Basics of your health plan benefitsSome care requires advance approval from HMSA. When services are provided by participating providers, they take care of precertification for you

2016 PPO Plans

Basics of your health plan benefits

DENTALVISION

MEDICAL DRUG

GroupSubscriber Name

Subscriber IDXLPR001234567890

RXBINRXPCNRXGRP

Member NameKEIKI K ALOHA

RX3989ADV004336515

0AIV03800

14520KIMO K ALOHA

04

Show your membership card Think of your membership card as your passport to care. Show it every time you see a provider or fill a prescription.

Welcome!

Thank you for choosing HMSA. We deeply appreciate your trust and promise that we’ll always be here for you.

Your good health is our top priority. We’ll work with your doctor to keep you healthy and do all we can to get you compassionate care when you need it.

There’s a lot to think about as you get started with your new plan. And we know you’re busy. We’ll get you the information you need in plain-and-simple language the way you want it, whether it’s on paper, over the phone, or online. This booklet will help you get started.

Establish a relationship with your provider Your relationship with your doctor is important. It’s a partnership that can last for many years. Your doctor works with you to maintain your good health and treat medical conditions, illnesses, or injuries.

Choose participating providers Choose providers from HMSA’s large network, which includes Hawaii physicians, hospitals, dentists, pharmacies, and other health care providers. Our participating providers go through a credentialing process, meet criteria for providing care, file claims, and accept your copayment and HMSA’s reimbursement as payment in full for covered services.

For most covered services, you can also see licensed providers who don’t participate with HMSA. However, you accept more risk when you get care from nonparticipating providers. For example, they may not file a claim for you or handle precertification. And since they don’t agree to accept HMSA’s reimbursement as payment in full, you must pay the difference when the bill is more than the eligible charge. That means you may pay more if you receive care from nonparticipating providers.

Use HMSA’s Find a Doctor tool online at hmsa.com. The online directory has current information about participating providers, including primary care providers, specialists, hospitals, urgent care centers, and other care facilities. Or, if you prefer, call us. We’re happy to help.

Subscriber information

Group information

Access to BCBS provider network out-of-state

PPO sample

Dependent information

Plan type & coverage information

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hmsa.com

Save money with mail-order drugs Purchase prescription drugs from our participating mail-order providers at the best prices possible and have medications delivered right to your doorstep. Your plan also offers benefits for prescriptions purchased from retail pharmacies.

Have peace of mind when you travel HMSA is a part of the Blue Cross and Blue Shield Association (BCBSA). This means you don’t need to worry about your health when you’re away from home. With the BlueCard program, you’ll have access to Blue Cross and Blue Shield doctors across the U.S. Mainland and in more than 200 countries and territories around the world. See your Guide to Benefits for more information.

Get help fast from a doctor with Online Care No appointment, no waiting, no hassle. HMSA’s Online Care makes it easy to talk to a doctor immediately, wherever you are in Hawaii. Go to hmsaonlinecare.com to learn more.

Understand what your plan covers You have comprehensive coverage with your plan, but don’t assume everything is covered. This booklet provides an overview, but it’s only a summary. It isn’t a complete explanation of benefits. Coverage decisions are based on the terms and conditions of your plan, including specific exclusions and limitations, not all of which are described in this booklet.

For a complete description of benefits, see your Guide to Benefits (available on request and online). The Guide to Benefits is a written description of your plan, and any riders or certificates and amendments. It includes important information about your plan benefits, limitations, and exclusions.

Other important notesEligible charge vs. actual charge HMSA is always looking for ways to help slow rising health care costs for everyone in Hawaii. Setting an eligible charge for services is one way we do that. Eligible charge is a cap on the total amount we pay for covered services. It’s often less than the actual charge or the amount a provider would bill patients for medical services and supplies. Participating providers agree to accept the eligible charge as the most they’ll collect for covered services.

The actual charge for providers who don’t contract with HMSA is often higher than HMSA’s eligible charge. If you receive services from a nonparticipating provider and the actual charge is more than the eligible charge, you owe the difference. The difference, in some cases, can be a lot.

Precertification Some care requires advance approval from HMSA. When services are provided by participating providers, they take care of precertification for you. If you get care from a nonparticipating provider, you’re responsible for getting precertification approval. For a complete list of care that requires precertification, see Chapter 5: Precertification in your Guide to Benefits.

Subsidy Information The Affordable Care Act (ACA) requires us to let you know that a portion of your invoice includes the amount necessary to cover services required to be segregated under Section 1303 of the ACA. This applies to your 2015 plan and may apply to your 2016 plan if you qualify for a subsidy. Visit this link for more information: law.cornell.edu/cfr/text/45/156.280.

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https://hmsaonlinecare.com/landing.htm

www.law.cornell.edu/cfr/text/45/156.280

Until you meet the deductible each calendar year, you pay 100 percent of your medical expenses.

Covered before you reach the deductible:

• Most retail generic drugs.• Mail-order generic drugs.• Most wellness care. • Preventive dental services (applies only if you purchased an individual dental plan).• HMSA’s Online Care.• Disease management programs.• Vision services (adult and child).

Once you meet the out-of-pocket maximum, we pay all covered expenses for the rest of the calendar year.

Other amounts you may owe:

• If you go to a nonparticipating vision, retail prescription drug, or dental provider, you take on more financial responsibility.

See “Eligible charge vs. actual charge” on page 4.

For Bronze Plan members only, skip step 2 for all services.

All amounts you pay and we pay are based on eligible charge.

Eligible charge is often less than the provider’s actual charge.

Once you meet the deductible, you pay a portion and we pay the rest.

Covered before you reach the deductible:

• Mail-order generic drugs.• Most wellness care. • Preventive dental services (applies only if you purchased an individual dental plan).• Oral chemotherapy.• Spacers and peak flow meters.• U.S. Preventive Services Task Force (USPSTF) recommended drugs.• Preferred diabetic supplies.• Polycarbonate lenses.• HMSA’s Online Care.• Disease management programs.

3 We pay

of eligible charges after you meet the

out-of-pocketmaximum

100%21

You pay

of your deductible100%

We pay the rest

You pay a portion ofthe cost

What you pay and what we pay

5 6

What you pay What you pay (after you meet the deductible)

Copayments for medical care

Plans

Wellness & preventive care

Visits to a provider’s office

Emergency room services

Most other services

Participating/ Non- participating




Platinum None/30% $20/30% 20%/20% 10%/30%

Gold None/50% $30/50% 20%/20% 30%/50%

Gold 1000

None/40% $20/40% 20%/20% 20%/40%

Silver 1500

None/60% $40/60% 20%/20% 40%/60%

Silver 2500

None/40% $30/40% 20%/20% 20%/40%

Bronze 6850

None/None None/None None/None None/None

Catastro- phic

None/None None/None None/None None/None

All percentages shown in this table are based on eligible charge.

Annual deductible – the fixed dollar amount you pay each calendar year before your health plan pays for certain services.

Plans Single Family

Platinum $0 $0

Gold $0 $0

Gold 1000 $1,000 $2,000

Silver 1500 $1,500 $3,000

Silver 2500 $2,500 $5,000

Bronze 6850 $6,850 $13,700

Catastrophic $6,850 N/A

Annual out-of-pocket maximum – the most in deductible and copayment amounts you pay for most covered services in one calendar year.

Plans Single Family

Platinum $6,000 $12,000

Gold $6,850 $13,700

Gold 100 $6,850 $13,700

Silver 1500 $6,850 $13,700

Silver 2500 $6,850 $13,700

Bronze 6850 $6,850 $13,700

Catastrophic $6,850 N/A

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Copayments for prescription drugs

Participating retail pharmacy*

Mail-order pharmacy** or 90-day at Retail

Nonparticipating retail pharmacy*

Tier 1 Platinum/Gold: $7

Silver/Bronze: $10

Catastrophic: None

Platinum/Gold: $11

Silver/Bronze: $20

Catastrophic: None

Platinum/Gold: $7 plus 20% of remaining eligible charge

Silver: $10 plus 20% of remaining eligible charge

Bronze/Catastrophic: None


Silver: $50


Platinum/Gold: $65

Silver: $125

Bronze/ Catastrophic: None




* You receive a 30-day supply when you purchase from a retail pharmacy. ** Participating mail order is the most cost-effective option because you receive a 90-day supply.

Copayments for prescription drugs (continued)




Tier 3 Platinum/Gold: $30 plus $45 Tier 3 cost share

Silver/Bronze: $50 plus $50 Tier 3


Platinum/Gold: $65 plus $135 Tier 3

Silver/Bronze: $125 plus $150 Tier 3 cost share


Platinum/Gold: $30 plus $45 Tier 3 cost share; plus 20% of remaining eligible charge

Silver/Bronze: $50 plus $50 Tier 3 cost share; plus 20% of remaining eligible charge



Silver: $150


Platinum/Gold: Not covered

Silver: Not covered

Bronze/Catastrophic: Not covered


Silver: Not covered

Bronze/ Catastrophic: Not covered


Silver: $300



Silver: Not covered

Bronze/Catastrophic: Not covered


Silver/Bronze: Not covered

Bronze/ Catastrophic: Not covered


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Copayments for contraceptives




Tier 1 Platinum/Gold: None

Silver: None


Platinum/Gold: None

Silver/Bronze: None






Silver: $50


Platinum/Gold: $65

Silver: $125





Tier 3 Platinum/Gold: $30 plus $45 Tier 3 cost share

Silver: $50 plus $50 Tier 3 cost share


Platinum/Gold: $65 plus $135 Tier 3 cost share

Silver: $125 plus $150 Tier 3 cost share


Platinum/Gold: $30 plus $45 Tier 3 cost share; plus 20% of remaining eligible charge

Silver: $50 plus $50 Tier 3 cost share; plus 20% of remaining eligible charge



Copayments for contraceptives (continued)




Over-the-counter Contra- ceptives for women by prescription only

Platinum/Gold: None

Silver: None


Platinum/Gold: None

Silver: None





Cervical caps/diaphragms

Platinum/Gold: None

Silver: None


Platinum/Gold: None

Silver: None


Platinum/Gold: $10 per device

Silver: $10 per device



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Copayments for implants, injectables, & IUDs

Plans Participating retail pharmacy

Nonparticipating retail pharmacy

Platinum None 30%

Gold None 50%

Gold 1200 None 40%

Silver 1500 None 60%

Silver 2500 None 40%

Bronze 6850 None None

Catastrophic None None

Copayments for vision services for adults

Participating vision provider

Nonparticipating vision provider

Eye exam $10 per exam All charges over $40

Frames (standard)

$15 per standard frame All charges over $12

Lenses for frames

$10 per pair of lenses Single: All charges over $16 Multifocal: All charges over $25

Contact lenses

$25 plus charges over $130 All charges over $50

Contact lens fitting

All charges over $45 All charges over $20

The amounts you pay for adult vision services don’t apply toward reaching the out-of-pocket maximum.

Copayments for vision services for children

Platinum through bronze CatastrophicParticipating

vision providerNonparticipating vision provider

Eye exam $10 per exam 50% of eligible charge

None

Frames (standard)

$15 per standard frame

50% of eligible charge

None

Lenses for frames

$10 per pair of lenses


None

Contact lenses

50% of actual charge

50% of actual charge

None

Contact lens fitting



None

Poly- carbonate lenses

None 50% of eligible charge

None

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Copayments for dental care PPO plans (if you purchased dental benefits with your plan)

Plan Benefits PPP Pediatric Essential Plan PPP High Plan PPP Basic Plan

Monthly Premiums 39.37 (ages 0-18)$39.37 (ages 19-20)*1

$0 (ages 21+)

$39.13 (ages 0-18)

$39.13 (ages 19-20)$32.91 (ages 21+)

$32.85 (ages 0-18) $32.85 (ages 19-20)$15.89 (ages 21+)

Coverage Pediatric1 Pediatric1 Adult Pediatric1 Adult

Deductible $0 $0 $0 $252 $252

Waiting Period(s) 24 Month Medically Necessary Ortho

24 Month Medically Necessary Ortho

6 Month Basic 12 Month Major

24 Month Medically Necessary Ortho

6 Month Basic

Preventive Participating Provider/Nonparticipating Provider3

Exams 0%/20% 0%/20% 0% 10% 10%

X-rays 0%/20% 0%/20% 0% 10% 10%

Cleanings 0%/20% 0%/20% 0% 10% 10%

Routine/Basic Participating Provider/Nonparticipating Provider3

Fillings 30%/40% 30%/40% 30% 40% 40%

Periodontal Treatment 30%/40% 30% 50%4 40% Not a Benefit

Root Canals 30%/40% 30% 50%4 40% Not a Benefit

IMPORTANT NOTE: The Affordable Care Act (ACA) requires that all individual health plans include pediatric dental benefits as an essential health benefit.

* Members ages 19-20 will be charged $39.37, but aren’t eligible for plan benefits.

1 Pediatric benefits apply to members ages 0–18.

2 Applies to preventive, basic, and major services.

3 Amount you’re responsible for varies based on if the provider is a participating or nonparticipating network provider in HMSA’s Preferred Provider Network. In addition, you may owe the difference between the amount billed by your provider and the eligible charge when services are received from a nonparticipating provider or if you choose a high-cost procedure.

4 These services are covered under the major category. A waiting period may apply. Please refer to the Dental Guide to Benefits for more information on benefits.

Some pediatric services require prior authorization to ensure certain treatments, procedures, or devices meet the payment determination criteria before the service is rendered. Please refer to the Dental Guide to Benefits at hmsa.com/dental for complete information on benefits and provisions.

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Copayments for dental care PPO plans (if you purchased dental benefits with your plan) (continued)

Plan Benefits PPP Pediatric Essential Plan PPP High Plan PPP Basic Plan

Pediatric1 Pediatric1 Adult Pediatric1 Adult

Major Participating Provider/Nonparticipating Provider3

Crowns 50%/60% 50%/60% 50%/60% 60%/70% Not a Benefit

Bridges (adults only) Not a Benefit Not a Benefit Participating: 50% Not a Benefit Not a Benefit

Denture (complete/partial) Participating: 50% 50%/60% 50%/60% 50%/60% Not a Benefit

Calendar Year

Calendar Year Maximum Does Not Apply Does Not Apply $1,000 Does Not Apply $1,000

Out-of-Pocket Maximum $350 Child $700 (2+ Children) Max

$350 Child $700 (2+ Children) Max

Does Not Apply $350 Child $700 (2+ Children) Max

Does Not Apply

Rollover No No Yes No Yes

1 Pediatric benefits apply to members ages 0–18.

Some pediatric services require prior authorization to ensure certain treatments, procedures, or devices meet the payment determination criteria before the service is rendered. Please refer to the Dental Guide to Benefits at hmsa.com/dental for complete information on benefits and provisions.

17 18

AND AND

You receive care froma participating provider ora recognized and licensed nonparticipating provider.

1 2

Services are listed as coveredin your Guide to Benefits and:

• For covered services you receive from a nonparticipating provider, if precertification applies, precertification approval is received.

• The covered service meets all criteria for your condition and diagnosis as well as payment determination criteria and HMSA’s medical policies; and

3

Your deductible was met for the calendar year.

WePay➡THEN

Our process for paying a claimTo avoid unexpected fees, please review how we decide if a claim is payable.

The process shown assumes:

• We receive a claim. • Your plan is active at the time you receive services. • Another party or another plan is not responsible for payment. • You haven’t reached a benefit maximum. A benefit maximum is a frequency,

duration, or visit limit that applies to some covered services or supplies. If you reach a benefit maximum during the calendar year, coverage for that service or supply ends until the next calendar year.

• You haven’t met your copayment maximum (also known as out-of-pocket maximum) for the year.

When you don’t agree If you wish to dispute a decision made by HMSA related to coverage, reimbursement, or any other decision or action by HMSA, ask for an appeal in writing (unless you’re asking for an expedited appeal). Send the appeal within one year from the date of the action or decision you’re contesting. In the case of coverage or reimbursement disputes, this is one year from the date we first informed you of the denial or limitation of your claim, or of the denial of coverage for any requested service or supply.

For more information, see Chapter 8 of your Guide to Benefits. We’re also happy to help you over the phone at 948-5090 or 1 (800) 462-2085 toll-free.

Learn more Whether you’re a new member or you’ve been with us for a while, we’re here for you. Call or visit us at an HMSA Center or office near you. Check out our online tools and resources at hmsa.com. Or find information and tips on Facebook, Twitter, or Instagram.

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Services Summary notes Chapter # Chapter name Subsection name

Alcohol or drug dependence Not covered solely because court ordered.

4 Description of Benefits Behavioral Health – Mental Health and Substance Abuse

Allergy testing and treatment Covered. 4 Description of Benefits Testing, Laboratory, and Radiology

Ambulance (air and ground)

Covered, but air ambulance is covered within Hawaii only.

4 Description of Benefits Other Medical Services

Anesthesia Monitored anesthesia when you meet high-risk criteria.

4 Description of Benefits Physician Services

Also see Dental Services (Pediatric) in this booklet

Behavioral health – Mental health

Precertification required for care in a residential rehabilitation facility outside Hawaii.

4 Description of Benefits Behavioral Health – Mental Health and Substance Abuse

Blood, blood products, and administration

Covered, including blood costs, blood bank services, and blood processing.

4 Description of Benefits Other Medical Services and Supplies

Cardiac rehabilitation Not covered. 6 Services Not Covered Miscellaneous Exclusions

Chemotherapy Coverage for high-dose chemotherapy only in conjunction with peripheral stem-cell transplants.

Chemotherapy drugs must be FDA-approved.

4

6

Description of Benefits

Services Not Covered

Chemotherapy and Radiation Therapy; Organ and Tissue Transplants

Miscellaneous Exclusions

Circumcision Coverage for newborn circumcision only.

4

6



Special Benefits for Children

Preventive and Routine

Clinical trials (routine care associated with clinical trials)

Covered when the routine care is associated with a clinical trial.


Continued on the next page

Services at a glanceThis table summarizes covered and not-covered services. It isn’t a complete explanation of coverage. To avoid unexpected fees, call us or consult your Guide to Benefits, which may be accessed through My Account on hmsa.com.

This booklet is a summary only and not a complete description of services, exclusions, or limitations. For complete information, see your Guide to Benefits.

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www.hmsa.com



Complications of non-covered procedures

Not covered. 6 Services Not Covered Miscellaneous Exclusions

Contraceptives (implants, injectables, IUDs)

One method per period of effectiveness. Also see Prescription Drugs in this booklet.

4 Description of Benefits Special Benefits for Women

Cosmetic services, surgery, supplies Not covered. 6 Services Not Covered Miscellaneous Exclusions

Dental – Services of a dentist

Limited to emergency or surgical services that would otherwise require a physician.

4

6



Other Medical Services and Supplies

Dental Care

Developmental delay services Not covered when provided by the government.

6 Services Not Covered Miscellaneous Exclusions

Diagnostic tests Covered. 4 Description of Benefits Testing, Laboratory, and Radiology

Dialysis and supplies Covered. 4 Description of Benefits Other Medical Services and Supplies

Disease management programs Covered when provided by a participating provider.

4 Description of Benefits Disease Management Programs and Preventive Services

Durable medical equipment and supplies

Covered, but limitations apply. 4

6





Emergency services continued on page 25

Covered when your condition is life-threatening or you need care immediately, such as when there is:

• Serious risk to the health of the individual or to a pregnant woman or her unborn child.

• Serious impairment to bodily functions.

• Serious dysfunction of any body organ or part.

4 Description of Benefits Emergency Services


23 24



Emergency services, continued

Emergency conditions include uncontrolled bleeding, difficulty breathing, broken bones and other major injuries, chest pain or pressure, coughing or vomiting blood, fainting, poisoning, sudden facial drooping or weakness in an arm or leg, sudden severe pain.

If you’re admitted as an inpatient after a visit to the emergency room, hospital inpatient benefits apply, not emergency room benefits.

4 Description of Benefits Emergency Services

Genetic testing and counseling Covered when specific criteria for genetic testing and counseling are met.

4

6



Testing, Laboratory, and Radiology

Counseling Services; Miscellaneous Exclusions

Growth hormone therapy Covered when specific criteria for growth hormone therapy are met.

4

6





Hearing services Evaluation for aids covered only in office of physician or audiologist. One hearing aid per ear every 60 months.

4

6





HMSA’s Online Care Covered for members age 18 and older.

4 Description of Benefits Online Care; Special Benefits – Disease Management; Preventive Services

Home health care Covered up to 150 visits per calendar year.

4 Description of Benefits Special Benefits for Homebound, Terminal, or Long-term Care

Hospice services Covered when provided by a participating hospice provider.

4 Description of Benefits Special Benefits for Homebound, Terminal, or Long-term Care

Hospital (and other facility) services Covered. 4 Description of Benefits Hospital and Facility Services


25 26


Immunizations and vaccinations Covered. High-risk conditions only as recommended by the Advisory Committee on Immunization Practices (ACIP). Also see Well-Care in this booklet.

4

6



Physician Services


Infertility treatment Covered for one in-vitro fertilization per lifetime.

4

6



Special Benefits for Member and Covered Spouse

Fertility and Infertility

Labs and pathology Covered. 4 Description of Benefits Testing, Laboratory, and Radiology

Mammography screening One baseline for women ages 35-39, then one per year thereafter.


Maternity care Reminder: Call us to add baby to your plan within 31 days of birth.


Newborn Care Reminder: Call us to add baby to your plan within 60 days of birth

10 General Provisions Children Who are Newborns or Adopted

Outpatient IV therapy Covered, but drugs must be FDA-approved.


Physician visits Covered. 4 Description of Benefits Physician Services

Pregnancy/maternity Inpatient stays after delivery for up to 48 hours from time of delivery for normal labor and delivery or 96 hours from time of delivery for a Caesarean birth.


Prescription drugs (outpatient)

Covered when purchased from participating and nonparticipating retail pharmacies or participating mail-order pharmacy. A maximum 42-day supply (or fraction thereof) for Omeprazole OTC when purchased in a store (no benefits for mail order). Also see Contraceptives in this booklet.

4

6



Prescription Drugs and Supplies

Drugs

Radiation therapy Covered. High-dose radiation only when related to a peripheral stem-cell transplant. Non-ionizing radiation not covered.

4

6



Chemotherapy and Radiation Therapy




27 28



Radiology Covered. Also see Mammography Screenings and Well-Care in this booklet.

4 Description of Benefits Testing, Laboratory, and Radiology

Reconstructive surgery Reconstructive surgery related to complications of a non-covered procedure aren’t covered.

4

6



Surgical Services


Rehabilitation and habilitative programs

Covered, including occupational, speech, and physical therapies. Group programs aren’t covered.

4 Description of Benefits Habilitative and Rehabilitative Therapy

Screenings and preventive counseling

Covered. Grade A and B, and frequency based on recommendations of the U.S. Preventive Services Task Force (USPSTF).

4 Description of Benefits Special Benefits for Women; Testing, Laboratory, and Radiology; Surgical Services, Special Benefits for Disease Management

Skilled nursing facility Covered up to 120 days maximum per calendar year, when certain criteria are met.

4 Description of Benefits Hospital and Facility Services

Surgery Covered. 4 Description of Benefits Surgical Services

Transplants – Organ and tissue

Covered when specific criteria are met, including that major organ transplants and transplant evaluations take place in a contracting transplant facility located in Hawaii or an approved Blue Distinction Center for Transplants.

4

6



Organ and Tissue Transplants

Transplants

Tubal ligation Covered. Reversals aren’t covered. 4

6



Special Benefits for Women

Fertility/Infertility

Vasectomy Covered. Reversals aren’t covered. 4

6



Special Benefits for Men

Fertility/Infertility


29 30


Vision services (age 19 and older)

Covered. Benefit maximums apply:

• One eye exam per calendar year. • One frame every 24 months. • One pair of lenses per calendar

year (one pair of prescription lenses or one pair of disposable or nondisposable contact lenses).

4

6



Vision Care Services for Adults

Vision Care

Vision services (children through age 18)


• One eye exam per calendar year. • One frame every calendar year. • One pair of prescription lenses

or one pair of contact lenses per calendar year.

4 Description of Benefits Special Benefits for Children – Pediatric Vision Care

Well-Care for adults (22 and older)


• Men: One PSA screening per calendar year for men 50 or over; one physical exam per calendar year.

• Women: One ob-gyn exam, including pap smear; one physical exam per calendar year.

4

6



Special Benefits Disease Management and Preventive Services


Well-Care for children (through age 21)

Covered. Benefit maximums apply in accord with guidelines set by Advisory Committee on Immunization Practices (ACIP) and other criteria. Well-child care includes care from a child’s birth through age 21, including office visits for medical history, physical exams, sensory screenings, development/behavioral assessments, anticipatory guidance, lab tests, and immunizations.

4 Description of Benefits Special Benefits for Children – Medical Care


31 32

We’re here to helpPhone 948-6111 on Oahu If you’re calling from the U.S. Mainland, please call 1 (800) 776-4672. If you need to call a local Hawaii telephone number from the Mainland, the area code is 808.

HMSA Centers Visit one of our HMSA Centers with extended evening and Saturday hours:

HMSA Center @ Honolulu 818 Keeaumoku St. Monday – Friday, 8 a.m. – 6 p.m. Saturday, 9 a.m. – 2 p.m.

HMSA Center @ Pearl City Pearl City Gateway 1132 Kuala St., Suite 400 Monday – Friday, 9 a.m. – 7 p.m. Saturday, 9 a.m. – 2 p.m.

HMSA Center @ Hilo Waiakea Center 303A E. Makaala St. Monday – Friday, 9 a.m. – 7 p.m. Saturday, 9 a.m. – 2 p.m.

Offices Visit your nearest HMSA office Monday through Friday, 8 a.m. – 4 p.m.

Kahului 33 Lono Ave., Suite 350

Kailua-Kona 75-1029 Henry St., Suite 301

Lihue 4366 Kukui Grove St., Suite 103

Visit hmsa.com/contact for our holiday schedule.

Online hmsa.com Facebook: facebook.com/myhmsa Twitter: @AskHMSA Instagram: @AskHMSA

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Documents

Basics of your health plan benefitsSome care requires advance approval from HMSA. When services are provided by participating providers, they take care of precertification for you