How do I determine my medical plan type?
Your HMSA membership card is your key to all medical services. It identifies you as an HMSA plan member. Your doctor and other providers use the information on your card to find out what type of plan you have with HMSA and how to file your claims for services.
The table below explains how your HMSA membership card can tell you which type of medical plan you have. Please note that this table describes the major HMSA medical plans. If your plan is not listed here, call HMSA Customer Relations for help. To learn about plan benefits unique to your particular plan, please review your Guide to Benefits and plan certificates.
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| PPO || |
Your medical coverage code is made up of numbers. Example: 673
Click here to see what the PPO card looks like.
Note that this patient's PPO medical coverage code is 673 and the member has drug and vision benefits.
PPO members have convenient access to health care through the largest provider network in the state. Though PPO plans offer you greater choice of doctors than HMO plans, we encourage you to choose HMSA participating providers to help keep your out-of-pocket expenses down. Please read Why your cost may be more when you see a nonparticipating provider for more information.
| HMO || |
Your medical coverage code is made up of letters. Example: X-C
Click here to see what the HMO card looks like.
Note that this patient's HMO medical coverage code is X-C and the member has drug and vision benefits.
HMO cards also include your health center and primary care provider (PCP) under your subscriber ID number. Please read Selecting your health center and PCP for more information.
Being part of a health maintenance organization (HMO) is like having your own health care team. You will receive care from a health center and a personal care provider (PCP), who coordinates all your care. Your PCP also arranges your care if you need to see a specialist within your health center. HMO participants must select both a health center and a PCP to fully enjoy the benefits of their plan. For more information about out-of-state care, see Does my HMO plan cover services on the U.S. Mainland?
| Medicare Plans: 65 C Plus (Cost), Akamai Advantage & Senior Connection || |
65C Plus (Cost): Your medical coverage code is made up of numbers and the 65C Plus (Cost) logo appears on your HMSA membership card. Click here to see what the 65C Plus (Cost) card looks like.
Akamai Advantage: Your medical coverage is made up of numbers and the Akamai Advantage logo appears at the bottom left corner of your HMSA membership card. Click here to see what the Akamai Advantage card looks like.
Senior Connection: Your medical coverage is made up of numbers. Coverage codes include: 160, 170, and 405.
| The HMSA Plan for QUEST Members || |
The word QUEST appears on your HMSA membership card.
Click here to see what the HMSA QUEST card looks like.
Your PCP and network are also listed on the card.
Note: Most of the information in the Customer Service Information Center refers to PPO or HMO plans. Contact HMSA Customer Relations for information about The HMSA Plan for QUEST Members, Senior Connection, Akamai Advantage, and 65C Plus (Cost) plans.