Hawaii Medical Service Association (HMSA) is the largest health insurer in Hawaii, providing a wide range of coverage options for individuals, families, and seniors. While most people understand their basic medical coverage for doctor visits and hospital stays, many members overlook the supplemental or “extra” benefits included in their plans. These additional services are designed to promote preventive care and overall well-being.
Understanding how to navigate these extra benefits can save you money and improve your quality of life. Whether you are enrolled in a commercial plan or a Medicare Advantage plan like HMSA Akamai Advantage, knowing what is available is the first step toward a healthier lifestyle. This guide explores the most common supplemental benefits and how you can start using them today.
What Are HMSA Extra Benefits?
Extra benefits, often called supplemental benefits, are services that go beyond the standard medical and surgical coverage required by law. These benefits focus on holistic health, addressing areas like vision, dental, hearing, and physical fitness. By providing these extras, HMSA aims to help members stay active and catch potential health issues before they become serious.
The specific benefits available to you depend on your specific plan type. For example, Medicare Advantage members often receive a broader suite of supplemental benefits compared to standard employer-sponsored plans. It is important to review your annual Evidence of Coverage (EOC) document to see exactly what your plan includes.
Essential Vision and Dental Coverage
Many HMSA plans include routine vision and dental care as part of their supplemental package. These services are crucial because oral and ocular health are often linked to systemic conditions like diabetes and heart disease.
Routine Vision Care
Supplemental vision benefits typically cover an annual eye exam and a set allowance for frames or contact lenses. Regular eye exams do more than just update your prescription; they allow optometrists to check for signs of glaucoma, cataracts, and macular degeneration. Members can usually find a provider within the HMSA vision network to minimize out-of-pocket costs.
Preventive Dental Services
Dental extras often focus on preventive care, such as cleanings, X-rays, and exams every six months. Some advanced plans may also provide a yearly allowance for comprehensive services like fillings or crowns. Maintaining regular dental visits helps prevent tooth decay and gum disease, which can impact your overall health if left untreated.
Fitness Programs and Gym Memberships
Staying active is one of the best ways to manage chronic conditions and maintain mobility as you age. HMSA recognizes this by offering fitness benefits to many of its members. One of the most popular programs included in many HMSA Medicare Advantage plans is Silver&Fit.
- Gym Access: Members can often access a wide network of participating fitness centers and YMCAs across Hawaii at no additional cost or for a very low co-pay.
- Home Fitness Kits: For those who prefer to exercise at home, some plans offer fitness kits that include yoga mats, resistance bands, or wearable trackers.
- Digital Resources: Many fitness benefits include access to online workout videos and wellness tracking tools through dedicated mobile apps.
By taking advantage of these programs, you can stay physically fit while also enjoying the social benefits of community exercise classes.
Over-the-Counter (OTC) Allowances
One of the most valuable extra benefits for many members is the Over-the-Counter (OTC) allowance. This benefit provides a fixed dollar amount every quarter to spend on health-related items that do not require a prescription. This allowance helps members manage minor ailments at home without spending their own money.
Common items you can purchase with an OTC allowance include:
- Pain relievers like ibuprofen or acetaminophen.
- First aid supplies such as bandages and antiseptic wipes.
- Cold and allergy medications.
- Vitamins and minerals.
- Toothpaste and oral care products.
- Sunscreen and skin care items.
Most plans provide a catalog or a dedicated website where you can order these items for home delivery. Some plans also offer a debit card that can be used at participating retail pharmacies across the islands.
Hearing Aids and Audio Support
Hearing loss can lead to social isolation and safety concerns, yet traditional Medicare often does not cover hearing aids. HMSA bridges this gap by offering supplemental hearing benefits. This typically includes a routine hearing exam and a significant discount or allowance toward the purchase of hearing aids.
Members can work with network audiologists to find the right technology for their needs. These benefits often include follow-up appointments for fitting and adjustments, ensuring that the devices work effectively for the user.
Transportation and Meal Benefits
For members recovering from a hospital stay or those with mobility challenges, HMSA may offer specialized support services. These are designed to remove barriers to care and ensure a smooth recovery process.
Non-Emergency Transportation
Some plans include a set number of one-way trips to and from medical appointments each year. This is especially helpful for members who no longer drive or do not have access to reliable public transportation. These rides can be scheduled in advance to ensure you never miss a check-up.
Post-Discharge Meal Delivery
After a stay in a hospital or skilled nursing facility, nutrition is vital for healing. Certain HMSA plans offer a temporary meal delivery service that provides nutritious, pre-packaged meals directly to your door. This allows members to focus on their recovery without the stress of grocery shopping or cooking.
How to Access Your Extra Benefits
Accessing these benefits is usually straightforward, but it does require some proactive steps. Start by creating an account on the HMSA member portal. This online dashboard provides a clear overview of your specific coverage and links to third-party vendors who manage services like fitness programs or OTC orders.
You should also keep your HMSA member ID card handy. Most providers will need the information on this card to verify your eligibility for supplemental services. If you are unsure if a benefit is covered, you can call the HMSA Customer Service number located on the back of your card for clarification.
Tips for Maximizing Your Coverage
To get the most value out of your health plan, consider the following tips:
- Check Your Quarterly Deadlines: Benefits like the OTC allowance often do not roll over. If you don’t use the funds by the end of the quarter, you lose them. Set a reminder to place your order every three months.
- Stay In-Network: Supplemental benefits are usually tied to a specific network of providers. Always verify that a gym, dentist, or eye doctor is a participating partner before scheduling an appointment.
- Attend HMSA Workshops: HMSA frequently hosts community workshops and webinars that explain how to use your benefits. These are excellent opportunities to ask questions and learn about new services.
- Review Your Plan Annually: Health plans change every year. During the Annual Enrollment Period, take the time to see if your extra benefits have been updated or if a different plan might offer more of the services you need.
Conclusion
HMSA extra benefits are a powerful tool for maintaining your health and reducing your out-of-pocket expenses. From gym memberships and dental cleanings to OTC supplies and hearing aids, these supplemental services provide comprehensive support that goes far beyond basic medical care. By taking the time to understand and utilize these resources, you can ensure you are getting the full value of your insurance coverage.
If you haven’t explored your extra benefits lately, now is the perfect time to log in to your member account or review your plan documents. Staying informed is the best way to take control of your health journey. For more information on navigating healthcare and insurance, explore our other articles on wellness and financial planning.