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• Organization Determination (Request for Prior Authorization)

  Some services and medical care require a coverage decision by HMSA before they can be covered.

• HMSA Medicare Advantage Plans Automatic Payments Form

  Have your HMSA Medicare Advantage premiums paid automatically each month when you fill out and submit this form. Most local banks, savings and loans, and credit unions participate.

• HMSA Individual Plan Automatic Payments Form

  You can avoid the stress of mailing your premiums to HMSA by signing up for automatic payment.

• HMSA Medicare Advantage Disenrollment Request Form

  This form is for current HMSA Medicare Advantage members who want to disenroll from Akamai Advantage.

• HMSA Medicare Advantage Coverage Determination Request

  Fill out this form if you have Medicare Part D and want to know if HMSA will cover a prescription drug and how much it will cost you.

• Step Therapy for Medicare Part B Prescription Drugs

  In some cases, your HMSA Medicare Advantage plan will require Step Therapy. This means you must first try one or more preferred drug alternatives to see if they work before taking a non-preferred drug.

• HMSA Medicare Advantage Member Appeals

  You can ask us to recheck a decision about your health plan or prescription drug coverage for services or benefits you've received.

• 2026 HMSA Akamai Advantage Dual Care (PPO D-SNP) Application Instructions

  Fill out this form if you've just become eligible for HMSA Akamai Advantage Dual Care or are enrolling during the open enrollment period.

• 2026 HMSA Medicare Advantage Application Instructions

  Fill out this form if you've just become eligible for HMSA Medicare Advantage or are enrolling during the open enrollment period.

• HMSA Drug Formulary

  Your formulary is a list of prescription drugs, both generic and brand name, that are covered under your drug plan. Find out what's inside your formulary.

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