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Update on HMSA operations related to Iselle. Learn more.

Member Resources: Akamai Advantage Select Plus 2014

To help HMSA Akamai Advantage members get the most out of your coverage, here’s a list of services and pointers. If you have any questions, call HMSA Customer Relations at 808-948-6000 on Oahu or 1-800-776-4672 toll-free seven days a week, 8 a.m. to 8 p.m. TTY users, call 711.

If you’d like to make a complaint or file a grievance, call us. You can also call 1-800-MEDICARE 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048. You can also submit a complaint online at the Medicare website.

For information on the Medicare Beneficiary Ombudsman, visit medicare.gov


Tools to help you get the most out of your plan

Find more resources on our Drug Tools page.

Dues Payment Service/EFT

A simple, convenient way to pay your monthly premiums and prescription drug coverage by partnering with your financial institution.

Instructions Download

Visitor/Travel Program

As an Akamai Advantage member, you can travel to 33 states on the Mainland and Puerto Rico and pay the same in-network costs you normally would when you’re home.

Akamai Advantage Dental Discount Program

HMSA Akamai Advantage members receive exclusive discounts for a variety of dental services.

HMSA365

Members can save on products and services like LASIK®, Lifeline®, fitness classes, hearing aids, and more!

Appoint an authorized representative

You can appoint a personal representative to act on your behalf in the event that you are too ill to make your payments or perform other matters concerning your HMSA membership.

Instructions Download

Interpretive Services

We have free interpreter services to answer your questions about your plan. Please give us a call.

Download

My Account

Register and log on to HMSA My Account to see your Explanation of Benefits online.

Changing your plan

Your health care needs may change as time goes on, and that’s OK. Give us a call if you need to change to another Akamai Advantage plan.

Instructions Download


Provider Network

Find a Doctor

Use our search tool to find your doctor in our network or to find another participating provider.

Provider Directory

The Provider Directory includes a list of our network providers and other participating facilities.


Evidence of Coverage

Use this booklet to learn about the details and rules of your plan. It also gives you important information like phone numbers, benefit charts to help you understand what’s covered, and your rights and responsibilities as an HMSA Akamai Advantage member.

Download

Membership card

EOC Chapter 1, Sec. 3.1

Your HMSA membership card is your ticket to more than quality health care. You can present your card to get discounts with HMSA365 or use it to get care outside of Hawaii.

Important numbers and resources

EOC Chapter 2

Whether you need to speak with someone about a claim or want to know when the next Medicare seminar is, give us a call.

Coverage decisions

EOC Chapter 9, Sec. 5.2

Also referred to as organization determinations, you can call HMSA to find out whether a medical service is covered on your plan and how much it will cost you.

Exceptions and appeals

EOC Chapter 9, Sec 5.3

If you disagree with us on any denied claim, we’ll take a second look at it.

Grievances

EOC Chapter 9, Sec. 10

We have a process to make a complaint about quality of care, waiting times, customer service, or other concerns not related to benefits, coverage, or payment.

Ending your membership (Disenrollment)

EOC Chapter 10

When it’s time for you or HMSA to end your coverage, you’ll want to be familiar with the process.


Organization Determinations and Appeals

Organization determinations
(Prior authorization)

Prior authorization, or precertification, is required for certain medical services. If there’s a service you’d like to have and aren’t sure if it’s covered on your plan, give us a call and we’ll find out. There are also some tips in your Evidence of Coverage.

If you need a total number of grievances, appeals, and exceptions filed with Akamai Advantage, please call HMSA Customer Relations at 808-948-6000 on Oahu or 1-800-776-4672 toll-free on the Neighbor Islands or Mainland. Telephone representatives are available seven days a week, 8 a.m. to 8 p.m. TTY users, call 711.

Appeals

If you disagree with us on any denied claim, we’ll take a second look at it.

Appointing a representative

You can name another person to act as your representative for certain health care decisions.

Instructions Download