The Hawaii Medical Service Association (HMSA) Comprehensive Medical (797) plan is a Preferred Provider Organization (PPO) that contracts with a network of physicians and other medical professionals from which you can select your provider.
Here is a summary of the key plan features:
HPN Solutions HMO
In-network*
Annual Deductible
$350 individual / $1,050 family
Coinsurance
20%
Annual Out-of-Pocket Maximum
$3,000 individual / $9,000 family
Outpatient Services
Preventive Care
No charge
Primary Care/Specialist Office Visits
$17 copay / visit
Virtual Visit
No charge
Urgent Care
$17 copay / visit
Emergency Room
20% after deductible
Diagnostic Lab and X-Ray
20% after deductible
Outpatient Surgery
20% after deductible
Inpatient Hospitalization
20% after deductible
Other Services
Mental Health/Substance Abuse
20% after deductible
Durable Medical Equipment
20% after deductible
Prosthetic Devices
20% after deductible
Home Health Care
No charge
Skilled Nursing or Extended Care Facility
20% after deductible
*For out-of-network coverage details, review the plan document. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider’s charge and what your plan pays (balance billing). Be aware, your network provider might use an out-of-network provider for some services (such as lab work). Check with your provider before you get services.
HMSA offers virtual health care visits, which means you can sit back and talk to board-certified doctors anywhere you’re most comfortable. It’s perfect for those times when you’re too busy to get an appointment with your primary care doctor or they are simply too far away.
Urgent conditions such as bronchitis or ear and sinus infections
Common conditions such as a cold or the flu
Chronic conditions such as diabetes, hypertension, and allergies
Medication management
Diabetes prevention
Nutrition education
Health and wellbeing goals
Emotional support
Stress and anxiety management
Couples or family counseling
To learn more and get started, go to HMSA's Online Care or download the HMSA Online Care app on the App Store or Google Play.
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