The Hawaii Medicaid Program Covers:

The Hawaii State Department of Human Services (DHS) offers several programs that provide coverage of medical services for low income Hawaii residents. The federally funded Medicaid Program is the primary source for most medical assistance programs. In addition to the Medicaid programs, there are several programs that are exclusively State funded. The Medicaid Fee-For Service Program and the Hawaii QUEST Medicaid managed care program provide comprehensive coverage of medically necessary services, while other programs may offer coverage of specific services. DHS will determine the appropriate program an applicant is eligible for.

Each program has separate requirements for who can participate, the amount of assets and income, and the coverage provided.

 

Other Programs

  • Medicaid Fee-For-Service Program (FFS) provides coverage for residents who are age 65 and older, or under age 65 who are certified to be blind or disabled.
  • Long Term Care: Special provisions apply to individuals who need medical assistance for long term care
  • Liens: Medicaid recipients in nursing facilities who own home property will be evaluated for the placement of a Lien.
    Pregnant Women: Special provisions apply to women who are pregnant.
  • Hawaii QUEST Program (QUEST), provides coverage for residents who are under age 65 and are not certified to be blind or disabled.
  • Pregnant Women: Special provisions apply to women who are pregnant.


 

  • QUEST-Net Program provides coverage for Medicaid FFS or QUEST recipients who no longer qualify for those programs.
  • QUEST Adult Coverage Expansion Program (ACE) provides coverage for adults who cannot be enrolled in QUEST due to the QUEST enrollment cap.
  • Transitional Medical Assistance Program (TMA) provides continued coverage for certain families with children who lose Medicaid FFS or QUEST eligibility due to increased earnings or child support.
  • State Medical Assistance for Immigrant Children Program is a State funded program that provides coverage for legal resident immigrant children who cannot be covered by the Medicaid FFS or QUEST programs.
  • State Medical Assistance for Pregnant Legal Immigrant Women Program is a State funded program that provides coverage for legal resident immigrant pregnant who cannot be covered by the
  • Medicaid FFS or QUEST programs.
  • Medicare Savings Program provides coverage of Medicare premiums, deductibles and co-insurance for low-income Medicare beneficiaries.
  • Hawaii RX Plus is a State-funded drug discount program that enables eligible members to receive the Medicaid discount for drugs.
  • State Pharmacy Assistance Program is a State funded program that assists with the payment of Medicare Part D co-payments with State funds.