Member Resources: Essential Advantage (HMO)

Request HMSA Akamai Advantage Provider Directory

If you’d like an HMSA Akamai Advantage Provider Directory, please fill out the form below. We will mail it to you within three business days.

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We’ll mail your HMSA Akamai Advantage Provider Directory within three business days. If you have other questions you would like to get answered now, please call us.

Hours Available
You can call from 8 a.m to 8 p.m., seven days a week

Get the most out of your health plan. Learn about the many benefits you have as an HMSA member.

Questions? For help with claims information or health plan benefits, call 808-948-6000 on Oahu or 1-800-660-4672 toll-free seven days a week, 8 a.m. to 8 p.m. TTY users, call 711.

If your Essential Advantage plan doesn’t meet your needs or if you’d like to file a grievance, call us. You can also call 1-800-MEDICARE 24 hours a day, seven days a week. For TTY, call 1-877-486-2048. You can also submit a complaint at

Tools to help you get the most from your plan

Automatic Payment Service/EFT

Pay your monthly premiums and prescription drug benefits through your financial institution.

Instructions Download

Appoint an authorized representative

Have a friend or family member act on your behalf if you’re too ill to make decisions about your health care.

Instructions Download

Changing your plan

Your health care needs may change as time goes on. Call us at 808-948-6235 or 1-800-693-4672 to learn about other HMSA Akamai Advantage plan options.

My Account

Register for and log on to My Account to see your Part D Explanation of Benefits online.

Disenrollment Request

Need to end your health plan? Fill out this form to disenroll from your plan.

Instructions Download

Drug Tools

Find out if your plan pays for prescription medications and search for generic alternatives.

Extra Help

Do you need help paying for your prescription drugs? The Low-Income Subsidy program may reduce your prescription drug copayments.

Medication Therapy Management Program

If you qualify for this program, a pharmacist will call you to discuss your medications.

Personal Medication List

Provider Network

Find a Doctor

Search for health care providers.

Provider Directory

Search for doctors, pharmacies, and other health care providers.

Disclaimer: The pharmacy network and provider network may change at any time. You’ll receive notice when necessary.

Find a pharmacy

Search for pharmacies in Hawaii and on the Mainland.

Request a provider directory

If you’d like an Essential Advantage Provider Directory, please fill out the form. We’ll mail it to you within three business days.

Prescription Drugs

These online tools help you get the most from your prescription drug benefit.


Search for medications or download your plan’s drug list. Find cost, availability, and any requirements.

Formulary search

Comprehensive formulary

A comprehensive formulary is the entire list of drugs that your Part D plan pays for.

The formulary may change at any time. We’ll let you know about any changes.

Mail–order Prescription Drug Service

Save time and money when you get an extended supply of maintenance medications for chronic conditions mailed to your home. To sign up, call CVS Caremark’s Customer Care at 1-800-479-3659 or visit My Account.


Prior authorization

We want to make sure you’re taking medications that are right for you. Your plan must approve certain prescription drugs before you take them.


Step therapy

In some cases, we may ask you to try a less-expensive drug before we pay for a more-expensive one.


Evidence of Coverage

The Evidence of Coverage contains details about your health plan. It includes important information such as phone numbers, a list of medical services your plan pays for, and your rights and responsibilities as an Essential Advantage member. Please read this important document and keep it for reference.


Membership card

EOC Chapter 1, Sec. 3.1

Your HMSA membership card is your ticket to quality medical care in Hawaii. Carry it with you when you see a doctor or go to a hospital.

Important numbers and resources

EOC Chapter 2

Need to speak with someone about a claim? Call us to learn more about your health plan.

Coverage decisions

EOC Chapter 9, Sec. 5.2

Call us to see if your plan pays for certain medical services and how much it may cost.

Exceptions and appeals for medical services

EOC Chapter 9, Sec. 5.3

If you disagree with our decision to deny a medical claim, we’ll take a second look at it.


EOC Chapter 9, Sec. 10

If your plan isn’t meeting your needs, you can file a complaint about the quality of care you receive, waiting times, customer service, or other concerns not related to your health plan benefits or payment.

Ending your membership (disenrollment)

EOC Chapter 10

Find out what you need to do if your health plan ends.

Coverage determination

EOC Chapter 9 Sec. 6.4

You can ask us about your prescription drug benefits, including quantity limits, prior authorization, step therapy, and cost sharing.

Appeals for prescription drugs

EOC Chapter 9 Sec. 6.5

If we denied your request to pay for a prescription drug, you can appeal our decision.

Exceptions for prescription drugs

EOC Chapter 9 Sec. 6.2

If your health plan doesn’t pay for a drug you need, we’ll work with you and your doctor to find a solution. We want to make sure you get the medications you need.

Transition process

EOC Chapter 5 Sec. 5.2

If your health plan doesn’t pay for a drug that you need, we may offer you a temporary supply. This gives you and your doctor time to find an alternative treatment.

Organization Determinations and Appeals for Medical Benefits

Organization determinations
(Prior authorization)

For your safety, prior authorization, or precertification, is required for certain medical services. That means your provider will need to ask your health plan first whether it will pay for that service. If you’d like to receive a service but aren’t sure if your plan will pay for it, call us or check your Evidence of Coverage.


If you disagree with a claim we denied, you can appeal that decision.

Appointing a representative

You can authorize someone to act as your representative for certain health care decisions.

Instructions Download

Coverage Determinations and Appeals for Prescription Drugs

Coverage determinations

Need a drug that your health plan doesn’t pay for? Need an exception to prior authorizations, quantity limits, step therapy, or drug tiers? You or the doctor who prescribed the medication can ask us to make an exception.

Instructions Download


If your request for a prescription drug is denied, you can appeal that decision.

Instructions Download

Appointing a representative

You can authorize someone to act as your representative for certain health care decisions.

Instructions Download