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HMSA Drug Plans

HMSA Private Business Plans

 

 

HMSA Non-Formulary Plans

HMSA Non-Formulary plans offers two tiers of drug benefits.

 

Note: There may be drugs which are specifically excluded from coverage, such as over-the-counter medication, vitamins, drugs for cosmetic uses, and drugs for sexual dysfunction or infertility.

 

 

 

HMSA Choice Formulary Plans

The HMSA Choice Formulary is a four-tiered open formulary.An open formulary includes all prescription drugs except those that are excluded under the health plan benefit.Brand drugs which are not listed on the formulary are considered Tier 3 Other Brand drugs and generics not listed are on Tier 1.

 

Note: There may be drugs which are specifically excluded from coverage, such as over-the-counter medication, vitamins, drugs for cosmetic uses, and drugs for sexual dysfunction or infertility. 

 

 

 

HMSA Select Formulary Plans

The HMSA Select Formulary is a four-tiered open formulary.An open formulary includes all prescription drugs except those prescription drugs that are excluded under the health plan benefit.  Brand drugs which are not listed on the formulary are considered Tier 3 Other Brand drugs and generics not listed are on Tier 1.

 

Note: There may be drugs which are specifically excluded from coverage, such as over-the-counter medication, vitamins, drugs for cosmetic uses, and drugs for sexual dysfunction or infertility.

 

 

 

HMSA Essential Prescription Formulary Plans

The HMSA Essential Prescription Formulary is a five-tiered managed formulary which limits the number of prescription medications covered and requires prior authorization for drugs that are non-formulary.

  

Note: There may be drugs which are specifically excluded from coverage, such as over-the-counter medications, vitamins, drugs for cosmetic uses, and drugs for sexual dysfunction or infertility.

 

 

 

HMSA Children's Plan

The HMSA Children's Plan is an individual plan for children who are Hawaii residents and are 31 days through 18 years of age and are not enrolled in another health plan, including The HMSA Plan for QUEST Integration Members.

 

The HMSA Children's Plan offers limited drug benefits, which are listed in the Children's Plan Formulary. The formulary is closed, meaning only drugs listed are covered benefits of the plan.

 

 

QUEST Integration Plan

The HMSA QUEST Integration Formulary is managed, drives generic use, and uses over-the-counter products when possible.However, the formulary is fortified with selected brand drugs, which have been determined to be medically necessary when equivalent generic drugs are not available or the brand drug offers better therapeutic outcomes or a more favorable safety profile.

 

 

 

Medicare Advantage Plans

The HMSA Akamai Advantage® Formulary is a five-tiered closed formulary which limits the number of prescription medications covered and requires prior authorization for drugs that are non-formulary.

 

Tier 1 - Preferred Generics

Tier 2 - Non-Preferred Generics

Tier 3 - Preferred Brands

Tier 4 - Non-Preferred Brands

Tier 5 - Specialty Tier

 

 

 

To view the previous version of this page, click the link below:

 

HMSA Drug Plans - OBSOLETE

 

First Published:07/20/2015
Latest Revision:12/07/2017
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