Health Plan Hawaii

Are you looking for comprehensive coverage in a cost-effective, managed care plan? The answer is Health Plan Hawaii (HPH). This health maintenance organization (HMO) plan emphasizes maintaining your good health with preventive care benefits. HPH combines the cost savings of an HMO with the flexibility to choose providers from the largest HMO network in Hawaii.

Focus on Preventive Health

Prevention is key to maintaining good health and containing medical costs. We encourage you and your family to take advantage of these routine and preventive care benefits:

• Routine physicals for adults and children.
• Screenings and immunizations.
• Prenatal, well-baby and well-child care.
• Well-woman exams, including mammograms and Pap tests.
• Men’s health exams, including prostate cancer screenings.

Health Centers and Provider Network

As Health Plan Hawaii members, you and your family receive benefits and quality care from the largest HMO network in Hawaii. When you join HPH, you have a choice of excellent personal care providers (PCP) and health centers.

• Hawaii’s largest HMO network with 1,800 physicians and specialists, so it’s likely your current physicians are already part of the HPH network.
• Conveniently located health centers offer you access to clinics, independent physician groups, and multi-specialty facilities.
• Freedom to select a PCP of your choice for routine care and specialist referrals. Maintaining an ongoing relationship with your PCP will help ensure optimal care.

As an added benefit, you and each of your eligible family members can choose different health centers and PCPs to address your individual needs:

• General, family practice or internal medicine physician for adults.
• OB-GYN for women.
• Pediatrician, family or general practice physician.

Self-Referrals

No referrals are needed when you see a provider within your health center for:

• Annual routine gynecological care.
• Annual vision exams.
• Mental health and substance abuse benefits.

Low, Fixed Copayments

Another major advantage of HPH is its predictable costs with low, fixed copayments for:

• Office visits.
• Emergency room visits.
• Hospital stays.
• Adult immunizations.

Coverage that Travels with You

HMSA provides you with peace of mind if you need medical attention while traveling outside Hawaii. HMSA belongs to the Blue Cross and Blue Shield BlueCard® network, the largest HMO network of providers nationwide, who participate in:

• Away From Home Care®. Coverage coast-to-coast with access to over 500,000 primary care physicians, specialists and hospitals nationwide when living temporarily on the Mainland.
• Guest Membership. Members on the Mainland for 90 days or more receive full benefits from other Blue Cross and Blue Shield providers.

Health and Wellness Programs

HMSA offers you a variety of health and wellness programs designed to help you develop and maintain a healthy lifestyle. This includes Well-Being Connection, health education classes and workshops, preventive health reminders, and more.

Eligibility:

Health Plan Hawaii is available through an employer group health plan. Check with your employer regarding your health plan benefits.

Benefit Summary

HMSA’s HPH is available through an employer group health plan. Medical benefits for small businesses (two to 50 employees) are explained in the Benefit Summary. Please refer to your HMSA card to confirm your medical plan code. If you have questions, please contact customer service.

* For businesses with more than 50 employees, please contact your HMSA account representative for the Benefit Summary.