Advanced Care Program

HMSA’s Advanced Care Program supports members who have three or more targeted chronic conditions and could benefit from increased support and care management. The program provides clinician-led care coordination and support from community health workers.

Advanced Care offers personalized support to help you understand and manage your health conditions and get timely, coordinated access to care. We work closely with your doctors to help coordinate your treatment, medication, and other services. Our goal is to ensure you can access the care you need and achieve your best health and well-being.

This program is voluntary and available at no cost to eligible HMSA members.

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How will I work with my care manager?

Care management and coordination are provided by registered nurses, social workers, and community health workers. Advanced Care managers address medical, behavioral, and mental health needs and support social needs for those with complex conditions.

Services may include:

  • Timely, accurate, and creative member-centered care coordination.
  • Evidenced-based interventions to manage conditions, improve health outcomes, and avoid unnecessary care.
  • PCP visits or establishing care with a PCP if needed.

In addition your care management team will connect with you or your caregiver by phone, virtual visit, or in person. You can meet or talk with them from home, your provider’s office, or an HMSA Center.

Your care manager and community health worker can collaborate with your health care team to:

  • Coordinate your care plan.
  • Discuss your health needs with your care team and caregiver(s).
  • Help you understand and follow instructions from your health care team.
  • Help you understand your medications and treatment plan.
  • Create or reinforce an action plan that includes steps to take if your symptoms worsen and when to contact your doctor.
  • Help you understand discharge instructions if you’re hospitalized.
  • Help you set and achieve health goals.
  • Connect you with resources to support your health and well-being.
  • Discuss an advance health care directive, living will, or power of attorney.
  • Help coordinate out-of-state care.

For more information about this program, call HMSA Health and Well-being Support at 1-855-329-5461, option 1.

What resources can I use?

Below are links to instructions and forms that you may need.

HMSA Coordination of Benefits

This form will help coordinate your health plan benefits.

Advance Health Care Directive

An Advance Directive is a written statement about your future medical care.

HMSA Authorized Representative form [PDF]

Complete this form to appoint a family member, friend, or another person who may need to access your health information on your behalf.

Mail-service Order form

Mail-order prescription medications are available to most HMSA drug plan members. You can save money with mail-order drugs because copayments are generally lower than when you buy from retail pharmacies. Check your drug plan certificate to see if you have mail order as a benefit.

External Resources for Additional Support:

Elderly Affairs

808-643-2372

City and County of Honolulu Elderly Affairs Division

elderlyaffairs.com/

808-768-7700

CMS Coordination of Benefits

Click on the CMS.gov link. If you have more than one health plan, coordination of benefits will ensure that the primary plan pays first.

Maui County Office on Aging

mauicountyadrc.org/

Maui: 808-270-7774

Molokai: 808-553-5241

Lanai: 808-565-6818

Hawaii County Office of Aging

hcoahawaii.org/

808-961-8600

Hilo: 808-961-8626

Kona: 808-323-4392

County of Kauai Agency on Elderly Affairs

kauaiadrc.org

808-241-4470

Hawaii CARES Crisis Hotline – Call 988

https://hicares.hawaii.gov/

Crisis hotline 988

More Resources to Help You on Your Journey.

hmsa urgent care

A Guide to After-hours Care [PDF]

Use this guide so you know where to go for your care.

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Your Guide to Benefits will tell you what your health plan pays for and what you can expect to pay out of pocket. You may access your Guide to Benefits through My Account. If your plan’s Guide to Benefits isn’t online, call us at 808-948-6079 or 1-800-776-4672.

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Health Condition Support and Resources

Get personalized support for your health conditions. Our team of clinicians, coaches, and educators can help connect you with the resources you need.

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Health Education Workshops

Attend workshops in person or online at no cost on a variety of well-being topics, such as nutrition, physical activity and exercise, stress management, and more.

Disclaimer

The information you obtain from the sources on this site or any other service offered by or through this site should not substitute for or be used instead of a relationship with a health care professional. We encourage you to seek the advice of and regularly consult with physicians and other health care providers.