Hawaii Health Insurance
Hawaii’s State Medicaid Plan (Fee-for-Service Medicaid Program):
Medicaid pays for medical care and services for individuals and families with very limited assets and income who cannot afford to pay all of their medical bills. It is especially valuable to older people (age 65 or older) with serious, recurring health problems who cannot meet all of their medical expenses from Medicare alone as well as those who are certified blind or disabled. A person may be eligible for partial assistance or for complete medical coverage depending upon monthly income and assets. Effective 1999, a provision was added to include blind or disabled pregnant women and children (under nineteen-years old) born after September 30, 1983.
Coverage is provided under Hawaii’s Fee-For-Service Medicaid Program where doctors or other health care providers are paid directly for their services. When seeking services, find out if the agency accepts Medicaid payments. If not, the patient will be responsible for the bill. Medicaid does not reimburse the client.
In Hawaii, Medicaid can pay for certain medically necessary services and items. General listing: Medicaid benefit coverage.
For eligibility process: http://www.med-quest.us/eligibility/medicaid/medicaid.html
To apply for Medicaid, call your closest Med-Quest Office to ask that an application form be mailed to you or you can download that form (DHS 1100). To fill in the form you will need to gather background information on your income and assets and fill in your Social Security number. Be prepared to show your birth certificate to the office at a subsequent interview. At that appointment, request current free publications describing Medicaid eligibility and services for your reference.
For additional information about Medicaid programs, contact Hawaii’s Medicaid and MedQuest offices nearest you.
Note: Applications for food stamps and Medicaid, are available on the DHS website for clients. DHS’s RealChoices ACCESS (Accountability for Consumer Choice Entry Support System) allows users to begin the process of applying for benefits by entering information into web-based forms and submitting them to DHS. The system generates a completed government form in Adope PDF that is downloaded directly to the user’s browser. The form can be saved or printed for delivery to DHS. The online portal was developed by Adobe Systems Incorporated, in collaboration with DHS, the University of Hawaii, and AssistGuide, a developer of online services.For more information click on: http://www.RealChoices.org (reported by Legal Aid Society of Hawaii, May 5, 2004)
Hawaii’s Quest Program:
The Medicaid Quest Program is administered by the Department of Human Services. It provides health coverage through health plans from HMSA, Kaiser and Aloha Care, for eligible Hawaii residents who have difficulty getting a traditional health plan.
A description of the program, services covered, phone contacts and such are provided at: http://www.state.hi.us/dhs/Q-Book.html. Their website is: http://www.med-quest.us/.
For eligibility requirements: http://www.med-quest.us/eligibility/quest/quest.html.
You can download the application form from the Quest website at http://www.med-quest.us/forms/eligibility/index.html or call your your closest local office for an application form to be mailed to you.
For additional information about MedQuest, contact your closest Medicaid and MedQuest office.
Medicaid – Long-term Care:
If you are seeking long-term care or home care services under Medicaid, certain medical and financial eligibility criteria must be met. Provided on a long-term basis (more than 30 consecutive days), it is designed to assist people with chronic debilitating health conditions.This service and eligibility requirements are mentioned at: http://www.med-quest.us/eligibility/longtermcare/index.html.
For an application form, local office addresses and contact numbers: http://www.med-quest.us/forms/eligibility/forms/DHS%201100%20Rev.%200303-FinalFinal.pdf.
For a copy of the Medical Assistance Renewal Form: http://www.med-quest.us/forms/eligibility/forms/DHS%201100B-1202-%20FINAL%2001-14-03.pdf.
For additional information about Medicaid Long-term Care, contact your closest Medicaid and MedQuest office.
Medicaid – Pregnant Women Care:
Medical coverage is provided for lower-income Hawaii residents. For eligibility requirements and the types of services offered in this program: http://www.med-quest.us/eligibility/pregnant/index.html. Another site you can visit is: http://www.state.hi.us/dhs/Pregnant%20Women.html.
Ask that Form DHS 1109: Confirmation of Pregnancy Form, as well as Form DHS 1100: Medical Assistance Application be sent to you. DHS 1100 is also available on-line at http://www.med-quest.us/forms/eligibility/index.html. After completing the form, contact the closest local office from the listing provided on the back of the form.
For additional information about Medicaid care for pregnant women, contact your closest Medicaid and MedQuest office.
Note: Effective September 2003, the Centers for Medicare and Medicaid Services allows states to accept self-declaration of pregnancy. A YES/NO question
is now on Med-QUEST’s application to eliminate the medical verification barrier
for eligible pregnant women. Download the latest version of the form in
typeable PDFformat at http://coveringkids.com/library/. (Reported by Legal Aid Society of Hawaii, December 23, 2003).
A Medicaid waiver is when the Federal Government allows or grants States permission to waive certain federal requirements in order to operate a specific kind of waiver program for those who are in medical need or severely disabled (http://cms.hhs.gov/medicaid/1915c/default.asp). President Bush spearheaded the “New Freedom Initiative” to advance the cause of self-determination for these programs (http://cms.hhs.gov/newfreedom/default.asp) and “Independence Plus” (http://cms.hhs.gov/independenceplus/default.asp) serves as the template by which individuals and their families are directing how they want to live their lives. Hawaii’s Medicaid Home and Community waiver programs are administered by the Department of Human Services, Adult and Community Care Services Branch. 810 Richards Street, Suite 400, Honolulu, HI. 96813. Phone: 586-5560 (V); 586-5700 (Fax). For a description and information on eligibility requirements for each home and community–based program and their respective phone contacts http://www.state.hi.us/dhs/ACCSB%20Services%20Brochure.pdf.
Hawaii Covering Kids:
Children and youth under 19 years old, who are legal immigrants can apply for free health insurance through the State’s Quest and Medicaid programs. Eligibility is based on family size and income. Services include: regular checkups, doctor visits, emergency care, eyeglasses, immunizations, counseling, prescription medicines and dental care. Applying for Quest and Medicaid will not affect their immigration status. Visit their website for further information and application forms.
Note: Children under age 21 who receive QUEST, QUEST-Net, or Medicaid are eligible for more health benefits than adults since the State must cover Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services. The coverage includes complete medical and dental exams, hearing tests, vision tests, laboratory tests, unlimited mental health benefits, immunizations, tuberculosis skin tests, and help with scheduling appointments and transportation (upon request). Children should be screened for medical, vision, hearing, and dental problems at pre-set periodic intervals and when a problem is suspected. For more information on the specific EPSDT rules, see Hawaii Administrative Rules 17-1737-53 through 62 (http://www.state.hi.us/dhs/1737.pdf). The National Health Law Program (NHeLP) recently released an EPSDT manual entitled “Toward a Healthy Future: Medicaid Early and Periodic Screening, Diagnostic and Treatment Service For Poor Children and Youth.” (Reported by Legal Aid Society of Hawaii, August 21, 2003)
Breast and Cervical Cancer Control Program:
This program is in the Department of Health. You can link to their program website
(http://www.hawaii.gov/health/family-child-health/chronic-disease/cancer/index.html)
or you can contact the program at (808) 692-7481 (Oahu); Fax (808) 692-7478 (Oahu) or email: ktkitaga@health.state.hi.us.
Hawaii Presciption Care Association (HPCA):
HPCA is a non-profit organization that works with needy individuals who are below a certain income level and over 100 pharmaceutical companies to provide access to prescription drugs for little to no charge. Link to their website for a description of their program, download application forms and view contact phone numbers. Contact information for Oahu and neighbor islands is also available by linking to the “Local Resources - Support Organizations” sections of this site.
Hawaii Rx Plus Program:
Under the Department of Human Services (DHS), this program is a precription drugs assistance program. It is designed to provide reduced costing drugs to residents of the State of Hawaii who have a family income equal to or less than 350 percent of the Federal Poverty Level (FPL), who lack prescription drug coverage, and who enroll in the Hawaii Rx Plus program. Link to their website for a description of their program, download their application forms and view local pharmacists particpating in this program.
