If you live in Hawaii, your medical plans are offered through HMSA. You can choose from a Health Maintenance Organization (HMO) plan that covers only in-network care or a Preferred Provider Organization (PPO) plan that covers both in- and out-of-network care.

Since the big difference between the two plans is in-network vs out-of-network coverage, you'll want to check if the doctors who are important to you are in-network. You can call 1-800-776-4672 or view the Online Provider Directory at hmsa.com.

Below are more details on the plans:

HMSA Health Maintenance Organization (HMO) plan

This plan covers in-network care including office visits, prescription drugs, naturopathy, acupuncture and hearing aids. There is no deductible and you pay nothing for preventive care. You'll pay less out of your paycheck for this plan and you have a $20 copay for primary care and specialists (you need a referral).

The maximum you'll pay for the year is $2,500 for an individual or $7,500 if you cover dependents. The maximum you'll pay for the year for prescription drugs is $3,600 for yourself and $4,200 if you cover dependents.

HMSA Preferred Provider Organization (PPO) plan

This plan covers both in-network and out-of-network care including office visits, prescription drugs, acupuncture and hearing aids. You pay more out of your paycheck for this plan than the HMO plan as you're able to see any doctor you'd like.

There is no deductible for in-network care and you pay nothing for preventive care. For out-of-network care, there is an annual deductible of $100 for yourself or up to $300 if you cover dependents. This plan charges a $12 copay or coinsurance for office visits. No referrals are needed for specialists.

The maximum you'll pay for the year is $2,500 if it's only you or $7,500 if you cover dependents for medical services. The maximum you'll pay for the year for prescription drugs is $3,600 individually and $4,200 if you cover dependents.

Bi-Weekly Costs

For each plan, there are different rates, based on who you cover.

Provider Contact

HMSA (Hawaii Only)
Toll Free: (800) 776-4672
hmsa.com
Group #94833
Hours: M-F 8 a.m. – 5 p.m. Local Time