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Does my HMO plan cover services on the U.S. Mainland?

If you have an HMO plan, you are covered for services received from providers on the U.S. Mainland when:

  • Your care is for emergency or urgent conditions.
  • Your services for non-emergency or non-urgent services are approved by HMSA prior to the service being received.
  • You are enrolled in the Guest Membership program, a program that allows you to have a PCP on the U.S. Mainland if you will be living away from your health center's service area for more than 90 days.

All other services are not covered and you are responsible for the total cost.

Note: HMSA's Children's Plan covers emergency care outside of Hawaii, but does not cover other services outside of Hawaii, including urgent and routine care. 

If you experience a medical emergency while traveling outside Hawaii, go to the nearest emergency facility. 

If you require urgent care, please call BlueCard to find a provider that participates with the local Mainland Blue Cross and Blue Shield plans. 

  • By coordinating your care with BlueCard, you receive benefits similar to those when receiving health care from Hawaii providers. 
  • If you have urgent care services without going through BlueCard, the services are not covered and you are responsible for the total cost.

For additional important information, we encourage you to read:

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Article Details

Article Details
  • Article ID: KB00033
  • Created:
    1/31/2011 4:58:57 PM
  • Last Modified:
    1/11/2012 1:57:16 PM

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