Search

Search

Edit tags: coverage

Results

• What's an Annual Copayment Maximum?

  The annual copayment maximum is a fixed limit or cap to your total out-of-pocket expenses for most covered services in a calendar year or plan year.

• What's a Lifetime Maximum?

  A lifetime maximum is the maximum dollar amount that will be paid on your behalf under your HMSA plan.

• What’s a Benefit Maximum?

  A benefit maximum is a limit on a covered service or supply. A service or supply may be limited by dollar amount, duration, or number of visits.

• Using Nonparticipating Providers for Physical or Occupational Therapy

  If you're currently seeing a provider outside Hawaii or a nonparticipating provider for therapy services, ask the provider to submit a precertification request for any services.

• Services Your Plan Doesn't Cover

  Our benefits are designed to keep you safe, promote correct use of services, and keep health care costs down.

• Services Involving New Technology

  HMSA requires precertification for any treatment involving new technology. The service won't be covered if your treatment doesn't meet HMSA's payment guidelines.

• Screening and Diagnostic Tests

  HMSA plans cover a variety of tests that can fall under one of two categories: screening or diagnostic. The reason you are taking a test determines the category.

• Request For Insurance Commissioner External Review

  You can ask to have an independent review organization look over your appeal if you think we made a mistake.

• Find an HMSA Participating Retail Pharmacy

  You can use the Find a Doctor tool to find an HMSA participating pharmacy, too. Find out how it works.

• Physical Exams

  Your physical exam benefits will cover a checkup and any vision, hearing, or other recommended screening tests appropriate for your age and gender.

• Prev
• 6
• 7
• 8
• 9
• 10
• Next