Reviews
This profile includes reviews for Hawaii Medical Service Association's headquarters and its corporate-owned locations. To view all corporate locations, see
Customer Review Ratings
Average of 4 Customer Reviews
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Review fromAriel G
Date: 11/08/2024
1 starI've had a disappointing experience with HMSA regarding gender-affirming care. I was enrolled in their Federal 87 plan for years, waiting patiently for federal government to mandate coverage for facial feminization surgery. Once these changes took effect at the beginning of 2024 pursuant to OPM directive, I excitedly contacted HMSA, expecting coverage. Instead, I was informed that the procedure was still considered 'cosmetic' by HMSA standards but that it would be reviewed on a case-by-case basis. Even with several doctors and the government on my side, HMSA said they would not cover my care.With open enrollment now underway, I reached out again to confirm if this would change for 2025. Unfortunately, I was told that their policy remains unchanged and that facial feminization surgery would only be covered when deemed 'medically necessary.' Despite providing multiple assessments from healthcare providers stating the medical necessity of this care, HMSA did not offer any clarity or assurance on their decision-making process, nor any concrete guidance on what constitutes 'medically necessary' in this case, even though it aligns with recognized standards like WPATH.A representative did tell me that a new policy would probably be released early next year, but could not provide any details. They even suggested I look into other carriers based on how slowly HMSA moves and changes. This ongoing lack of transparency and support has led me to seek coverage with a different carrier for 2025. For anyone in the transgender community considering HMSA, I'd advise looking into other options for more reliable support in gender-affirming healthcare. I don't know how *** continues to allow HMSA to provide coverage to federal employees....Review fromCarol R
Date: 01/29/2024
1 starCarol R
Date: 01/29/2024
If it was possible to give company a less than zero , i would. I have been on hold for over two hours. Earlier (same day) I asked for company call back twice,I received a call back and when i pressed 1 as requested I was again pit on hold. Currently, I have spent over 4 hours trying to speak customer **********************, and I am still waiting. Also,my husband has also spent over three hours trying to get to speak to someone. This is truly disgusting and unacceptable.
Hawaii Medical Service Association
Date: 01/31/2024
I see that one of our representatives from our ********** ******************* is currently assisting our member at this time.
HMSA is working hard to fill all our servicing positions with quality, local representatives. We are committed to regain our previous servicing performance levels of an average of five minutes or less. We are also working with our telephone systems to improve our call back feature.
We have an on-line inquiry service available on HMSA.com for you to send an e-mail to our servicing center as another option and on HMSA's My Account there is the e-mail option Ask HMSA form.
We apologize for the frustration and inconvenience you encountered.
*********************** - Customer Relations Manager
Review fromJenny S
Date: 12/28/2023
1 starHMSA has the entire market in Hawaii. Because of this, there is little accountability to pay physicians in a timely and accurate manner. Recently they outsourced all of the claims overseas. These representatives are not trained throroughly and it seems they still don't have enough people to process claims. They pay claims inaccurately over and over again, and there is absolutely NO recourse for physicians. If physicians choose to not participate, they can say goodbye to their livelihood. Simply stated, HMSA does not perform well because they DON'T have to perform well as there is ZERO competition. They don't care, they don't have to care and there seems to be little accountability from any one in key decision making positions. The president recently scored a HUGE bonus while his company may save a few dollars by delivering unacceptable service to the providers that care for their members. If providers delivered the same service they receive from HMSA to HMSA's members, people would DIE faster than I can finish this review. Simply put, HMSA demands physicians deliver in a way that they do not deliver.Review fromAmira S
Date: 01/20/2023
1 starHMSA out-of-state claims has been a nightmare for all of 2022. I am still waiting on claims from over 6 months ago to be entered into their system, never mind processed or paid. I filed a claim in February 2022, it was paid in August only after multiple calls, emails, and excuses. Claims for May 2022 only showed as pending this month - January 2023, again after numerous calls, emails and excuses. Claims for ***** are not in the system, neither are claims for July-November. I even sent claim requests by certified mail in July to ensure they arrived. Those were apparently received, but then lost and not entered into the system at all, I had to resend via email. All customer ********************** reps have been kind and helpful to the extent of their ability. The problem is at a level above just the person you speak to on the phone. I used to have a very favorable opinion and good experiences with this insurance company, even when out of state. Now, after this ordeal, I cannot recommend their services to anyone in good conscience. I was told it was a staffing issue but I find that hard to believe after nearly a year. Wholly unacceptable. If we did not pay our premium for 6-9 months, would we still be members? Not for long I'm sure. So why is this length of delay in even acknowledging and addressing claims acceptable? Short answer - it's not. Would give zero stars if possible.
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