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Hawaii Medicaid Fee-For-Service Program

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undefined Hawaii Medicaid Fee-For-Service Program?

Medical assistance is medical coverage provided for eligible low-income Hawaii residents. Hawaii has two medical assistance programs called Hawaii QUEST and Medicaid Fee-For-Service. Generally, for eligible individuals who are age 65 and over, or certified blind or disabled, coverage is provided under Hawaii's Medicaid Fee-For-Service Program where providers are paid directly for covered services. For all other eligible individuals, coverage is provided under a managed care program called Hawaii QUEST.

The income standard used to determine your eligibility would depend on your coverage group. When applying for Medicaid, the Department will determine your coverage group and use the income standard of that group to determine your eligibility.

Medical assistance is medical coverage provided for eligible low-income Hawaii residents. Hawaii has two medical assistance programs called Hawaii QUEST and Medicaid Fee-For-Service. Generally, for eligible individuals who are age 65 and over, or certified blind or disabled, coverage is provided under Hawaii's Medicaid Fee-For-Service Program where providers are paid directly for covered services. For all other eligible individuals, coverage is provided under a managed care program called Hawaii QUEST.

The income standard used to determine your eligibility would depend on your coverage group. When applying for Medicaid, the Department will determine your coverage group and use the income standard of that group to determine your eligibility.

undefined Hawaii Medicaid Fee-For-Service Program?

To be eligible for Hawaii Medicaid Fee-for-Service, you must be a resident of the state of Hawaii, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. You must also be one of the following:

  • Pregnant, or
  • Be responsible for a child 18 years of age or younger, or
  • Blind, or
  • Have a disability or a family member in your household with a disability.
  • Be 65 years of age or older.

In order to qualify, you must have an annual household income (before taxes) that is below the following amounts:

Annual Household Income Limits (before taxes)
Household Size*Maximum Income Level (Per Year)
1$23,023
2$31,255
3$39,488
4$47,721
5$55,954
6$64,186
7$72,419
8$80,652

*For households with more than eight people, add $8,233 per additional person. Always check with the appropriate managing agency to ensure the most accurate guidelines.

Contact the nearest office of the Med-QUEST Division's Eligibility Branch to request an application form.

The Med-QUEST Division accepts applications at eligibility offices located throughout Hawaii. (Most hospitals and certain health centers have also made arrangements to forward your medical application to us.) If you are currently receiving food stamps, your caseworker can process your medical application.

For more information, please visit the Med-QUEST Division's website.

Complete the application form and return it to the Med-QUEST office. They may contact you to schedule an appointment to establish your eligibility. You may be required at that time to provide verification of your date of birth, citizenship, Social Security Number, income, and assets. If you are unable to represent yourself, you may appoint someone to represent you. This could be your spouse, adult child, sibling, other relatives, a friend, or anyone else who knows of your situation.

Go to the Hawaii My Medical Benefits website to access applications and further information.

800-316-8005

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