, and members may seek care from any in or out-of-network provider that agrees to the plan's terms. Some PFFS plans include prescription drug coverage. Otherwise, members may seek coverage for medications through standalone Medicare drug plans, which are also known as Part D plans.
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Special Needs Plans are designed for individuals with specific conditions or medical characteristics. Benefits such as providers and drug formularies are tailored to members' unique needs, and most care is provided by in-network physicians and facilities. SNPs are required to provide prescription drug coverage.
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Some beneficiaries may be eligible for standalone prescription drug plans. Otherwise known as a PDP or Part D plan, a standalone prescription drug plan adds coverage for prescription medications to Original Medicare and some PFFS plans. It’s important to note that some MA plans, such as HMOs, may disenroll members who sign up for a separate drug plan.
Medicare Advantage Plans
Devoted Health
Devoted Health Medicare Plans in Kauai County, HI
The following table includes cost information and other plan details for Devoted Health private Medicare plans available in Hawaii in 2024.
| Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
|---|---|---|---|---|---|---|
| Devoted CHOICE Hawaii (PPO) | H2686: 001 | $0 | $200 | $6,700 | Yes | Plan too new to be measured |
| Devoted CHOICE GIVEBACK Hawaii (PPO) | H2686: 003 | $0 | $545 | $8,300 | Yes | Plan too new to be measured |
| Devoted CHOICE PLUS Hawaii (PPO) | H2686: 002 | $6 | $200 | $5,500 | Yes | Plan too new to be measured |
Humana Inc. Medicare Plans in Kauai County, HI
The following table includes cost information and other plan details for Humana Inc. private Medicare plans available in Hawaii in 2024.
| Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
|---|---|---|---|---|---|---|
| HumanaChoice H5216-233 (PPO) | H5216: 233 | $0 | $0 | $5,900 | Yes | 4.5 out of 5 |
| Humana USAA Honor (PPO) | H5216: 234 | $0 | N/A | $7,550 | No | 4.5 out of 5 |
| Humana Gold Plus H0028-048 (HMO) | H0028: 048 | $0 | $0 | $5,850 | Yes | 4 out of 5 |
| HumanaChoice H5216-313 (PPO) | H5216: 313 | $23 | $160 | $5,400 | Yes | 4.5 out of 5 |
| HumanaChoice H5216-232 (PPO) | H5216: 232 | $58 | $0 | $5,350 | Yes | 4.5 out of 5 |
UnitedHealthcare Medicare Plans in Kauai County, HI
The following table includes cost information and other plan details for UnitedHealthcare private Medicare plans available in Hawaii in 2024.
| Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
|---|---|---|---|---|---|---|
| AARP Medicare Advantage Patriot No Rx HI-MA01 (PPO) | H2406: 041 | $0 | N/A | $6,700 | No | 4 out of 5 |
| UHC Dual Complete HI-S001 (PPO D-SNP) | H2406: 051 | $0 | $0 | $8,850 | Yes | 4 out of 5 |
| AARP Medicare Advantage from UHC HI-0003 (PPO) | H2406: 059 | $17 | $0 | $5,700 | Yes | 4 out of 5 |
Wellcare Health Plans, Inc. Medicare Plans in Kauai County, HI
The following table includes cost information and other plan details for Wellcare Health Plans, Inc. private Medicare plans available in Hawaii in 2024.
| Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
|---|---|---|---|---|---|---|
| Wellcare 'Ohana Patriot Open (PPO) | H6605: 002 | $0 | N/A | $8,850 | No | 2 out of 5 |
| Wellcare 'Ohana Dual Align (HMO D-SNP) | H2491: 004 | $0 | $0 | $8,850 | Yes | 3 out of 5 |
| Wellcare 'Ohana Dual Liberty (HMO D-SNP) | H2491: 026 | $0 | $0 | $8,850 | Yes | 3 out of 5 |
| Wellcare 'Ohana Low Premium Open (PPO) | H6605: 004 | $33 | $300 | $8,850 | Yes | 2 out of 5 |
