Being A Member

Important information about being an AlohaCare Advantage (HMO D-SNP) or AlohaCare Advantage Plus (HMO D-SNP) member.

AlohaCare Advantage Plans Costs

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.

Service Area

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.

Enrollment Form

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 (Medicaid) 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 (Medicaid) 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.

Rights & Responsibilities

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

Protected Health Information (PHI)

AlohaCare keeps all of your personal information private. You can request to release your protected health information to another person that you designate.

Protected Health Information (PHI) Authorization Form

Rights Upon Disenrollment

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.

Resources

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.

Additional Information

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 (including limited English proficiency and primary language), age, disability, or sex. AlohaCare does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Language Assistance:

ENGLISH

ATTENTION: If you speak English, free language assistance services are available to you. Appropriate auxiliary aids and services to provide information in accessible formats are also available free of charge. Call 1-808-973-6395 (TTY: 1-877-447-5990) or speak to your provider.”

中文 (Cantonese)

注意：如果您说[中文]，我们将免费为您提供语言协助服务。我们还免费提供适当的辅助工具和服务，以无障碍格式提供信息。致电 1-808-973-6395（文本电话：1-877-447-5990）或咨询您的服务提供商。”

ILOCANO

PANANGIKASO: No agsasaoka iti Ilocano, magun-odmo dagiti libre a serbisio ti tulong iti pagsasao. Libre met laeng a magun-odan dagiti maitutop a katulongan ken serbisio a mangipaay iti impormasion kadagiti ma-akses a pormat. Awagan ti 808-973-6395 (TTY: 1-877-447-5990) wenno makisarita iti mangipapaay kenka.”

한국어 (Korean)

주의: [한국어]를 사용하시는 경우 무료 언어 지원 서비스를 이용하실 수 있습니다. 이용 가능한 형식으로 정보를 제공하는 적절한 보조 기구 및 서비스도 무료로 제공됩니다. 1-808-973-6395 (TTY: 1-877-447-5990)번으로 전화하거나 서비스 제공업체에 문의하십시오."

Tagalog

PAALALA: Kung nagsasalita ka ng Tagalog, magagamit mo ang mga libreng serbisyong tulong sa wika. Magagamit din nang libre ang mga naaangkop na auxiliary na tulong at serbisyo upang magbigay ng impormasyon sa mga naa-access na format. Tumawag sa 1-808-973-6395 (TTY: 1-877-447-5990) o makipag-usap sa iyong provider.”

Việt (Vietnamese)

LƯU Ý: Nếu bạn nói tiếng Việt, chúng tôi cung cấp miễn phí các dịch vụ hỗ trợ ngôn ngữ. Các hỗ trợ dịch vụ phù hợp để cung cấp thông tin theo các định dạng dễ tiếp cận cũng được cung cấp miễn phí. Vui lòng gọi theo số 1-808-973-6395 (Người khuyết tật: 1-877-447-5990) hoặc trao đổi với người cung cấp dịch vụ của bạn.”

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