Search

Search

Edit tags: benefits

Results

• Who Should Get the MMR Vaccine?

  The Hawaii Department of Health (DOH) has issued an advisory recommending an additional measles, mumps, and rubella (MMR) vaccine for at-risk individuals.

• Who Qualifies as an Eligible Dependent?

  Generally, a subscriber's spouse and children are eligible dependents. Check with your plan administrator or Guide to Benefits for more information.

• What Are Generic Drugs and When Does a Drug Become Generic?

  Generic drug versions may be introduced after the patent for the brand-name drug expires, which is usually 20 years.

• Patient Centered Medical Home: A Path to Quality, Affordable Health Care

  A patient-centered medical home is not a building, it's a model of care designed to better coordinate your care with an emphasis on your overall well-being.

• When Prior Approval (Precertification) is Denied or Not Requested

  If your precertification request is denied and you disagree with HMSA's decision, you or your provider may submit an appeal.

• What's an Eligible Charge?

  The eligible charge is the lower of the participating provider's actual charge or HMSA's maximum allowable fee.

• What's a Report to Member?

  The Report to Member is an explanation of benefits. It is not a bill for services or supplies.

• What's an Annual Deductible?

  The annual deductible is a fixed dollar amount you pay for covered services each calendar year or plan year before HMSA will pay for certain services.

• What's an Annual Copayment Maximum?

  The annual copayment maximum is a fixed limit or cap to your total out-of-pocket expenses for most covered services in a calendar year or plan year.

• What's a Lifetime Maximum?

  A lifetime maximum is the maximum dollar amount that will be paid on your behalf under your HMSA plan.

• Prev
• 3
• 4
• 5
• 6
• 7
• Next