HMSA’s 65C Plus (Cost) is closed to new members as of Jan. 1, 2011. Current 65C Plus members can
remain in 65C Plus in 2013, unless they choose to leave the plan. HMSA is offering
Akamai Advantage for an effective date of Jan. 1, 2013.
With 65C Plus Basic Option (Cost), you have low monthly premiums and cost-share
for outpatient services, such as:
- Doctor’s visits.
- Lab tests.
For more detailed explanation, please refer to the appropriate plan option Summary of Benefits or Evidence of Coverage brochure.
65C Plus (Cost) is easy to use. 65C Plus (Cost) contracting providers file claims
for 65C Plus (Cost) members. There are no enrollment waiting periods or health screenings,
and you’ll never lose your coverage because of your health status.
Current 65C Plus (Cost) members with questions about their plan may contact
Customer Service from 8 a.m. to 8 p.m., seven days a week.
Oahu: (808) 948-6000
Neighbor Islands: 1 (800) 776-4672 (toll-free)
For the hearing- and speech-impaired:
HMSA 65C Plus
P.O. Box 860
Honolulu, HI 96808-0860
Appeals & Grievances
65C Plus (Cost) has a contract with the Centers for Medicare & Medicaid Services
(CMS), the government agency that runs the Medicare program. This contract renews
each year. At the end of each year, the contract is reviewed, and either 65C Plus
(Cost) or CMS can decide to end it. It is possible for our contract to end at some
other time during the year, too. If the contract should end, HMSA will provide advance
notice to all 65C Plus (Cost) members.
- Benefits, premium, and/or copayments/coinsurance may change on Jan. 1, of each year.
- Limitations, copayments, and restrictions may apply.
- If you use a non-network provider without an approved referral from a network provider,
the non-network provider will submit your claim for processing to Medicare first.
Medicare will apply the annual Part B deductible before it pays for any services.
Once Medicare processes your claim, submit the Medicare Summary Notice to HMSA for
processing your plan benefits. The Medicare Part B deductible must be met first
before HMSA will apply our plan benefits. You pay the non-network provider for any
amount not covered by Medicare and our plan. The Plans RTM, also called the EOB,
explains your financial liability. The Part B deductible is waived for a pelvic
exam, Pap smear collection, PSA test, and mammography screening.
- The benefit information provided is a brief summary, not a complete
description of benefits. For more information, contact the plan.