Medical & Dental Coverage
AlohaCare Advantage Plus (HMO SNP) is a plan that is specifically designed to meet the special needs of individuals who are currently enrolled in Medicare and have full benefit Medicaid coverage. Some of your benefits include:
Doctor Visits
- Hospital Stays
- Vision Coverage
- Hearing Coverage
- Preventive Services
- Preventative Dental Services
- Tests, X-rays & Lab Services
- 24-hour Nurse Advice Line
- Member Service Navigators for personal care coordination
- Prepaid Flex Debit Card
Limitations, copayments and restrictions may apply. For a complete listing of benefits, see your
Summary of Benefits.
Acupuncture and Chiropractic services for AlohaCare Advantage Plus (HMO SNP) members are administered through American Specialty Health, Inc. (ASH)
- Chiropractic visits are only covered for spine subluxation correction
- $0 copay for each Acupuncture visit for chronic low back pain
- Covered services include: Up to 12 visits in 90 days are covered for Medicare beneficiaries under the following circumstances:
- For the purpose of this benefit, chronic low back pain is defined as:
- Lasting 12 weeks or longer;
- Nonspecific, in that it has no identifiable systemic cause (i.e. not associated with metastatic, inflammatory, infectious disease, etc.);
- Not associated with surgery; and
- Not associated with pregnancy.
- An additional eight (8) sessions will be covered for those patients demonstrating an improvement.
- No more than 20 acupuncture treatments may be administered annually.
- Treatment must be discontinued if the patient is not improving or is regressing.
ASH Customer Service: 800.678.9133
Monday - Friday, 3:00 a.m. to 6:00 p.m. & Saturday, 10:00 a.m. to 6:00 p.m. Hawaii Standard Time
Dental services for AlohaCare Advantage Plus (HMO SNP) plan members are administered through Hawaii Dental Service (HDS).
By clicking the links, you will be leaving the AlohaCare website.
The popular OTC debit card for AlohaCare’s Advantage Plus members got a major upgrade this year. You can now use your monthly $70 flex card to buy healthy food and over-the-counter health products and help pay for utilities. Please be sure to review how to use your card so you can make the most of it.
- Each month, you get $70 added to your flex card. Use all of it each month. Leftover amounts will not rollover to the next month and it can’t be cashed out.
- Use the card at participating retailers. Retailers include: Walmart, Longs/CVS, Safeway, Walgreens, and Moloka’i Drugs.
- Only the balance available on your card can be used for purchases. Purchases that exceed your balance will not be paid through your card. You can check your balance using your online account or you can call us.
- Setup your online account using the desktop version of the website found at https://alohacare.lh1ondemand.com/ ↗. Through your account, you can access:
- The complete list of retailers that will accept your flex card.
- A list of eligible items covered by your flex card.
- Your card balance.
- You can also call 1-833-654-3080 to get your account balance, recent activity or to activate your card.
As usual, we’re always here if you have questions or need support. Call 808-973-6395, toll-free 1-866-973-6395, or TTY/TDD 1-877-447-5990. Hours available are October 1 to March 31, 8 a.m. to 8 p.m., 7 days a week and April 1 to September 30, 8 a.m. to 8 p.m., Monday through Friday.
Important Update – Need help paying rent?
Use Your AlohaCare Medicare Over-The-Counter Card.
Use the $70 monthly credit on your AlohaCare Prepaid Flex Debit Card to pay part of your rent. AlohaCare Medicare members who live in approved rural zip code locations are eligible.
For help verifying your eligibility, call AlohaCare for free:
Toll-free at 1-888-875-4979
1-808-973-2475
TTY 1-877-447-5990
7:45 a.m. to 8 p.m. Hawaiʻi time (October 1 to March 31, 7 days a week)
7:45 a.m. to 8 p.m. Hawaiʻi time (April 1 to September 30, Monday through Friday)
Need an interpreter? Our Member Services team will provide free language interpreter services for non-English speakers.
In 2026, AlohaCare Advantage and Advantage Plus Members will experience changes to their Prepaid Flex Debit Card benefit. It will become the Prepaid Care Card. Members can use their Prepaid Care Card to buy over-the-counter health products.
The following benefits will be available starting 1/1/2026:
- Each month, you will have funds added to your Prepaid Care Card. Use all of it each month. Leftover amounts will be rolled over for 1 month only and the funds can’t be cashed out.
- AlohaCare Advantage Plus members will receive $100 every month.
- AlohaCare Advantage members will receive $75 every month.
- Use the Prepaid Care Card at participating retailers. Current retailers include Walmart, Longs/CVS, Safeway, and Walgreens.
- Here is a link to the NationsBenefits website to find eligible products, available 1/1/2026. AlohaCare.NationsBenefits.com
- We want everyone to be able to use their funds. If you have a store where you want to spend your funds, please call us toll free 1 877-647-0879 . We will reach out to the store to see if they want to join our network. We are always looking for new stores to add, so let us know if you have a favorite!
- Only the balance available on your card can be used for purchases. Purchases that exceed your balance will not be paid through your card. You can check your balance using your online account or you can call us.
- If your total purchase amount is more than the available balance on your card, you can use another card to complete the purchase.
- Login to your online account available 1/1/2026 to use the desktop version of the website found at AlohaCare.NationsBenefits.com. Through your account, you can easily:
- Access online ordering
- Activate and manage card
- Check eligibility for products and services
- View available balance and transaction history
- Update personal account informaiton
- Find participating retailers.
- You can also call toll-free 1 877-647-0879 (TTY: 711) to check your account balance, get help using your benefit and more.
For help verifying your eligibility, call AlohaCare for free:
Toll-free at 1-888-875-4979
1-808-973-2475
TTY 1-877-447-5990
7:45 a.m. to 8 p.m. Hawaiʻi time (October 1 to March 31, 7 days a week)
7:45 a.m. to 8 p.m. Hawaiʻi time (April 1 to September 30, Monday through Friday)
Need an interpreter? Our Member Services team will provide free language interpreter services for non-English speakers.
AlohaCare Advantage Plus has a limited annual benefit that covers emergency services you may need while traveling outside of the U.S.
The purpose of this program is to ensure the continuous evaluation and improvement of processes associated with the quality of mental health and addictions care received by our members. It also includes the retrospective monitoring and problem solving associated with the care and service delivered. The program explanation, annual evaluation and Utilization Management decision-making criteria are available to all members and contracted providers.
Asking for coverage decisions prior to receiving benefits
A coverage decision is a decision we make about your benefits and coverage or about the amount we will pay for your medical care. For example, if your plan network doctor refers you to a medical specialist not inside the network, this referral is considered a favorable coverage decision unless either your network doctor can show that you received a standard denial notice for this medical specialist, or the Evidence of Coverage makes it clear that the referred service is never covered under any condition. You or your doctor can also contact us and ask for a coverage decision if your doctor is unsure whether we will cover a particular medical service or refuses to provide medical care you think that you need. In other words, if you want to know if we will cover a medical care before you receive it, you can ask us to make a coverage decision for you. In limited circumstances a request for a coverage decision will be dismissed, which means we won’t review the request. Examples of when a request will be dismissed include if the request is incomplete, if someone makes the request on your behalf but isn’t legally authorized to do so or if you ask for your request to be withdrawn. If we dismiss a request for a coverage decision, we will send a notice explaining why the request was dismissed and how to ask for a review of the dismissal. We are making a coverage decision for you whenever we decide what is covered for you and how much we pay. In some cases, we might decide the medical care is not covered or is no longer covered by Medicare for you. If you disagree with this coverage decision, you can make an appeal (refer to appeals tab).
How to ask for a coverage decision
You may refer to Section 6.2 in your Evidence of Coverage (EOC) for a Step-by-step guide on how to request a coverage decision. (Please double check EOC that this section reference will still be accurate for 2026)
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