No matter where you are in your health and well-being journey, learning more about the resources available to you can help you make the most of your health plan. Explore the tools that offer you convenience and more for your well-being.
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In Hawaii, so many things were missed this past year. Don’t let your cancer screening be one of them. Talk to your primary care provider (PCP) and schedule your screenings.
Attend workshops on a variety of well-being topics, like Family Fitness, Diabetes 101: Understanding Diabetes, Season’s Eatings, and more.
Get discounts on products and services related to health and well-being, including discounted gym memberships with the Active &Fit® Program.
Quit tobacco (including cigarettes, smokeless, and e-cigarettes) for good with help from your doctor, trained coaches, tailored quit plans, and online support.
Virta is a provider-led, research-backed treatment that reverses type 2 diabetes, meaning that patients can lower their blood sugar and A1c, all while reducing diabetes medications and losing weight. HMSA’s Federal Plan 87 fully covers the cost of Virta for you and your eligible family members with type 2 diabetes.*
Watch Walter's testimonial 19Are you at risk for type 2 diabetes? This 24-month program can help you change your lifestyle so you can prevent it.
Federal Plan Members – Are you at risk for diabetes? [PDF]21
Certified coaches help you create a plan to take control of your well-being and offer support as you work toward your goals.
Do you have questions about your medications? Do you know the best time of day to take them? Do you have difficulty paying for them?
This program is available to eligible members at no cost to help them take their medications safely and effectively. A pharmacist will review your medications and provide recommendations.
With the Ornish Lifestyle Medicine™ program, you can strengthen your well-being, feel younger, and be more active.
Learn how to stay informed and involved in your health care.
Find out your rights and responsibilities about your health care.
Here are average costs for some common medical procedures. Hospitalization and facility costs aren’t included.
For more information about your benefits, please review your 2024 Plan Brochure.
Click Member Login to access the medical cost calculator and get a personalized estimate based on your plan benefits.
| Procedure | Estimated Fee |
|---|---|
| Office visits | |
| New patient visit, level 2 | $99 |
| New patient visit, level 3 | $151 |
| New patient visit, level 4 | $224 |
| New patient visit, level 5 (high severity) | $282 |
| Office visits (preventive) | |
| Well-baby office visit, new patient (under 1 year) | $129 |
| Well-child office visit, new patient (1 to 4 years) | $139 |
| Well-child office visit, new patient (5 to 11 years) | $139 |
| Well-child office visit, new patient (12 to 17 years) | $150 |
| Well-adult office visit, new patient (18 to 39 years) | $174 |
| Well-adult office visit, new patient (40 to 64 years) | $174 |
| Well-adult office visit, new patient (65 and older) | $174 |
| Psychotherapy visits | |
| Group psychological therapy | $46 |
| Individual psychotherapy, 60 minutes | $167 |
| Eye examinations | |
| Eye exam, routine visit, new patient | $106 |
| Eye exam and treatment, new patient | $196 |
| Vision screening test | $4 |
| Hearing services | |
| Comprehensive audiometry evaluation | $67 |
| Ear cleaning | $75 |
| Eardrum test | $14 |
| Hearing screening test (pure tone, air only) | $15 |
| Physical therapy services | |
| Electric stimulation therapy, treatment only | $20 |
| Physical therapy evaluation | $89 |
| Physical therapy exercises, treatment only (each 15-minute segment) | $34 |
| Physical therapy, hot and cold application, treatment only | $6 |
| Physical therapy, ultrasound, treatment only (each 15-minute segment) | $15 |
| Manual therapy techniques, each 15 minutes | $31 |
| Neuromuscular reeducation | $38 |
| Therapeutic activities | $39 |
| Vaccines and other injections | |
| Immunization administration | $22 |
| Immunization administration through 18 years of age | $22 |
| Immunization administration through 18 years of age, additional component | $6 |
| Allergy shot | $12 |
| Chicken pox vaccine | $188 |
| Diphtheria, tetanus booster vaccine | $30 |
| Diphtheria, tetanus, pertussis vaccine | $56 |
| Flu shot, children (3 years and older) | $21 |
| Flu shot, infants | $21 |
| Flu shot, adults (18 to 64) | $70 |
| Hepatitis B vaccine | $72 |
| Measles, mumps, and rubella vaccine | $99 |
| Polio vaccine | $44 |
| Tests and procedures | |
| Breathing capacity test | $55 |
| Breathing treatment | $38 |
| Colonoscopy and removal of abnormal tissue using cautery | $809 |
| Colonoscopy and removal of abnormal tissue using snare technique | $757 |
| Colonoscopy and removal of colon tissue for examination | $736 |
| Diagnostic colonoscopy | $566 |
| Diagnostic proctosigmoidoscopy | $172 |
| Diagnostic sigmoidoscopy | $253 |
| Draining fluid from around swollen joint | $103 |
| Electrocardiogram | $36 |
| Fetal monitoring | $81 |
| Incisional biopsy of skin, single lesion | $181 |
| Punch biopsy of skin, single lesion | $149 |
| Sigmoidoscopy and removal of tissue for examination | $322 |
| Stress test | $129 |
| Surgically destroying an abnormal area of skin | $147 |
| Tangential biopsy of skin, single lesion | $119 |
| Ultrasound test of heart | $380 |
| X-rays, CT scans, and other imaging studies | |
| CT scan of chest, including dye | $459 |
| CT scan of pelvis, including dye | $441 |
| CT scan of pelvis, without dye | $387 |
| CT scan of sinus and nasal passages | $327 |
| CT scan of stomach area, with dye | $449 |
| CT scan of stomach area, without dye | $380 |
| Mammogram (one side) | $204 |
| Mammogram (two views) | $258 |
| Mammogram (screening) | $205 |
| Breast tomosynthesis BI | $74 |
| MRI brain stem with contrast | $834 |
| MRI cardiac with, without contrast with stress | $1264 |
| MRI neck with contrast | $815 |
| Pregnancy ultrasound | $179 |
| Review of CT scan of the head or brain | $308 |
| Ultrasound of pelvis | $163 |
| Ultrasound of stomach area | $193 |
| Vaginal ultrasound | $189 |
| X-ray for osteoporosis | $185 |
| X-ray of ankle (complete) | $61 |
| X-ray of both knees | $68 |
| X-ray of chest (one view) | $37 |
| X-ray of chest (two views) | $49 |
| X-ray of finger | $63 |
| X-ray of foot (complete) | $54 |
| X-ray of hand (complete) | $59 |
| X-ray of knee (complete) | $77 |
| X-ray of stomach area (complete) | $78 |
| X-ray of wrist (complete) | $68 |
| Laboratory tests | |
| Albumin test | $10 |
| Alkaline phosphatase test | $9 |
| Allergy test | $6 |
| In vitro allergen specific IgE testing | $9 |
| ALT test | $10 |
| Amylase test | $12 |
| AST test | $9 |
| Bilirubin test (total) | $9 |
| Blood antibody test | $26 |
| Blood clotting test | $7 |
| Blood sugar test, diagnostic | $7 |
| Blood sugar test, monitoring | $23 |
| Calcium test (total) | $9 |
| Cholesterol level test | $8 |
| Complete blood count | $14 |
| Comprehensive metabolic panel | $19 |
| Creatinine test | $9 |
| Hemoglobin A1C | $18 |
| Hepatitis B surface antigen test | $19 |
| Hepatitis C test | $26 |
| Kidney function test | $16 |
| Laboratory chemistry test for creatine kinase | $12 |
| Lipid panel test | $24 |
| Magnesium test | $12 |
| Pap test, cervical cancer screening | $39 |
| Phosphorus test | $9 |
| Routine venipuncture | $9 |
| Procedure | Estimated Fee |
|---|---|
| Office visits | |
| New patient visit, level 2 | $99 |
| New patient visit, level 3 | $151 |
| New patient visit, level 4 | $224 |
| New patient visit, level 5 (high severity) | $282 |
| Office visits (preventive) | |
| Well-baby office visit, new patient (under 1 year) | $129 |
| Well-child office visit, new patient (1 to 4 years) | $139 |
| Well-child office visit, new patient (5 to 11 years) | $139 |
| Well-child office visit, new patient (12 to 17 years) | $150 |
| Well-adult office visit, new patient (18 to 39 years) | $174 |
| Well-adult office visit, new patient (40 to 64 years) | $174 |
| Well-adult office visit, new patient (65 and older) | $174 |
| Psychotherapy visits | |
| Group psychological therapy | $46 |
| Individual psychotherapy, 60 minutes | $167 |
| Eye examinations | |
| Eye exam, routine visit, new patient | $106 |
| Eye exam and treatment, new patient | $196 |
| Vision screening test | $4 |
| Hearing services | |
| Comprehensive audiometry evaluation | $67 |
| Ear cleaning | $75 |
| Eardrum test | $14 |
| Hearing screening test (pure tone, air only) | $15 |
| Physical therapy services | |
| Electric stimulation therapy, treatment only | $20 |
| Physical therapy evaluation | $89 |
| Physical therapy exercises, treatment only (each 15-minute segment) | $34 |
| Physical therapy, hot and cold application, treatment only | $6 |
| Physical therapy, ultrasound, treatment only (each 15-minute segment) | $15 |
| Manual therapy techniques, each 15 minutes | $31 |
| Neuromuscular reeducation | $38 |
| Therapeutic activities | $39 |
| Vaccines and other injections | |
| Immunization administration | $22 |
| Immunization administration through 18 years of age | $22 |
| Immunization administration through 18 years of age, additional component | $6 |
| Allergy shot | $12 |
| Chicken pox vaccine | $188 |
| Diphtheria, tetanus booster vaccine | $30 |
| Diphtheria, tetanus, pertussis vaccine | $56 |
| Flu shot, children (3 years and older) | $21 |
| Flu shot, infants | $21 |
| Flu shot, adults (18 to 64) | $70 |
| Hepatitis B vaccine | $72 |
| Measles, mumps, and rubella vaccine | $99 |
| Polio vaccine | $44 |
| Tests and procedures | |
| Breathing capacity test | $55 |
| Breathing treatment | $38 |
| Colonoscopy and removal of abnormal tissue using cautery | $809 |
| Colonoscopy and removal of abnormal tissue using snare technique | $757 |
| Colonoscopy and removal of colon tissue for examination | $736 |
| Diagnostic colonoscopy | $566 |
| Diagnostic proctosigmoidoscopy | $172 |
| Diagnostic sigmoidoscopy | $253 |
| Draining fluid from around swollen joint | $103 |
| Electrocardiogram | $36 |
| Fetal monitoring | $81 |
| Incisional biopsy of skin, single lesion | $181 |
| Punch biopsy of skin, single lesion | $149 |
| Sigmoidoscopy and removal of tissue for examination | $322 |
| Stress test | $129 |
| Surgically destroying an abnormal area of skin | $147 |
| Tangential biopsy of skin, single lesion | $119 |
| Ultrasound test of heart | $380 |
| X-rays, CT scans, and other imaging studies | |
| CT scan of chest, including dye | $459 |
| CT scan of pelvis, including dye | $441 |
| CT scan of pelvis, without dye | $387 |
| CT scan of sinus and nasal passages | $327 |
| CT scan of stomach area, with dye | $449 |
| CT scan of stomach area, without dye | $380 |
| Mammogram (one side) | $204 |
| Mammogram (two views) | $258 |
| Mammogram (screening) | $205 |
| Breast tomosynthesis BI | $74 |
| MRI brain stem with contrast | $834 |
| MRI cardiac with, without contrast with stress | $1264 |
| MRI neck with contrast | $815 |
| Pregnancy ultrasound | $179 |
| Review of CT scan of the head or brain | $308 |
| Ultrasound of pelvis | $163 |
| Ultrasound of stomach area | $193 |
| Vaginal ultrasound | $189 |
| X-ray for osteoporosis | $185 |
| X-ray of ankle (complete) | $61 |
| X-ray of both knees | $68 |
| X-ray of chest (one view) | $37 |
| X-ray of chest (two views) | $49 |
| X-ray of finger | $63 |
| X-ray of foot (complete) | $54 |
| X-ray of hand (complete) | $59 |
| X-ray of knee (complete) | $77 |
| X-ray of stomach area (complete) | $78 |
| X-ray of wrist (complete) | $68 |
| Laboratory tests | |
| Albumin test | $10 |
| Alkaline phosphatase test | $9 |
| Allergy test | $6 |
| In vitro allergen specific IgE testing | $9 |
| ALT test | $10 |
| Amylase test | $12 |
| AST test | $9 |
| Bilirubin test (total) | $9 |
| Blood antibody test | $26 |
| Blood clotting test | $7 |
| Blood sugar test, diagnostic | $7 |
| Blood sugar test, monitoring | $23 |
| Calcium test (total) | $9 |
| Cholesterol level test | $8 |
| Complete blood count | $14 |
| Comprehensive metabolic panel | $19 |
| Creatinine test | $9 |
| Hemoglobin A1C | $18 |
| Hepatitis B surface antigen test | $19 |
| Hepatitis C test | $26 |
| Kidney function test | $16 |
| Laboratory chemistry test for creatine kinase | $12 |
| Lipid panel test | $24 |
| Magnesium test | $12 |
| Pap test, cervical cancer screening | $39 |
| Phosphorus test | $9 |
| Routine venipuncture | $9 |
Information on Claims and Appeals to the Office of Personnel Management [PDF]28
* Virta is available to HMSA’s Federal Plan 87 members and eligible dependents between the ages of 18 and 79. This benefit is currently being offered to those with type 2 diabetes. There are some medical conditions that would exclude patients from the Virta treatment. Start the application process now to find out if you qualify. Virta is an independent company and health care provider, providing Disease Management services on behalf of HMSA.
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