Your Health Plan Benefits Outside the United States

HMSA members, except those covered by the HMSA Children’s plan, have benefits for medical services delivered outside the United States through the BlueCard Worldwide network.

Note: The HMSA Children’s Plan does cover emergency services, but urgent care isn’t a covered benefit.

PPO plan benefits

HMSA’s PPO plans cover medical services delivered outside the United States by both participating BlueCard Worldwide providers and nonparticipating providers. To get the best benefit, visit a BlueCard Worldwide provider. You’ll pay a greater share of the total costs if you see a nonparticipating provider.

HMO plan benefits

HMSA’s HMO plans cover limited services outside the United States. Emergency services are a benefit. Urgent care is also a benefit when services are received from a BlueCard Worldwide provider. All other medical services must have a referral from your primary care provider and approval from HMSA before services are rendered or you’ll bear the entire costs of services, which can be significant.

Please refer to your Guide to Benefits or call HMSA Customer Relations for information about your specific plan benefit.

Payment for services outside the United States

You may be responsible for the total charge in full at the time of service for outpatient services. You may also be responsible for the total charge in full at the time of service for inpatient services received from a nonparticipating provider. HMSA will reimburse you for a portion of the costs, based on your plan benefits, when your claim is processed.

HMSA pays benefits based on the foreign currency conversion rate in effect at the time services were rendered. Reimbursement for medical services rendered in foreign countries are based on the actual charge you paid or the eligible charge for equivalent services in Hawaii, whichever is lower.

For more information about filing your claim to HMSA for services received outside the United States, please read Filing Medical Claims for Services from Nonparticipating Providers. If you want to be reimbursed in the foreign currency of the country you’re visiting, you may file your claim with BlueCard Worldwide instead of HMSA. BlueCard Worldwide claim filing information can be found on the BlueCard Worldwide - When Traveling Outside the U.S. Web page.

For additional important information, we encourage you to read: