Dental PPO
Freedom of Choice
HMSA’s Dental PPO plan gives you the freedom to visit any dental provider
you choose. To get the best value for your health care dollar, HMSA recommends that
you choose a participating Dental PPO provider from our statewide network. It’s
easy to find an HMSA participating PPO dental provider in your area.
Find a Doctor.
Cost Savings
Receiving high quality preventive dental care is affordable when visiting an HMSA
participating Dental PPO provider:
Dental PPO covers most services without preauthorization. You’ll share in a percentage
of the cost of services. Please check your plan materials for waiting periods, age
restrictions, and other limitations.
Oral Health for Total Health
HMSA has a four-tiered approach to help at-risk members get proper dental care.
With Oral Health for Total Health, integrated medical and dental claims information
allows us to:
- Identify at-risk members who would benefit from our oral health program through
medical claims data and member self-enrollment.
- Educate our members who have coronary artery disease, diabetes, or oral cancer,
as well as pregnant women, about the benefits of good oral health.
- Engage in targeted intervention for select members who are not maintaining their
oral health.
- Remove financial barriers through Enhanced Dental Benefits, a program that provides
at-risk members with condition-specific services beyond their regular dental benefits.
- No copayment for in-network providers.
- No deductible.
- Covered outside the annual maximum.
Enhanced Dental Benefits
On January 1, 2013, Enhanced Dental Benefits will be added to the Oral Health for
Total Health program. Enhanced Dental Benefits will provide additional support for
HMSA members who have specific medical conditions at no charge with no deductible
or coinsurance for in-network services when they visit an HMSA participating provider.
If you have been diagnosed with diabetes or coronary artery disease, you are automatically
enrolled for Enhanced Dental Benefits. If you are pregnant or diagnosed with oral
cancer, you are eligible for these benefits as well, but you will need to enroll for Enhanced
Dental Benefits. For detailed information on your benefits under Oral Health for
Total Health and Enhanced Dental Benefits, simply log on to My Account at hmsa.com
and click Benefits on the Welcome page, then click the View Dental Benefits button.
On My Dental Coverage page, click the Oral Health for Total Health link at the bottom.
Your mouth is the gateway to a healthier you. Keep your teeth and gums healthy for
overall better health.
Coverage that Travels with You
Your dental plan allows you to receive benefits when you see a participating dental
provider for covered services outside Hawaii. Finding a dentist when you’re on the Mainland is easy – just
visit the national dental provider network website.
Simply present your HMSA membership card to the provider during your visit
to verify your eligibility and benefits available under your plan. Fee schedules,
costs and savings may vary from services in Hawaii depending on regional location.
Eligibility: Dental PPO is available through an employer group
health plan. Check with your employer regarding your health plan benefits.
