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Hawaii Medicaid Fee-For-Service Program

What You Need To Know

Hawaii has set up two programs for its low-income residents. These programs are aimed at providing Hawaiian residents with medical assistance. These benefits programs are:

  1. Hawaii QUEST
  2. Medicaid Fee-For-Service

The second benefit program provides medical coverage to three kinds of groups. These categories can be defined as:

  • People aged 65 or above
  • People who are blind
  • People with disabilities

Their medical coverage is provided in a way that makes life easier for them. Medicaid achieves this by paying the healthcare providers for the services availed. This direct payment eliminates the worry for fees for these qualified individuals. Other individuals are advised to apply for the Hawaii QUEST program instead.

Eligibility of the person is dependent upon the group, especially concerning the income level. An applicant of Medicaid Fee-For-Service will be classified into one of the three categories. Once this has taken place, their income and eligibility will be seen accordingly.

Are You Eligible

A basic criterion has been set in regards to this program. Once these requirements are fulfilled, the person can consider further eligibility aspects. The person has to

  • Be a resident of the state of Hawaii
  • Be a U.S. national, citizen, or qualified alien
  • Require medical assistance
  • Have a financial situation which can be described as low or very low income.
  • Be aged 65 or above; or blind; or disabled.

The assets and earnings of the person are also considered. These are major factors in determining the eligibility of the person. It is expected that the applicants, those who are adults must not have more than 100% of the FPL. That is the current Federal Poverty Level (FPL). On the other hand, those below the age of 19 are expected to have an income less than 200% FPL. The FPL level is also different for pregnant women who must have a countable income below 185%. The size of the household for a pregnant woman would be considered with the addition of the unborn child.

The countable assets of the applicant are also considered. The following four situations outline the amounts as well as the household size.

  • For a household of one person, the assets must amount to or be less than $2,000
  • For a household of two people, the assets must amount to or be less than $3,000.
  • An additional person in the household leads to a $250 increase in the limit.
  • These assets limits do not apply to those individuals;
  • Who are below the age of 19.
  • Who are pregnant. It is not applicable during their pregnancy duration plus 60 days.

The annual household income requirement can be outlined through the help of the following table. It is important for the earnings of a household, before any tax deductions, to amount to:

Size Of The Household Maximum Annual Income Level ($)
1 19,126
2 25,882
3 32,639
4 39,395
5 46,151
6 52,908
7 59,664
8 66,421

A household may have more than eight residents. In such cases, an additional amount of $6757 is added per extra person. It is advised that an individual keep in touch with the managing agency. This can prove to be a helpful step. It will also help to ensure that the guidelines being following are accurate.

How To Apply?

The application process can begin by contacting the closest Med-QUEST Division Eligibility Branch. Its location can be found through the help of the internet. One can easily request an application form from them. Applications are accepted by this office through the eligibility offices set up throughout Hawaii. This includes the hospitals and health centers that forward the medical application to them. In case the potential applicant is a participant of the food stamp program, his caseworker can also submit his application.

Once the application form is completed, it is returned to the Med-QUEST office. It is then, the responsibility of the office to contact you for the scheduling of your interview. This interview would determine your eligibility furthermore. Therefore, it is requested from the applicants to provide documents that can verify their:

  • Date of birth
  • Citizenship
  • Social Security Number
  • Income
  • Assets

If it is not possible for the person to represent themselves in the interview, they can appoint someone else. The person must be well aware of the situation of the applicant. This can include spouse, adult child, sibling, other family relations and friends.

For Further Information

The authority behind Medicaid Fee-For-Service has set up a website to cater to the queries of people. It contains information that can help people to determine their eligibility for it. Along with this Med-Quest Division’s website, Hawaii My Medical Benefits website is also available. It provides ease of access to the residents of Hawaii concerning their applications and other information.

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