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• Organization Determination (Request for Prior Authorization)

  Some services and medical care require a coverage decision by HMSA before they can be covered.

• ACA Plan Resources

  This transparency in coverage will tell you how to submit claims, get preauthorization, and see if a prescription drug is covered.

• Annual Cost Savings Reports Discontinued

  The Annual Cost Savings Report was discontinued in January 2020.

• Order Your Prescription Drugs through the Mail

  You can save money with mail-order drugs because copayments are generally lower than when you buy a smaller supply from retail pharmacies.

• Is There a Generic Equivalent for My Brand-name Drug?

  By checking your HMSA formulary, you can see if there are any generic drug alternatives to any brand-name drugs you may be taking.

• Filing Medical Claims for Services from Nonparticipating Providers

  Providers will usually submit claims for you. If they don't, you can submit a claim yourself by following these steps.

• Improved Access to Claim Information Available in My Account

  HMSA's My Account now offers a better way to view your in-state and out-of-state claims information for most plans.

• Guest Membership on the Mainland for HMO Members

  If you're an HMSA HMO member living away from Hawaii for more than 90 days, you may have access to participating Blue Cross and Blue Shield providers through the Guest Membership program.

• Breast Feeding Support and Counseling

  Health care reform now includes breastfeeding counseling for new mothers and reimbursement for a breast pump.

• Dental Claim Form

  You can ask us to recheck a decision made about your health plan or prescription drug coverage for services or benefits you've received.

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