No. HMSA does not cover COVID-19 testing for surveillance or employment purposes. Find a COVID- 19 testing site near you.

No. HMSA does not cover diagnostic testing for COVID-19 for travel purposes, such as to avoid quarantines associated with business or leisure travel.

Following guidance issued by the U.S. Centers for Disease Control and Prevention, HMSA will cover antibody tests only if one of the following conditions is met:

• If an individual is still showing COVID-19 symptoms seven to14 days after the onset of the illness and the antibody test is administered in addition to recommended direct detection methods such as polymerase chain reaction (PCR tests).
• If an individual is having late complications that are suspected to be related to COVID-19 such as the rare multisystem inflammatory syndrome in children (i.e., Kawasaki or toxic-shock-like syndrome) and multisystem inflammatory syndrome in adults.

HMSA will not cover antibody testing if the test is being used to indicate immunity to COVID-19. HMSA fully supports clinical advancements that improve the diagnosis, treatment, and prevention of COVID-19. However, while antibody testing may play an important public health role in the way we track COVID-19 cases and assess its impact on our population, the antibody testing is not currently recognized by the CDC as a valid diagnostic test for COVID-19 (except in the situations listed above) or a reliable test to demonstrate immunity.

We will continue to monitor the latest guidance from CDC and will update our coverage as new recommendations are made.

Yes. HMSA is working closely with the Hawaii Department of Health and our provider network to support the Hawaii vaccination plan and provide coverage for the administration of authorized vaccines. Learn more about the COVID-19 vaccine.

Yes, HMSA covers all benefits required by this law. For more information, read about HMSA’s COVID-19 Benefit Changes.

No. To comply with CDC and DOH guidelines and to help manage the health care resources available for the public statewide, HMSA cannot arrange worksite testing.

Starting Jan. 15, 2022, HMSA will cover the cost for FDA-approved over-the-counter COVID-19 diagnostic test kits for HMSA commercial plan members during the public health emergency Learn more about over-the-counter (OTC) at-home COVID-19 tests.

Yes. The diagnostic testing will be covered at 100% even if members haven’t met their deductible.

Yes, all HMSA participating providers have access to the proper billing codes to ensure that patients aren’t charged for office visits tied to COVID-19 testing.

N95, surgical, cloth, and other masks, face shields, gloves, and hand sanitizers aren’t considered medical supplies. They aren’t covered under any HMSA health plan or health savings account (HSA).

No. There are no exclusions of coverage or limitations based on pandemic classification.

Yes. HMSA will cover diagnostic lab tests for COVID-19 according to CDC guidelines with no copayment for members through the end of the public health emergency.

If the test confirms that you have COVID-19, HMSA will continue to waive the cost share for medically necessary treatment through Dec. 31, 2022, for commercial plans.

Effective Jan. 1, 2023, regular cost shares and deductibles apply for treatment of COVID-19, including hospital and office visits, for fully insured commercial members and some self-insured plans, except as required by law.*

Medicare Advantage members will continue to have no copayment for those treatments where the law so requires, which includes COVID-19 monoclonal antibodies treatment through the calendar year in which the public health emergency exists or COVID-19 oral antivirals through the end of the public health emergency. Learn more about COVID-19 benefit changes.

Since standard plan benefits for treating an illness or injury will apply, it’s important to check your coverage online or contact customer service at the number listed on the back of your HMSA membership card. HMSA will ensure that coverage for diagnostic testing for COVID-19 is closely coordinated with guidance from federal, state, and public health authorities.

If your child is covered under your plan and is diagnosed with COVID-19, HMSA will cover any medically necessary services that are consistent with CDC guidance. Your plan’s copayment, deductible, and cost sharing will apply. Learn more about COVID-19 benefit changes.

If your child is covered under your health plan and is diagnosed with COVID-19, they may be covered for illness while abroad. If you have questions about your benefits, call HMSA’s Customer Relations department using the phone number on the back of your HMSA membership card. You can also call the BlueCard Worldwide Service Center at 1-800-810-BLUE (2583) to locate doctors and hospitals or obtain medical assistance services when outside the United States.

Yes. For fully insured commercial plan members, regular cost shares and deductibles will apply for telehealth visits

Medicare Advantage and QUEST Integration members will continue to have no copayment as part of their 2023 plan benefits for all telehealth visits, including e-visits. View a list of more FAQs about our telehealth benefits.

Yes. Audio- only check-in visits will be temporarily covered for commercial plan members, some self-insured plan members, and Medicare Advantage and QUEST Integration members through the end of the federal public health emergency*.

No. 一年中开放登记是没有必要的. Hawaii’s Prepaid Health Care Act requires employers to provide coverage to eligible employees who work more than 20 hours a week. Employees may waive coverage if they have other qualified coverage.

If the circumstances covered by the waiver change, the employee is eligible for a special enrollment period, during which they could enroll themselves and their dependents in the employer sponsored plan. Employees whose job status and corresponding medical coverage have changed because of the outbreak or another reason will also qualify to enroll in a new plan and can go to the health plans page to learn more about their plan options.

Employers can adjust their eligibility rules to allow employees who don’t meet the 20 hours per week minimum requirement to be enrolled in their health care plan. HMSA will allow those enrollments with the understanding that the employer applies those rules consistently across all employees and continues to contribute to premiums at current contribution amounts and that only eligible employees are enrolled in the plan.

Yes. HMSA processes eligibility based on information from the employer. As long as the employee remains on the eligibility file and premiums are paid, they will remain covered.

No, HMSA won’t allow the dependent to continue on the group plan because we offer other options for the dependent. These include employer coverage (if the dependent is employed), an ACA individual plan, or HMSA QUEST Integration.

Yes, the Internal Revenue Service (IRS) and the U.S. Department of Labor (DOL) issued regulations (“Joint Rule”) to help participants of certain group health plans maintain health coverage during the pandemic. The Joint Rule provides an extension of certain participant deadlines to enroll in coverage due to a qualifying event, elect and pay for COBRA coverage, and make or appeal benefit claims decisions.

If you’re an employer, contact your employment counsel to determine if you’re required to offer these extensions to your employees. More information on the Joint Rule .

The deadline for an eligible employee to enroll into COBRA coverage is extended to 60 days after the end of the “outbreak period”. For employees already enrolled in a COBRA plan, the deadline to pay monthly premiums are extended until 30 days after the end of the outbreak period.

As described in the Joint Rule, the outbreak period generally runs from March 1, 2020, until 60 days after the end of the federal national emergency declaration. The end of the national emergency declaration hasn’t been announced yet, so the end of the outbreak period hasn’t been determined yet.

Special enrollment periods generally allow employees to enroll in a group health plan outside of the normal open enrollment period if they experience a qualifying event such as loss of coverage, birth or adoption of a child, or marriage. Under the Joint Rule, the SEP is extended 30 days (or 60 if applicable) after either 1) the end of the outbreak period or 2) the end of one year following the qualifying event, whichever comes first.

Yes. HMSA will not adjust a group’s rates during their 12-month contract period even if the group experienced a reduction in staff. Adjustments due to changes in HMSA enrollment may be reflected in the group’s contract renewal.

HMSA plans offer multiple options to ensure our members have access to care. These include one of the state’s largest networks of primary care providers, urgent care centers with locations statewide, CVS/minuteclinics® in selected Longs Drugs stores on Oahu, and HMSA’s Online Care®.

With Online Care, anyone in Hawaii can register and download HMSA’s Online Care app on their smartphone or other mobile device or visit hmsaonlinecare.com from a computer. Online Care providers are available 24/7 at no cost to fully insured, individual, and Medicare Advantage members. For medical emergencies, such as difficulty breathing, people should always call 911 or go to the emergency room.

HMSA is committed to protecting you and your employees and ensuring continued access to the health care and services you need. An HMSA business continuity plan is in place to ensure we remain operational and available to answer health care questions, process claims, and address your needs and the needs of your employees.

• Within our own operations, we’re following the recommended guidelines from the DOH and the CDC.
• Our corporate guidelines have been updated to include hygiene education, sick leave, self-quarantine policies, social distancing, work from home, and travel and meeting policies specific to the COVID-19 situation.
• Sales team employees, including your account managers, have the ability to work remotely. Currently, all business processes are operating normally and we expect to continue meeting our usual standards. If the situation changes, we’ll be in direct contact to let you know what options are available.
• We’re working with our providers to prepare for a potential increase in demand for health care services to ensure several care options for you and your employees.
• We’re working with our strategic business partners and communicating with vendors to make sure they have plans in place to provide critical services.
• We’re working with the Hawaii COVID-19 Task Force to make sure we’re aligned and supporting the community’s needs.

Our sales team has been working remotely since March 16, 2020, and will continue to do so until further notice. There will be no disruption to service. Your dedicated HMSA sales team will continue to be accessible via email and phone.

To comply with HMSA’s interim travel policy, all non-essential travel (to the Neighbor Islands and the U.S. Mainland) has been canceled and meetings will be held virtually using teleconferencing technology whenever possible and appropriate.

In addition, HMSA is following the state’s position on public events and social gatherings. Our corporate meeting policy uses alternative options such as virtual meetings and teleconferences.

Yes. Like all employers, HMSA is carefully balancing our commitment to maintain full servicing to our members and the state of Hawaii while doing our best to protect the health and safety of our employees. We have travel and meeting guidelines that are specific to the COVID-19 situation and will use them to evaluate each employer and community event on a case-by-case basis.

If you have health plan questions not covered in these resources, call our customer service team at the number on the back of the HMSA membership card or contact your account manager.

Get all the latest COVID-19 updates from the Centers for Disease Control and Prevention (CDC), including information for people who are at risk for serious illness and hygiene tips for home, school, and work [PDF].

Your account manager has all necessary resources to work remotely. In the event of an office closure, you’ll be able to contact your account manager by email or mobile phone.

Yes, please contact your sales representative and ask for your employees to be removed.

Commercial businesses and members:

• Pay in person at one of our centers or offices
• To pay with a credit card, debit card, or bank account:
  • Call 1-855-613-9221 toll-free, or
  • Set up Auto Pay by going to duanvinhomemetri.net and registering for MyAccount.
• Mail a check to the address on your billing statement
• Visit a Walmart Money Center inside your nearest Walmart. Be sure to take your HMSA billing statement. Walmart will charge a service fee.
• If you have questions or need help with any of these options, call us:
  • Members: 808-948-6140 on Oahu or 1-800-782-4672 toll-free on the Neighbor Islands
  • Employer groups: 808-948-6376 on Oahu or 1-800-316-4672 toll-free on the Neighbor Islands
  • Monday through Friday, 8 a.m. to 5 p.m.

Medicare members:

• Pay in person at one of our centers or offices
• To pay with a credit card, debit card, or bank account:
  • Call 1-855-613-9221 toll-free, or
  • This option is only available while HMSA Centers and offices are temporarily closed to the public.
• Mail a check to the address on your billing statement.
• Visit a Walmart Money Center inside your nearest Walmart. Be sure to take your HMSA billing statement. Walmart will charge a service fee.
• If you need additional assistance, call:
  • Oahu: 808-948-6174
  • Neighbor Islands: 1-800-782-4672 toll-free
  • TTY: 711
  • Monday through Friday, 8 a.m. to 5 p.m.

We encourage all our members to stay informed on the latest information from public health organizations, including the Centers for Disease Control and Prevention (CDC) and the Hawaii Department of Health (DOH).

HMSA is continually updating our website and we’ve been sending email updates to members who request to have email contact from us.

HMSA is following recommendations from the Centers for Disease Control and Prevention (CDC) and the Blue Cross and Blue Shield Association. We recommend going to the CDC website for current information and recommendations.