Medical Plans
Hawaii Medical Service AssociationHeadquarters
Complaints
This profile includes complaints for Hawaii Medical Service Association's headquarters and its corporate-owned locations. To view all corporate locations, see
Customer Complaints Summary
- 30 total complaints in the last 3 years.
- 9 complaints closed in the last 12 months.
If you've experienced an issue
Submit a ComplaintThe complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.
Initial Complaint
Date:04/22/2025
Type:Billing IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
HMSA OWED ME MONEY THAT THEY HAVE ACKNOWLEGE IS PAYABLE TO ME, ONE IS FROM A CHECK THEY SENT OVER A YEAR AGO (2173.81)AND I NEVER RECEIVED. THEY TOLD ME THEY WOULD ISSUE ANOTHER CHECK OVER A MONTH AGO. IT IS IMPOSSIBLE TO TALK TO A COMPETENT PERSON ABOUT THIS. THE CUSTOMER ********************** IS AWFUL, ALWAYS LATE OR DISMISSIVE. THEY ALSO JUST CHARGED ME TWICE FOR MAY WHEN I TRANSITIONED TO ******** (*******. THEY HAVE NOT REIMBURSED ME OR EVEN ACKNOWLEDGED THE DOUBLE CHARGE. IT IS SIMPLY UNACCEPTABLE THAT HMSA CAN TAKE WHATEVER TIME THEY WANT TO PAY ME BACK AND CANCEL MY MEMBERSHIP WITHIN DAYS IF I DONT. IT IS UNFAIR TO EXPLOIT THEIR POWER AND IT DEMAND IMMEDIATE REPARATIKONS FOR $3445.53 PLS INTERESTS AND PENALTIESBusiness Response
Date: 06/16/2025
This inquiry was forwarded to our Membership and ******************** who are resolving and contacting the member regarding the two outstanding refunds.
Thank you - ***** *****
Initial Complaint
Date:03/07/2025
Type:Service or Repair IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I'm filing this complaint based on HMSA's false claims on their website regarding discounts for mail order prescriptions. Three of my prescriptions have increased in price this year, even though I have the same insurance plan. I contacted HMSA and CVS Caremark two times each, but they did not resolve my issue. When I spoke to an HMSA agent on the phone the third time (March 6), I was told that my prescription, Amitriptyline 10mg, would cost less through mail order but she said CVS Caremark would need to help me with that since she could not. She then transferred me to the wrong department at ************, and I was told by an agent there that my medication would not cost any less via mail order. I told the agent that based on their website, it would for a 90-day supply, but he said that wasn't what he was seeing on his end. He then said he couldn't help me and would have to transfer me to another department, which he never did. I have attached a screenshot from yesterday (March 6) showing the price of my prescription that would be eligible for a discount via mail order. This was also confirmed by an HMSA agent. The screenshot was taken directly from CVS Caremark's website, and I accessed this website through my HMSA patient portal. I know there is a request button under the mail order column, but when I tried that, it did not work. I know that to some, the discount may not seem like a lot of money. But I am struggling financially as everything is going up in price. HMSA increased my monthly premium by $40 for the same plan and now my prescriptions go up, too. All I wanted was for someone to help me. But after multiple tries, nobody ever did.Business Response
Date: 03/19/2025
Thank you for bringing this issue to our attention.
Due to HIPAA and CMS privacy requirements, I am unable to reply in detail via the Better Business Bureau. We will contact you in person to review and resolve your inquiry.
Here to help -
***** D. *****, Customer Relations Manager
************ ****************************************************************
Customer Answer
Date: 03/23/2025
Complaint: 23034752
I am rejecting this response because: HMSA has not yet contacted me about this, even though their response said they would.
Sincerely,
***** *****Business Response
Date: 04/11/2025
Thank you for following up with HMSA regarding this issue.
Because this issue is about our drug rider and pharmacy benefits, it was forwarded to CVS, HMSA's (PBM) pharmacy benefit manager. In researching this, it was discovered that it was reviewed under a different complaint number - 23032267. It appears a letter was sent to the BBB office in *********** on March 14, 2025, which should have been shared with Ms. ****** see attached.
Of importance,
As a courtesy, the account manager applied a credit of $15.00 to the Members account to match the copay displayed on the most recent order. CVS Caremark is working to resolve the issue of the incorrect cost for this plan being displayed on the website. We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Sincerely,
***** ******** Member AdvocateI will have the local CVS representative contact you directly.
***** D. *****
HMSA Customer Relations Manager
Initial Complaint
Date:01/05/2025
Type:Billing IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
They make it very difficult to use the debit cards probably because they keep what is not used. I used their Medline service and was charged to my debit and credit card. HMSA said ******* had done wrong, but I find I am still billed twice. HMSA had said they would deal with *******. The charges are still on my credit card. The things they sell are overpriced and not the best quality. You should check to see how much HMSA profits by making it so difficult for elderly to use the debit cards. Is someone getting a kickback for the double billing? I worded and talked to HMSA 11/2024.Business Response
Date: 01/31/2025
Thank you for your patience while we reviewed your inquiry.
We are confirming with Medline the actual charges made to your personal credit card vs. the *** Benefit debit card. In your previous contact with our Customer Relations you identified the two charges of $51.92 and $30.81 made on 11/4/24, which total $82.73. This total is different from the $165.46 identified here. I am also following up with the grievance you submitted on 11/25/2024.
We will have a specialist contact you to gather additional information.
Thank you - ***** *****
************ ****************************************************************
Initial Complaint
Date:11/16/2024
Type:Customer Service IssuesStatus:ResolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Please see uploaded documents, 2 letters to the President/CEO of HMSA asking for his help to resolve my problem. The letters explain my issue in detail.Business Response
Date: 11/18/2024
I apologize for the delay in responding and in the delay in reprocessing of the receipt from your cruise.
I have been working with our claims ******** department to correctly process this claim and provider the Report to Member as needed. I will contact you with the update.
***** Unger Customer Relations Manager
************ ****************************************************************
Customer Answer
Date: 11/18/2024
Complaint: 22565767
I am rejecting this response because: as of this date, I have not received a corrected Report to Member. I received a call today, from ***** *****, Customer Relations, stating that he will contact claims department directly and get back to me today or tomorrow with an update. In the past, I've been told I would get a phone call back from them but I have not. I do not wish to have this complaint closed until I receive a correct Report to Member that I can send to my travel insurance company.
Sincerely,
******* ********Business Response
Date: 12/10/2024
I apologize for the errors and the continued delays in resolving this issue.
I still have not received a definite date as to completion for payment and generation of the Report to Member for the complete cruise claim, even for the "interim" Report to Member while we correct the total charge.
I will continue to track and push the claims and provide you updates until completed.
Thank you - Kevin
**************************************************************** ************
Customer Answer
Date: 12/10/2024
Complaint: 22565767
I am rejecting this response because: the issue has not been resolved yet. I would like to keep this complaint open until it has been resolved.
Sincerely,
******* ********Business Response
Date: 12/20/2024
HMSA has completed processing of this issue.
We will continue to monitor and work with the member to ensure all needs are met.
***** Unger Customer Relations Manger
Customer Answer
Date: 12/25/2024
Complaint: 22565767
I am rejecting this response because: although I received a call from ***** *****, of HMSA, stating that there will be two additional Report to Member which should include the balance of my itemized medical bills incurred on my cruise, I have yet to receive them in the mail. These reports are required for me to file a claim with the travel insurance company. I would like to leave this complaint open until I receive the reports. Thank you.
Sincerely,
******* ********Customer Answer
Date: 01/14/2025
After 6 months, over a dozen phone calls with many unreturned calls, two letters to the President/CEO of HMSA and a complaint made to the BBB, Ive finally received the documentation that I needed to provide to the travel insurance company. I just received a check from them yesterday, for the balance of my medical expenses that resulted from medical treatment while on a cruise in May 2024.Initial Complaint
Date:11/10/2024
Type:Service or Repair IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
My son was sick in ***** and needed emergency care last December, and as soon as I returned home, I submitted a claim that same month. It took so many months to even get my check in the mail, but I couldn't even cash it because I was informed it was the wrong amount. I dropped the incorrect check in September at headquarters on *********, and still no check or word from anyone. I tried calling, but no information about when my check will arrive. I cannot believe that it takes a year to get reimbursed and that there were so many issues with this process.Business Response
Date: 11/14/2024
Thank you for bringing this to my attention.
I will research and follow up with you regarding the services for ********.
Thank you.
***** Unger Customer Relations Manager
************ ****************************************************************
Customer Answer
Date: 11/19/2024
Complaint: 22538411
I am rejecting this response because:1. After three business days, still no contact from HMSA about the case (case #********)
2. Called today and received no new information or updates (Every time I call, the representative offers to leave a message or tells me that the person handling my case will call back...but s/he never does. I only heard from HMSA once when someone informed me that the check they sent was incorrect.)
3. It should not take a year to get reimbursed for out-of-state/out-of-country claims
Sincerely,
SKFBusiness Response
Date: 01/31/2025
Thank you for talking with me yesterday regarding *********** December 11, 2023 outstanding claim.
Again, I apologize for the delay and problems you encountered with the reimbursement. As I said yesterday, we have received the refund of the incorrect payment and it has been correctly posted.
I am expediting processing the correct payment of $582.07 and will be tracking it to ensure no further delays. Payment will be completed within a week.
Please keep my contact information, so I can help you with any future questions or possible problems.
Kevin
************ ****************************************************************
Initial Complaint
Date:10/29/2024
Type:Service or Repair IssuesStatus:ResolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I was looking at the Find A Doctor provider directory on ************************** and saw that ******** ******* ****** *******, Electrologist, is listed as a provider in the *** network. The problem is, their website says theyve closed, and when I called their office, they confirmed theyve shut down, moved out of state, and are no longer treating HMSA patients. They even told me theyre not sure how long theyll stay listed as in-network because HMSA hasnt responded to their office in the past.Its frustrating that HMSA still lists this provider as available when theyre no longer in business. Id like ********************** to make sure the provider directory is kept up to date. Also, I think HMSA should add a way for patients to report problems with the directory. That way, if we notice something wrong or outdated, we can easily let HMSA know so they can fix it.Business Response
Date: 10/30/2024
Thank you for bringing this to our attention.
We will have our Provider Operations / Contracting research this issue and make the appropriate corrections.
In the mean time, here is my personal contact information,
***** D. ***** Customer Relations Manager
************ ****************************************************************
Customer Answer
Date: 10/30/2024
I have reviewed the response from the business regarding complaint ID ******** and am tentatively satisfied with their proposed resolution. However, I am concerned that they may not follow through on their actions or that any updates may take longer than expected, given their history of delays and lack of responsiveness in provider and credentialing matters. Such delays and non-responsiveness been noted in other BBB complaints and was also mentioned by the provider involved in this issue. If this problem persists for an extended period, I will submit a follow-up complaint.
Sincerely,
******** M
Initial Complaint
Date:10/10/2024
Type:Service or Repair IssuesStatus:ResolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I started a telelmedicine medical practice and signed a contract with HMSA in June 2024. I have been waiting for a provider number in order to file claims for HMSA PPO and HMO insured patient. I waited for 1 month of the expected time to receive a letter from HMSA to provider this number so I can file a claim. I have followed and email multiple times on a monthly basis and it has now been 4 months since contract were signed. My last email in Sept was not even replied. It has been the most unprofessional process that I experienced from a company with such a great reputation.Business Response
Date: 10/11/2024
Thank you for bringing this to my attention.
I will have a manager from our Provider Contracting contact you.
Here is my contact information as part of the resolution with HMSA and BBB.
Kevin D. Unger - Customer Relations Manager
808-948-6186
Initial Complaint
Date:09/10/2024
Type:Sales and Advertising IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I have a long compllex medical history dating back to 2013 *****, including disability.. Due to surgical complicatiions from Colorecal Cancer surgery, an **** ************** developed over time and worsened in early 2016. I was admitted to the ** at ***************** with an intra-abdomnial anastomotic leak,/sepsis with a prolonged hosptial stay (Feb 2016 to March /2016). Due to my complex anatomy, treatment included long-tern IV antibiotics and a skilled surgeon to drain the fistula. The surgical procedure was perfomred by Dr. ****** **** in Feb 2016. Medical management of the anal-*************** from 2016 to 2022 was complicated following a 2nd diagnosis of cancer, Diffuse Large B-Cell Lymphoma (DLBC). Chemo-RCHOP therapy for DLBC worsened my anal-************** with continuous burning rectal discomfort, defeacation 20 to 30 x per day, numerous small bowel obstructiions, inability to sleep, employment challenges, disability discrimination by employer. I moved back home to Hawaii in late 2023 beacuse I could not work. Shortly thereafter, I had multiple ** adminssions to ***************************** Center. In Febraury 2024, GI symptoms worsened. Medical mangement of the anal-************** had failed. To improve my qualtiy of life, surgical repair of the complex anal-************** and permanent colostory by a highly skilled GI surgeon with crystal clear familiarity of my complex gastrointestimal anatomy was needed The same colorectal surgeon, Dr. ****** **** (from 2016) perfomed both surgical procedures. HMSA's denial of payment does NOT alllow me (the patient) to live my best life and fails to support my healh and well-being. This has heightened and worsened by level of anxiety and stress in the setting of exisiting disabilities.Business Response
Date: 09/12/2024
Thank you for contacting the BBB and bringing this to our attention.
I will have someone from our ***************************** reach out to you to gather more information regarding this issue.
***** D. *****
Customer Relations Manager ************ ****************************************************************
Customer Answer
Date: 09/15/2024
Complaint: 22263745
I am rejecting this response because I am emotinally exhuasted after learning of HMSA's denial. Their actions has woresned my anxietey, caused emotional duress and does not support my health and well-being with quality healthcare as a paient with underlying disabilites. How does talking with customer relations to collect more information bring closer to this complaint?? I don't understand. Besides atempts were made to call HMSA, and the extensiive wait times were too long, that I hanged up the phone. Pertinent documents were sent to Dr. ****** ****;s office. These documents are availabe for HMSA,I am grateful for the time-sensitive, medically necessary intervention/surgery during February/ March/ April 2024 by Dr. ****** ****, who is highly skilled and has extensive knowledge/ familiarity of my complex surgical, medical history and gastrointestiional anatomy. i was doing okay following the surgery, until learining of HMSA's denial. Again, pertinent documents are availabe for HMSA at Dr. ****** ****** office.
Sincerely,
****** ****Business Response
Date: 09/25/2024
HMSA is working with the state **************** to determine the provider's status with the ***** plan. While your provider was participating with HMSA as a PPO provider, he has not registered with *****.
Our Customer Relations team will provide you an update on the status of the denied claims.
***** D. *****
Customer Relations Manager **************************************************************** ************
Customer Answer
Date: 09/28/2024
Complaint: 22263745
I am rejecting this response because of the lack of conctacting Dr. ****** ****** office and understanding the need to review all documents submitted to his office related to the services provided 2/25/24 , 4/10/24, 4/12/24.Claim # *****E000728 , *****E000759, *****E000374,I have spent a lot of time, effort and mental energy to submit key pieces of information to **************** regarding this horrififc denial by HMSA Furthermore, there are resourceful staff members at Dr. ****** ****** office who have important informaton about billing.
Sincerely,
****** ****Initial Complaint
Date:06/24/2024
Type:Customer Service IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
On 6/24/24 I attempted to call HMSA and was informed of a 45 min wait time. I left my name and number in the queue it is now almost 4 hours later and I have not received a call back. I called back in and currently have a 1:46 + hold/waiting time. The question I have is time sensitive and it doesn't look too promising I will get the answers I am looking for which will also cost me $1000. I am EXTREMELY disappointed in HMSA and your customer support (lack of). This is not the first time I have had ridiculously long wait times. I end up ending the call with out ever getting a call back and therefore my questions/concerns never getting answered or resolved. I will be filing a complaint with BBB in addition to this complaint.Business Response
Date: 06/25/2024
Thank you for contacting the BBB with this issue.
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.I will have a representative contact you and help you with your questions.
************** Unger Customer Relations Manager
************ **************************************
Initial Complaint
Date:06/04/2024
Type:Service or Repair IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Unfortunately (very unfortunately, since I had ****** prior to that), my new employer only offers HMSA, and for 6 months now I have been trying to find a ******* Care Provider in my area (Kona), and even willing to drive to other cities. For 6 months, I've made some 100 calls and NO ONE in the ********** is accepting new HMSA patients. The best I got was to be added to a wait list for a PA, no doctors. The HMSA number listed on the back of the card is out of service, and the 1800 number is not reachable. I've try calling their number some 50 times. I either leave a message and never get a response, or I wait for 1 hour+ on the line, until the call is disconnected. At this time, HMSA is unable to provide any healthcare at all. No PCP, no gynecologists, not a single doctor in the island of Hawaii has accepted a new HMSA patient request. Can anyone from HMSA help me? Your website is not useful (old information, mostly drs that no longer reside in ** or do not accept new HMSA patients). I can't talk to any representative. I am out of options and DO NOT HAVE ANY HEALTH CARE AT ALL.Business Response
Date: 06/04/2024
Thank you for contacting the Better Business Bureau.
I apologize for our longer wait times when you tried to contact HMSA. I will have a representative contact you and help find a PCP in the Kona area.
************************ - Customer Relations Manager ************
**************************************
Customer Answer
Date: 06/25/2024
Unfortunately, I still have no medical care at all from HMSA. A gentleman named ***** did call me once, saying he would help me to find a primary care provider in **** area, right after the complaint was posted. I have not heard from them ever since, and I am not able to get through the phone number provided. I am back to square zero with no medical care.
Here's a screenshot with a 53:36 minutes wait time to talk to someone at HMSA and still, they did not answer.Business Response
Date: 07/02/2024
I apologize, this inquiry was forwarded to our Provider Operations. I will follow up with them to make sure they contact you and help you with finding a Kona provider.
Thank You -
*********************;
Manager Customer Relations ************ **************************************
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