Important information about your plan benefits, limitations, and exclusions is included in your Guide to Benefits for medical and dental plans. Similar information for rider plans such as vision, drug, or chiropractic is included in the rider plan’s certificates. The Guide to Benefits, along with any rider certificates and amendments, is a written description of your health care coverage.
Every HMSA medical plan has a Guide to Benefits. Your Guide to Benefits is your reference guide and legal document that explains your plan coverage. Please take the time to familiarize yourself with the contents of this document. Topics in your Guide to Benefits include, but aren’t limited to:
- Out-of-state benefits.
- Your annual copayment maximum and deductible.
- A list of your benefits and copayment amounts.
- Services that aren’t covered by your plan.
- How to file claims when visiting a nonparticipating provider.
- Services that require precertification.
- How to appeal an HMSA decision.
- Third-party liability rules.
- How your benefits are coordinated.
- Enrolling your children on your plan.
- Information on COBRA.
You may have access to view and print your Guide to Benefits online through your HMSA My Account. (If your plan’s Guide to Benefits isn’t available online, please contact your employment office or HMSA Customer Relations to request a copy.)
To find your Guide to Benefits through My Account:
- Register and log on to My Account.
- Click on the Benefits tab on the top left of the page or View Benefits on the right side of the page.
- On the Benefits page, click on the PDF icons listed in the chart with Guide to Benefits and Summary of Changes.
The information in your Guide to Benefits supersedes any of the information contained on this site.