Complex Case Management

HMSA’s Case Management Program provides personalized support to help you understand and manage your health conditions and helps you get timely, coordinated access to the care you need.

We work closely with your doctors to help coordinate your treatment, medication, and other services. Our goal is to ensure that you have access to the care you need to achieve your best health and well-being.

This program is voluntary and available at no cost to HMSA members.

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How will I work with my case manager?

You have access to a team of Hawaii-based registered nurses who’ll connect with you or your caregiver by phone, virtual visit, or in person. You can meet or talk with them from your home, in your provider’s office, or at an HMSA Center.

Your case manager can:

  • Collaborate with your health care team to:
  • Coordinate your care plan.
  • Discuss your health needs with your care team and caregiver(s).
  • Help you understand and follow instructions from your health care team.
  • Help you understand your medications and treatment plan.
  • Reinforce an action plan that includes steps to take if your symptoms worsen and when to contact your doctor.
  • Make sure that you understand discharge instructions if you’re hospitalized.
  • Help you set and achieve health goals.
  • Connect you with resources to support your health and well-being.
  • Discuss an advance health care directive, living will, or power of attorney.
  • Help coordinate out-of-state care.

For more information about this program, call HMSA Health and Well-being Support at 1-855-329-5461, option 1.

What resources can I use?

Below are links to instructions and forms that you may need.

Advance Health Care Directive
An Advance Directive is a written statement about your future medical care.

HMSA Authorized Representative form [PDF]
This form is to appoint or revoke a family member, friend, or others who need access to your health information.

CMS Coordination of Benefits
Coordination of benefits is for individuals who have more than one health plan and determines primary payment responsibility.

Mail Service Order Form
Mail-order prescription medications are available to most HMSA drug plan members. You can save money with mail-order drugs because copayments are generally lower than when you buy from retail pharmacies. Check your drug plan certificate to see if you have mail order as a benefit.

External resources for additional support:

Elderly Affairs
808-643-2372

City and County of Honolulu Elderly Affairs Division
elderlyaffairs.com/
808-768-7700

Maui County Office on Aging
mauicountyadrc.org/
Maui: 808-270-7774
Molokai: 808-553-5241
Lanai: 808-565-6818

Hawaii County Office of Aging
hcoahawaii.org/
808-961-8600
Hilo: 808-961-8626
Kona: 808-323-4392

County of Kauai Agency on Elderly Affairs
kauaiadrc.org
808-241-4470

Hawaii CARES Crisis Hotline – Call 988
http://hicares.hawaii.gov/
Crisis hotline 988

More resources to help you on your journey.

hmsa urgent care

A Guide to After-hours Care [PDF]
Use this guide so you know where to go for your care.

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Your Guide to Benefits will tell you what your health plan pays for and what you can expect to pay out of pocket. You may access your Guide to Benefits through My Account. If your plan’s Guide to Benefits isn’t online, call us at 808-948-6079 or 1-800-776-4672.

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Health and Well-being Support
Get personalized support for your health conditions. Our team of clinicians, coaches, and educators can help connect you with the resources you need.

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Health Education Workshops
Attend workshops in person or online at no cost on a variety of well-being topics, such as nutrition, physical activity and exercise, stress management, and more.

Disclaimer

The information you obtain from the sources on this site or any other service offered by or through this site should not substitute for or be used instead of a relationship with a health care professional. We encourage you to seek the advice of and regularly consult with physicians and other health care providers.