- Learn how you might be eligible for Hawaii Medicaid and what healthcare benefits you might be entitled to. Find out how to apply for Medicaid in Hawaii.
Medicaid in Hawaii is administered by the Department of Human Services’ Med-QUEST Division and is jointly financed by the state and Federal Centers for Medicare and Medicaid Services. Medicaid is a joint federal and state partnership that provides healthcare coverage to very low- and no-income children and adults who are unable to pay for medically necessary services.
Hawaii offers two Medicaid programs called Hawaii Quest and Medicaid Fee-For-Service.
Hawaii Med-QUEST (commonly known as Quest for Quality, Universal Access, Efficiency, Sustainability, Transformation) is a division of the Department of Human Services that provides healthcare benefits to state residents who are eligible for Medicaid. It includes medical and mental health services. Dental care is provided under the Medicaid Fee-For-Service program.
Typically, eligible participants who are 65 years and older, blind or disabled receive healthcare under the state’s Medicaid Fee-For-Service program where medical providers are paid directly for covered services.
Applicants under the age of 18, pregnant women, parents and caretaker relatives, older adults 65 years old and over, blind, disabled people and low-income individuals are eligible for Medicaid. Hawaii Medicaid provides healthcare support and resources for an estimated 367,000 state residents based on financial and medical need.
What Benefits Does Hawaii Medicaid Cover?
Hawaii Medicaid typically covers routine medical appointments and preventative care, emergency services and outpatient health visits.
Medicaid in Hawaii also includes a dental service benefit as part of its standard Medicaid Fee-For-Service coverage option. Dental services are provided by dentists enrolled in the state’s Medicaid program. Telephone inquiries about the dental plan and services can be made by calling (888) 792-1070.
For participants under the age of 21, coverage includes diagnostic and preventative services once every six months and nonemergency care, such as oral surgery and restorations. For adults 21 and older, coverage includes eliminating dental pain and infection, and treatment related to acute injuries to teeth.
Hawaii Medicaid participants are also eligible for behavioral health services that include substance abuse treatment programs, psychiatric or psychological evaluations and prescription drugs.
Who Is Eligible for Medicaid in Hawaii?
Hawaii residents are eligible for state Medicaid if they meet the income and asset requirements according to federal guidelines. To qualify for Medicaid Fee-For-Service in Hawaii, beneficiaries must earn less than the modified annual gross income (MAGI), which is set to 191% of the federal poverty level. The federal numbers are $12,880 a year for individual adults and $26,500 for a family of four, and the maximum qualifying incomes in Hawaii are $19,525 and $40,073.
The qualifying incomes in Hawaii for individual adults under the Quest program is $14,680 and $30,130 for a family of four. Amounts vary according to family size.
Eligibility depends on the size of your family, the value of assets and category of service you are applying for. People whose QUEST eligibility is based on their income are typically approved under the following thresholds:
- Children: up to 308% of the federal poverty line
- Pregnant women: up to 191% of the federal poverty line
- Parent/Caretaker relatives - up to 105% of the federal poverty line
- Adults under the age of 65 who do not receive Supplemental Security Income or Medicare - up to 133% of the federal poverty line
Children in Hawaii can enroll in the Children’s Health Insurance Program (CHIP) and are eligible to receive routine check-ups, doctor visits, prescription drug benefits, dental and vision care and emergency services.
How Do I Enroll in Medicaid in Hawaii ?
The best way to see if you or your household members qualify for Medicaid is to apply. There are three simple ways to apply for healthcare benefits:
- Submit an online application
- Apply over the phone by calling Med-QUEST’s call center at (800) 316-8005
- Download a Medicaid application form at the Department of Human Services website
Contact Information for Hawaii Medicaid
There are several convenient ways to contact the Medicaid office in Hawaii. The public can reach the office’s main switchboard in Oahu at (808) 524-3370 or for those located on neighboring islands at (800) 316-8005.
Telephone inquiries about specific Medicaid services, the application process or an eligibility status can be made by phone, online or via email at HCSBInquiries@dhs.Hawaii.gov. Applications and general correspondence may be sent to the Oahu Medicaid office at:
801 Dillingham Boulevard, 3rd Floor
Honolulu, HI 96817-4582