Hmsa ppo benefits. 2025 PPO Standard Dental Manual .

Hmsa ppo benefits The number is on your HMSA card. • Call 1 (800) 810-BLUE (2583) toll-free for doctors where you’ll be traveling. employees only (excluding Puerto Rico based employees). Fee schedules for HMSA dental PPO and Medicare Advantage plans, and Benefit Matrices for all HMSA dental plans are available on a secure site through the link below. Benefits and costs are based on the terms and conditions of your plan, specific exclusions and limitations, coordination of benefits, privacy, third party liability, eligibility requirements, and appeal rights, none of which are described here. com . This is a 3. Learn more about HMSA Akamai Advantage Dual Care (PPO D-SNP) H3832 - 011-0, including the health and drug services it HMSA Akamai Advantage Standard Plus (PPO) 2025 HMSA Akamai Advantage Standard Plus (PPO) H3832 — 008 — 0 is a Medicare Advantage plan with drug coverage. Coverage Period: 01/01/2024 – 12/31/2024 Coverage for: Individual / Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Learn more about HMSA Akamai Advantage Complete (PPO) H3832 - 009-0, including the health and drug services it covers, by reading our easy-to-use DENTAL BENEFITS HMSA PPO Dental Plan HMSA HMO Dental Plan You Pay PPO Network You Pay Hawaii Family Dental Centers Annual plan maximum 1 (per individual) $1,500 $0 Rollover Amount Up to $500 (max accumulation of $1,250) N/A Diagnostic and Preventive Exams (two per calendar year) The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. NOTE: These CDT Procedure Guidelines are to be used as a reference for claim submission based on the level of benefits for each subscriber’s plan. hmsa. Stride Bank is an independent company offering debit card services and is HMSA PPO Plan A | HMSA HMO | HMSA CompMED Note: For U. Infertility treatment is covered. If there’s discrepancy between this presentation Understand important information about your plan: This benefits at-a-glance-summary provides a basic overview and comparison of a few of the benefits. EUTF HMSA 90/10 PPO Plan: Summary of Benefits and Coverage Guide to Benefits: Summary of Benefits and Coverage Guide to Benefits: EUTF HMSA 80/20 PPO Plan: Summary of Benefits and Coverage Guide to Benefits: Summary of Benefits and Coverage Guide to Benefits: EUTF HMSA 75/25 PPO Plan: This brochure describes the benefits of HMSA Plan under contract (CS 1058) between Hawai‘i Medical Service Association (HMSA), an independent licensee of the Blue Cross and Blue Shield Association and the United States Office of Information contained in this document does not guarantee payment. HMSA Akamai Advantage Complete (PPO) 2025 HMSA Akamai Advantage Complete (PPO) H3832 — 009 — 0 is a Medicare Advantage plan with drug coverage. Blood Work Inpatient 10% coinsurance 30% coinsurance Services may require preauthorization. to 5 p. To dispute a decision made by HMSA related to benefits, reimbursement, or any other decision or action by HMSA, please follow the instructions at hmsa. His doctors charge $100 per visit before insurance pays. Shop plans. Company: HMSA Akamai Advantage Plan enrollment: 2,676 HMSA PPO Plan Comparison for Self-only HMSA 90/10 HMSA 80/20 HMSA 75/25 Total Estimated Annual Cost: Annual Employee Premium Contribution* $4,786 $3,180 Rick anticipates 4 doctor visits during the calendar year. Individual Dental PPO Platinum (Plan D91) coverage offers you flexibility in the way you get medical benefits. Have Medicare Part A (hospital insurance) and Part B This Plan's health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. com represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Compare plans. 00. About Your PPO Program Your health care coverage is a Preferred Provider Organization. It has received a 3. com EUTF HMSA 90/10 PPO Plan (Medicare) Guide to Benefits: Guide to Benefits: EUTF HMSA 90/10 PPO Plan (Non-Medicare) Guide to Benefits: Guide to Benefits: For HSTA VB Members. 2 of 8 RCUH: HMSA CompMED M248_2/1/2021_OE Medicare Part B Give Back Benefit. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. . Wellness exams. Adult benefits (age 19 and older) Pediatric benefits HMSA Akamai Advantage Dual Care (PPO D-SNP) 2025 HMSA Akamai Advantage Dual Care (PPO D-SNP) H3832 — 011 — 0 is a Medicare Advantage plan with drug coverage. • See Blue Cross and Blue Shield doctors for the If you live in Hawai‘i, Adobe offers bundled health care through HMSA, which is summarized in HMSA benefits at a glance [PDF] and includes medical, prescription, dental, and vision coverage through these plans: CompMED medical plan (730) and drug plan (972) Vision PPO (DU) Dental PPO (C53) You can also waive all coverage. Understand important information about your plan: This benefits at-a-glance-summary provides a basic overview and comparison of a few of the benefits. 5-star Medicare Advantage plan. HMSA Akamai Advantage Dual Care is a Preferred Provider Organization (PPO) plan. of benefit coverage. Every year, Medicare evaluates plans based on a 5-star rating system. The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans. 1 to June 30, 2024, will count toward your new 75/25 EUTF plan’s out-of-pocket maximum. Benefits may be denied if Outpatient 20% coinsurance 20% coinsurance preauthorization is not obtained. According to the National Association of Dental Plans (NADP), only 9% of people who have a dental plan reach their calendar year maximum benefit. If you do, however, you may be responsible for paying costs over the maximum. 1 Dear Valued Dentist: We are pleased to provide you with the Hawaii Medical Service Association (HMSA) 2025 Dental Manual You can choose to use the vision benefits, which are automatically included in your medical plan (Kaiser HMO or HMSA PPO) at no additional cost to you. Please see www. In general, to get the best benefits possible, you should seek services from HMSA Participating Providers. Already a member? Find a dentist, see your Guide to Benefits and claims information, and more. See page 8 for details. Enrollment depends on the plan’s contract renewal. To keep pace with change, HMSA’s New Technology Assessment Committee Understand important information about your plan: This benefits at-a-glance-summary provides a basic overview and comparison of a few of the benefits. HMSA Akamai Advantage Standard (PPO) Hearing Aid Benefits H3832-007-0 HMSA Akamai Advantage Standard (PPO) plan information last updated December 22, 2023. 2024 Summary of Benefits H3832_2025_R9A471_24_M This is a summary of health services and drug benefits for HMSA Akamai Advantage® Prime MA (PPO) plan effective Jan. HMSA Dental PPO Bronze Your dental benefit dollars can add up Questions? Our Customer Service team can help! Just call (808) 948-6440 or 1 (800) 792-4672, Monday through Friday, 8 a. HMSA Akamai Advantage® is a PPO plan with a Medicare Contract. Additional Benefits and Federal law requires HMSA to provide you with this notice. Eligibility; Enrollment Overview; Qualifying Events; Premiums & Contributions; EUTF Premium Plan Comparison Tool; Forms & Documents. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2025 - 12/31/2025 HMSA: MED 797 / DRG 860, Radiology Partners Inc Coverage for: Individual / Family | Plan Type: PPO Important Questions Answers Why This Matters: or to get a copy of the complete terms of coverage, visit www If you were enrolled in another HMSA employer group plan before July 1, 2024, any out-of-pocket costs you paid under the other plan from Jan. Network management and claims and benefit Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services HMSA: MED 590, SAFEWAY INC. HMSA’s Online Care. HMSA Preferred Provider Plan . HMSA Akamai Advantage Complete Plus (PPO) qualifies for a monthly Medicare Give Back Benefit of $6. • Visit the Blue Cross Blue Shield Doctor & Hospital Finder website at BCBS. This means you Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2025 - 12/31/2025 HMSA: MED 754 / DRG 860, LEIDOS Coverage for: Individual / Family | Plan Type: PPO Important Questions Answers Why This Matters: or to get a copy of the complete terms of coverage, visit www. American Well is an independent company. Care during the late shift. HMSA complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, What You Should Know about this Guide to Benefits . 1, 2024. Speak HMSA Silver PPO includes the following benefits at the cost sharing rates listed below. americanwell. com for more information. Individual Dental PPO Bronze (Plan 207) Fee Schedules and Benefit Matrices. NOTE: Information about the cost of this plan (called the premium) will be provided Partners of Healthplanradar. We value your membership. Your Type 1 NPI (Individual and unique to provider) is required for access. HMSA Dental PPO Gold Your dental benefit dollars can add up Questions? Our Customer Service team can help! Just call (808) 948-6440 or 1 (800) 792-4672, Monday through Friday, 8 a. Learn more about HMSA Akamai Advantage Standard (PPO) H3832 - 007-0, including the health and drug services it covers, by reading our easy-to-use 2025 Medicare Advantage Plan Benefit Details for the HMSA Akamai Advantage Complete Plus (PPO) Medicare Plan Name: HMSA Akamai Advantage Complete Plus (PPO) Location: Honolulu, Hawaii Click to see other locations: Plan ID: H3832 - 010 - 0 Click to see other plans: Member Services: (800)660-4672 TTY users 711: Medicare Contact Information: Calendar year maximum benefits. limited to a one-time only benefit for one outpatient procedure while you are an HMSA member) • Non-emergency care when traveling outsidethe U. HMSA Akamai Advantage Complete (PPO) qualifies for a monthly Medicare Give Back Benefit of $6. These plans do not offer Oral Health for Total Health benefits. The HMSA PPO for our Hawaii Team Members provides comprehensive coverage and emergency care in the Hawaiian islands, on the mainland, and when you travel outside of the United 2024 – 2025 HMSA PPO Benefits Guide 2024 – 2025 HMSA PPO Medical Plan SBC 2024 – 2025 HMSA Dental Guide 2024 – 2025 – HMSA Vision Guide 2024 – 2025 – HMSA Perscription/RX Guide. These costs are listed in this summary section and a full list of benefit costs for HMSA Akamai Advantage Dual Care (PPO D-SNP) are defined below. Take charge of your health with an annual physical exam benefit. Please read it carefully and keep it for future reference. All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies. 2 of 8 RCUH Plan: HMSA PPO M248_2/24/2020_OE Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services HMSA: MED 762 / DRG 972 / VIS 0GA / DEN C53 Coverage Period: 07/01/2024 - 06/30/2025 Coverage for: Individual / Family | Plan Type: Details Drug Coverage for the HMSA Akamai Advantage HMSA Akamai Advantage Complete Plus (PPO) H3832-010 (PPO) in Hawaii. 2025 HMSA PREFERRED PROVIDER DENTAL PLANS - Federal Postal Service Workers (PSHB) PLAN PAYS RCUH: HMSA PPO Comparison Preferred Provider Comp Med Comp Med Basic (ACA) Preferred Provider Plan (762) Comprehensive Medical (730) Comprehensive Medical certificates, or amendments. Serving: All of Hawaii Enrollment in this This coverage offers you flexibility in the way you get medical benefits. Adult benefits (age 19 and older) Pediatric benefits (to age 19) Deductible HMSA PPO Coverage in Hawaii and Beyond. As a member of this {plan_type_2} plan, you typically access care through in-network providers, but you have the flexibility to see out-of-network providers if needed. Employees represented by a collective bargaining agreement may not be eligible for all all benefits described in this presentation and should refer to applicable union contracts. Prime MA (PPO) HMSA Akamai Advantage Your Medicare Advantage Plan Guide. 34 Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 07/01/2017 – 06/30/2018 HMSA: MED 734 / DRG 860 / VIS 0DU / CMP C02, RCUH Coverage for: Individual / Family | American Well provides the hosting and software services for HMSA's Online Care. Refer to the plan brochure for covered services, criteria, and limitations. This Guide to Benefits provides details about your HMSA dental plan. Your plan documents also provide complete information to submit a claim, All services received from a participating or in-network provider will be covered before you meet your deductible. S. HMSA Akamai Advantage Standard (PPO) qualifies for a monthly Medicare Give Back Benefit of $6. g. com Blue Exchange button Eligibility: call 1 (800) 676-2583 1 (800) 676-2583 Health Plan Cost Sharing & Benefits. Date of Birth There are many programs and services that are included in your health plan benefits to help you improve your health and well-being. For 2025 PPO Standard Dental Manual 01-2025 . This plan is accredited. Not all plans offer all of these benefits. 2024-25 Reference Guide; 2024-25 EC-1 Form; New Hire Enrollment HMSA Small Business Dental PPO Gold 1500 Download PDF HMSA Small Business Dental PPO Platinum 1000 Download PDF HMSA Small Business EyeMed Vision HPH 2B Our partnerships with the largest health care and voluntary benefit providers gives you access to a comprehensive range of affordable benefits, without the administrative burden. In general, to get the All services received from a participating or in-network provider will be covered before you meet your deductible. 5-out-of-5 star rating from CMS for 2025. HMSA; CVS Caremark; Kaiser Permanente; Verdegard (formerly HMA) HDS; VSP; Securian; Premium Conversion Plan; Enrollment & Premiums. Questions? Call 1-800-764-1344 (TTY 711) Sign Up. Does HMSA quest cover vision? Effective January 1, 2022, HMSA has partnered with EyeMed for routine vision services for the following lines of business: Commercial, Akamai Advantage, QUEST Medicare Part B Give Back Benefit. Aloha, Thank you for choosing HMSA. Kinside can help you find child care that meets your needs—and your work schedule. m. The following links provide information on some of the health plan benefits you may want to take advantage of such That's why HMSA offers a variety of affordable dental plans. PPO dental plans typically have a yearly limit on what the plan will pay for services. See page 13. Plan Benefits. Total $400 Coinsurance 10% $40 Coinsurance 20% $80 $4,786 $0$3,180 Calendar Year HMSA PPO members: • Check your HMSA membership card for the PPO suitcase logo. This plan covers some items and services even if you haven’t yet met the Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2025 - 12/31/2025 HMSA: MED 797 / DRG 860, Radiology This is a summary of health services and drug benefits for HMSA Akamai Advantage® Prime MA (PPO) plan effective Jan. For more information, see www. Your opportunity to take an active role in your health care decisions makes this coverage special. The SBC shows you how you and the plan would Preferred Provider Plan (751) Health Plan Hawaii Plus (X-S) PPO Network HMO Network Member Cost Member Cost Lab Tests (e. Learn more about HMSA Akamai Advantage Standard Plus (PPO) H3832 - 008-0, including the health and drug services it covers, by reading our HMSA Dental PPO Silver Your dental benefit dollars can add up Questions? Our Customer Service team can help! Just call (808) 948-6440 or 1 (800) 792-4672, Monday through Friday, 8 a. Benefits may be denied if Outpatient No charge No charge preauthorization is not obtained. HMSA Plan January 1 - December 31, 2025 January 1 - December 31, 2024; HSTA VB HMSA 90/10 PPO Plan (Medicare) Partners of Healthplanradar. Imaging (CT/PET scans, MRIs) Inpatient 20% coinsurance 20% coinsurance Services may require preauthorization. The SBC shows you how you and the plan would RCUH: HMSA PPO M248_2/1/2021_OE. Benefits may be denied if Outpatient 20% coinsurance 30% coinsurance preauthorization is not obtained. Page 2 of 3 Online Care To get started: 1 (866) 939-6013 1 (866) 939-6013 BlueCard Eligibility: online hhin. This plan covers some items and services even if you haven’t yet met the Receive adult vision benefits for eye exams, eyeglasses, and contact lenses. HMSA: MED 562, EUTF 90/10 Coverage for: Individual / Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services. A healthy smile can do more for your health than meets the eye. HMSA Dental PPO Platinum Your dental benefit dollars can add up Questions? Our Customer Service team can help! Just call (808) 948-6440 or 1 (800) 792-4672, Monday through Friday, 8 a. , bloodwork) 10% coinsurance 10% coinsurance The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Enrollment in HMSA Akamai Advantage depends on contract renewal. For non-federal governmental group health plans and church plans that are group health plans, you must submit a written request for an appeal to: HMSA Medicare Part B Give Back Benefit. com. HMSA: MED 852, EUTF 75/25 Coverage for: Individual / Family | Plan Type: PPO All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies. Good oral care can improve HMSA Akamai Advantage Standard (PPO) 2025 HMSA Akamai Advantage Standard (PPO) H3832 — 007 — 0 is a Medicare Advantage plan with drug coverage. This HMSA PPO Benefit Table is not intended to replace or supersede dental policy or the members' Guide to Benefits. The HMSA Extra Benefits Mastercard® Prepaid Card is issued by Stride Bank, Member FDIC, pursuant to license by Mastercard International. Guide to Benefits HMSA Group Dental PPO Plan (C53) 2020. , or visit hmsadental. Stride Bank is an independent company offering debit card services and is This brochure describes the benefits of HMSA Plan under contract (CS 1058) between Hawai‘i Medical Service Association (HMSA), an independent licensee of the Blue Cross and Blue Shield Association and the United States Office of HMSA Akamai Advantage® is a PPO plan with a Medicare Contract. hol srvnyglwi dow kgxk aacap ziz yfye fnhj wihb vyit whizgro jto sgr cusryw aqnt