In Hawaii, the Medicaid program is also called MedQuest, and the agency that administers it is the Hawaii Department of Human Services. Medicaid is a wide-ranging health insurance program for low-income individuals of all ages.
Inhalation therapy and physical therapy. Surgical and anesthetic supplies, drugs, and medicines. Post stabilization services. Physician's and surgeon's visits for covered inpatient days.
Requirements to be eligible for Hawaii QUEST include:
- be a Hawaii resident;
- meet citizenship status requirements;
- have a Social Security number;
- not be certified as blind or disabled.
- not be age 65 or over:
- not be living in a public institution;
Urgent Care. Urgent care is covered when a member is temporarily absent from the service area, or when the member is in the service area but the member's health center is temporarily unavailable or inaccessible.
Hawaii Medical Service Association
not be age 65 or over: not be living in a public institution; have income not more than 100% of the current FPL except for pregnant women and children up to age 6, who may have income up to the amounts listed above; not be eligible for health insurance from your employer (except for AFDC and GA recipients).
Program Requirements
| Household Size* | Maximum Income Level (Per Year) |
|---|
| 1 | $14,380 |
| 2 | $19,460 |
| 3 | $24,540 |
| 4 | $29,620 |
As a member, you get an Active&Fit discounted gym membership. Your gym discount depends on your current plan.
HMSA Akamai Advantage® is a Medicare Advantage plan to help members live well. It has all the benefits of Original Medicare and much more to help them be at their best health and well-being.
With Kaiser your doctors have to be within the Kaiser Care System. With HMSA you have more choices with your doctors as long as they take HMSA which majority do. So if you don't mind only having a limited amount of doctors to choose from then go with kaiser and you will find the right doctor through them.
High-deductible health plan
This plan has low premiums and a high deductible , so you'll pay less for monthly premiums and pay more when you receive services. It's a great option if you don't expect to use many health services.The State of Hawaii Med-QUEST Division (MQD) provides eligible low-income adults and children access to health and medical coverage through managed care plans.
PPO members have convenient access to health care through a large statewide network. Though PPO plans offer you greater choice of doctors than Health Maintenance Organization (HMO) plans, we encourage you to choose HMSA participating providers to help keep your out-of-pocket expenses down.
HMOs, while often not having a deductible or having a low deductible, typically require copayment fees for non-preventive visits. A PPO, on the other hand, allows members to see any health care provider in the insurance company's network, without a referral -- even specialists.
PPO Health Insurance Plans
PPO plans provide more flexibility when picking a doctor or hospital. However, your benefits will be better if you stay in the PPO network. Premiums tend to be higher, and it's common for there to be a deductible.News Release: Hawaii's Average Rates for Insurance Exchange Among Lowest
| Hawaii Individual Plans (nonsmoker) Monthly Premiums before reductions | Age 21 | Age 50 |
|---|
| Average Platinum Plan Premium | $240 | $428 |
| Average Gold Plan Premium | $205 | $367 |
| Average Silver Plan Premium | $169 | $302 |
| Average Bronze Plan Premium | $120 | $215 |
Fee-for-Service (FFS) Plans (non-PPO)
A traditional type of insurance in which the health plan will either pay the medical provider directly or reimburse you after you have filed an insurance claim for each covered medical expense. When you need medical attention, you visit the doctor or hospital of your choice.In 2019, according to newly-released figures from the U.S. Department of Housing and Urban Development, a single person living on Oahu is considered “low income” if they earn $67,500 or less. A year ago, it was $65,350. And in 2017, “low-income” was considered $58,600.
Aloha, Medicaid Beneficiaries! Dental services for Hawaii's Medicaid beneficiaries are covered through the State's Medicaid program administered by Hawaii Dental Service (HDS) and coordinated by HDS's partner, Community Case Management Corp. (CCMC).
There are several ways you can begin applying for Medicaid. You can go to www.medicaid.gov, or the website for your state's Medicaid agency. If you do not have online access, Medicaid has local eligibility offices in each state where you can file your application, or you can apply over the phone.
What are the Hawaii QUEST eligibility requirements?
- be a Hawaii resident;
- meet citizenship status requirements;
- have a Social Security number;
- not be certified as blind or disabled.
- not be age 65 or over:
- not be living in a public institution;
Medicare is a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income. Medicaid is a state and federal program that provides health coverage if you have a very low income. They will work together to provide you with health coverage and lower your costs.
Apply for Medicaid
- Call Med-QUEST Customer Service: 1-800-316-8005 toll-free TTY users, call 1-800-603-1201 toll-free or 711.
- Fillable PDF Application. Fill out the application as completely as possible. Print the completed application then mail or fax to the Med-QUEST Division Eligibility Office nearest you.
Hawaii adopted Medicaid expansion through the Affordable Care Act, extending eligibility for Medicaid to adults with income up to 133 percent of the poverty level (138 percent with the automatic 5 percent income disregard). Medicaid expansion took effect in January 2014.
Applications for Health Care Coverage are accepted:
- On-line at
- Over the phone at 1-877-628-5076.
- By mail delivered to Med-QUEST Division Eligibility Offices [/box]
If you are living in
Hawaii and you wish to establish residency, you should begin by doing the following: File a
Hawaii resident personal income tax form.
Looks like it's a combination of:
- Primary "domicile" (place you live) in Hawaii for 12 months.
- Work in/file Hawaii State Taxes.
- Register to Vote in Hawaii.
As a general guideline, in Hawai'i to qualify fo Medicaid if there are four people in your family your income cannot be higher than $3,208 per month. That amount changes based on the number of people in your family.
Hawaii Children's Health Insurance Program (CHIP) provides low-cost health insurance for eligible children. Get free quotes on Hawaii health insurance plans from leading companies, and apply for health care coverage directly online.
Hawaii Medical Service Association (HMSA) is a nonprofit health insurer in the state of Hawaii. HMSA was founded in 1938, is an independent licensee of the Blue Cross Blue Shield Association, and is the largest insurer in the state of Hawaii serving more than 700,000 people.
(1)Hawaii Department of Health, Honolulu 96801. To date, Hawaii is the only state to have implemented near-universal health insurance. The cornerstone of this program is the country's only requirement that employers provide health insurance for all employees who work at least 20 hours per week.
Hawaii was the first state to require employers to offer and help pay for health insurance for their employees. Under the Hawaii Prepaid Health Care Act (HPHCA) employees who work more than 20 hours per week must be covered (Haw. Hawaii has no general law requiring continuation of group health insurance coverage.
News Release: Hawaii's Average Rates for Insurance Exchange Among Lowest
| Hawaii Individual Plans (nonsmoker) Monthly Premiums before reductions | Age 21 | Age 50 |
|---|
| Average Platinum Plan Premium | $240 | $428 |
| Average Gold Plan Premium | $205 | $367 |
| Average Silver Plan Premium | $169 | $302 |
| Average Bronze Plan Premium | $120 | $215 |
The Aloha State stands No. 1 in overall health and public health, second in access to health care and third in quality of health care in the Best States rankings at U.S. News & World Report. And Hawaii is working at keeping it that way.
(1)Hawaii Department of Health, Honolulu 96801. To date, Hawaii is the only state to have implemented near-universal health insurance. The cornerstone of this program is the country's only requirement that employers provide health insurance for all employees who work at least 20 hours per week.
In order to qualify for this benefit program, you must be a resident of the state of Hawaii, a U.S. national, citizen, or qualified alien in need of health care/insurance assistance, whose financial situation would be characterized as low income. You must not be age 65 or older, blind, or disabled.
