Provider Network Notice
An Important Notice Regarding HMAA’s Participating Provider Network
As an HMAA member, you may choose from our comprehensive list of more than 5,000 physicians, dentists, hospitals, clinics, chiropractors, acupuncturists, naturopaths and pharmacies located throughout Hawaii. While our geographic service area is the State of Hawaii, you may access our Mainland Network for the following services. (Some benefits may not be included in your health plan.)
If you are planning to travel to the Mainland, contact the Mainland Provider Network or HMAA prior to traveling to identify participating providers in the area you intend to travel to.
For Medical Care:
Access the Private Healthcare Systems (PHCS) Healthy Directions Network or the MultiPlan Network should you require medical services, including emergency care, while traveling to the Mainland. These Mainland networks are not available for alternative care (chiropractic, naturopathic and acupuncture) services.
Whether it’s one of our many Hawaii providers or a Mainland provider, using a participating provider or facility will maximize your coverage and reduce your out-of-pocket expense.
You may use a provider or facility that is non-participating with HMAA or our Mainland Networks. However, because HMAA has no agreement with these non-participating providers and facilities, you will be responsible for the difference between the entire billed amount and HMAA’s payment. As a result, your out-of-pocket expenses will be substantially higher. This includes the use of a non-participating provider or facility in emergency care situations. The provider or facility may require you to pay the entire bill at the time you receive services, and to file your claim directly with HMAA. When you see a non-participating provider, you are responsible for all payment arrangements because HMAA does not reimburse non-participating providers or facilities directly. You may refer to your Summary Plan Description and Schedule of Benefits, or call HMAA for more information.
Note: HMAA does not guarantee the availability of Mainland participating providers, including emergency care providers, in all areas.
HMAA has no agreements with providers outside of the United States. All such claims are processed and paid at the non-participating provider level. Please refer to the Out-of-Country and Out-of-State Instructions for additional information.
Please be aware that at times, there may be several providers (such as a surgeon, anesthesiologist, laboratory and facility) involved in a treatment plan. It is important to remember that each provider may have a separate contract with HMAA and that the participating status should be verified separately. Likewise, if you are referred to a provider for services, ask the referring provider to recommend an HMAA participating provider. This will ensure a higher level of coverage for your health care services and reduce your out-of-pocket expenses.
New providers or facilities that initiated their participating agreement after the HMAA provider directory was published may not be listed. Conversely, there may be providers or facilities listed that terminated their participating agreement after the directory was published. HMAA will not be responsible for paying claims at the participating level if the provider or facility is non-participating at the time of service. Please verify whether your provider or facility is currently participating with HMAA before you obtain services. You may also find the most current version of the provider directory on this site.
Some providers listed in the directory may practice at more than one location and may not participate with HMAA at all locations. Please verify participating locations with your provider before you obtain services. If the provider is non-participating and you wish to obtain an estimate of the charges involved in a service prior to treatment, contact HMAA’s Customer Service Center and ask for the Non-Par Eligible Charge Request Form.
For questions regarding claims, benefits, and participating providers, please contact HMAA’s Customer Service Center at 808-941-4622, toll-free at 888-941-4622, or via e-mail at CustomerService@hmaa.com.
Click here to view our participating vs. non-participating provider visual illustration.
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