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Human Services Hawaii.gov

SUBMIT THROUGH HCWIP PORTAL

An easy and convenient way to apply for Hawaii CWIP.

You will be directed to our MyBenefits Portal.

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SUBMIT COMPLETED PAPER FORM

Please click here if you are ready to attach a completed 1193 CWIP form. 

**You will need the form signed by the Examiner before doing this.

UPLOAD COMPLETED FORM
Click Here to Sign Up!

If you need an auxiliary/aid service or other accommodation due to a disability, please call (808) 900-5570 or email [email protected] (Please identify in the subject line: HCWIP) Requests made as early as possible will allow adequate time to fulfill your request. 

MedQUEST portal​:

https://medquest.hawaii.gov/myaccount/

Tutorial for Parent(s)
Tutorial for Parent(s)

Hawai‘i Child Wellness Incentive Program

Tutorial for Provider
Tutorial for Provider

Hawai‘i Child Wellness Incentive Program

Program FAQs

Q: What is HCWIP?

A:  The Hawai‘i Child Wellness Incentive Program (HCWIP) is a pilot program enacted by the Hawai‘i State Legislature as an incentive to ensure the health of children in Hawai‘i, including early detection of potential illnesses.  The pilot program shall pay $50 to each state Medicaid benefit recipient parent for each completed well—child examination of that recipient parent's child, provided that only one payment may be made per child each year.

Q: Who is eligible for the $50 incentive?

A:  HCWIP is targeted toward Medicaid/QUEST Beneficiary Parent(s) who have unmarried child(ren), including adopted and stepchildren below 18 years of age.  Each qualifying child can receive the incentive when they have a well-child examination each year.  Medicaid eligibility for the child is not required.

Q. What are the steps needed to get a $50 incentive card?

A:   After you apply, take your child to complete a well-child examination, then submit the completed application to [email protected].  You will receive notification when your card has been mailed to you.

Q. I updated my address on my online application so my card will be sent to this address.  Will this information also get transmitted to my KOLEA account?

A: The updated information will not be transmitted to KOLEA, therefore the applicant will have to submit a Change of Circumstances request to MedQuest to make this change.

Q. What is a Medicaid beneficiary parent?

A:  A parent that is actively enrolled in Medicaid/QUEST as a beneficiary and is legally responsible to support the child(ren).

Q: Can I apply for my grandchild/niece/nephew/cousin?

A:  No, the HCWIP benefit is only for children of Medicaid/QUEST parents, including adopted and stepchildren.

Q:  Can my application be denied?

A:  An application can be denied for the following reasons:

  •         The parent(s) are not actively receiving in Medicaid/QUEST 
  •         The doctor/LHCP does not have an active license in Hawai‘i
  •         The child is over 17 years old at the time of the well-child examination 
  •         The applicant is not the natural, adopted or stepparent of the child  
  •         A $50.00 incentive benefit was previously issued for the child this year
  •         The application was canceled online through the MyAccount Portal
  •         The child is married

The applicant shall be granted a review of the denial by the department and the department's decision from the review will be final.

Application FAQ’s

Q:  How can a Medicaid/QUEST parent apply?

           A:  Download or print DHS 1193 Form and Instructions (Rev. 05.2024).pdf

           Complete and sign Section 1 (parent information)

           Take your child to a Licensed Health Care Professional (LHCP) for a well-child examination and have the LHCP complete and sign Section 2.

           Go to our website https://medquest.hawaii.gov/cwip and select one of two options:

           If you have an online KOLEA account or want to sign up for one click here to go through the HCWIP portal (LINK)

           Or click here to simply complete the online form and upload your completed DHS 1193 (LINK)

Q: “What information is required to complete the DHS 1193 application?”

          A:  A Medicaid/QUEST parent will need to complete the application by filling out all the requested information, phone number and email address are optional.            Incomplete applications may result in a denial.

Q:  What information is required to complete the application?

A:  A Medicaid/QUEST parent will need their Medicaid ID, child’s full name and birthdate, and the name of the doctor/Licensed Health Care Professional (LHCP) who will conduct the exam.

Q: Does the provider need a Medicaid number?  

A:  The provider must be licensed to practice medicine in Hawai‘i.  The provider needs a Medicaid ID number to access your application in the online portal.  A paper application is required if a non-Medicaid provider is conducting the examination.

Q: What can I upload in the HCWIP application portal?

A: You may only upload a completed signed DHS 1193 Application signed by your child’s examiner who has validated the examination.  This means that Part 1 and 2 of the application should be completed and certified before the document is uploaded.  No other type of document should be attached.

Examination FAQs

Q: What is a well-child examination?

A: A “Well-child examination" also known as well-child visits, well-care visits, and well-care checkups including but not limited to:

  • Physical examination
  • Immunizations
  • Vision and hearing screening
  • Developmental and behavioral assessment
  • Oral health risk assessment
  • Social assessment
  • Parenting education on a range of topics 
  • Care coordination, as needed

Q:  The doctor who conducted my child’s exam is different than the doctor I named on my application.  Is my application still good?

A:  No, you will have to cancel the original application and submit another one using the doctor who completed the exam.

 

INCENTIVE CARD FAQs

Q:  How will I receive my incentive card?

A:  Upon receiving the confirmation from the doctor's office that a wellness examination was successfully completed, Med-QUEST Administration will approve the application and order the $50.00 Incentive card.  The card will be mailed to the address provided on the application.   

Q:  How does the card work?

A:  The Incentive card is a prepaid card and is simple and easy to use.  Your incentive card will have a value of $50.00 which can be used for multiple purchases for as long as value remains on the card.  Each time you use your incentive card, the value is reduced by the amount of the purchase until the incentive card value is zero.  Once your incentive card is activated, use it to purchase healthy necessities.  It  shall not be used to purchase items that are unhealthy or pose an endangerment, to include but not limited to alcohol, firearms, and illegal drugs. 

Q:  Can my incentive card be used to obtain cash at an ATM or bank? 

A:  No, your incentive card cannot be used for cash access at an ATM or bank.  You can use your incentive card at any U.S. merchant that accepts the debit card. 

Q:  What if the incentive card is damaged?

A:  If your card is damaged, you will need to contact HCWIP Customer Service at (833) 909-3631 and select [3] from the Menu Selection to report it.  You will need to return the damaged card to be replaced and a new card will be sent to you.  LOST OR STOLEN CARDS WILL NOT BE REPLACED. 

Q: When does the card expire?

A:  The $50 Incentive card expires one year after it has been issued. Expired cards will not be replaced.   

Forms

DHS 1193 Hawai‘i Child Wellness Incentive Form and Instructions PDF

 

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