MMC Benefits Handbook
How the Plan Works
This Plan helps you and your family pay for medical care. You may pay a copayment for certain services. Generally, your care is fully covered after you pay a set copayment per visit. You select a primary care physician (PCP) who will manage your care and refer you to a specialist or other provider in the network if necessary. Except in an emergency, you do not receive benefits if you receive care outside the network.
For more information, including coverage criteria, other limitations of covered services, and excluded services, see the HMSA's Health Plan Hawaii Plus Health Maintenance Organization (HMO) Guide to Benefits. Go to Colleague Connect ( Click Pay & Benefits, under Find a document, select Search all documents.
Certain expenses not covered by the Plan, such as copayments and services that are not covered, may be reimbursed through a Health Care Flexible Spending Account.
Some services have specific limits or restrictions; see individual service for more information.
Benefits are only paid for medically necessary charges or for specified wellness care expenses.
Preauthorization may be required in order to receive coverage for certain services.