What is the difference between Medicaid and Hawaii QUEST?
The Medical Assistance Program
(MEDICAID) has been in effect since January 1966. In August 1994, Hawaii’s Medicaid Program separated into two methods of providing services for the two major groups of recipients. Generally, for individuals who are age 65 and over, or certified blind or disabled, coverage is provided under Hawaii’s Fee-For-Service Medicaid Program where providers are paid directly for their services. For all other individuals, coverage is provided under a managed care program called Hawaii QUEST. Beginning February 2009, individuals who are age 65 and over, or certified blind or disabled are no longer covered under the Fee-For-Service program, medical insurance coverage is provided under a managed care plan call Quest Expanded Access (QExA). Some medical insurance programs such as dental services continue under the Fee-For-Service model.
Hawaii QUEST, commonly known as QUEST is a program that provides health coverage through health plans for eligible Hawaii residents. It provides medical and mental health services. Dental Services are provided under the Medicaid Fee-For-Service Program. QUEST is administered by the Department of Human Services, Med-QUEST Division and is financed through the State of Hawaii and the Federal Centers for Medicare and Medicaid Services.
Q: How Do I Know When to Contact the Med-QUEST Division and wWhen to Contact my Health Plan?
A: You should contact the Med-QUEST Division if:
You should contact your health plan if:
- you have a question about your QUEST eligibility;
- you get a job or change jobs;
- your income or assets change;
- you have a name or address change; or
- you have a change in your family, such as a birth, a death, a divorce, a marriage or someone moves into or out of your home.
- you have questions about how to get the care you need;
- you lose or misplace your medical plan card;
- you need special assistance; or
- you have a name or address change.
After I'm Enrolled Into a Medical Plan, Will I have to Stay in That Plan Forever?
No. You may change plans once a year during the "Plan Change Period." You will be mailed a packet with a form to fill out. Except for this annual change period and some exceptions, you must stay in your medical plan once you have been enrolled.
What About Dental Coverage?
Services are provided through the Medicaid Fee-For-Service Program. This means:
- You must get your dental care from a dentist who sees Medicaid patients. Ask the dentist you wish to see if he or she will see Medicaid patients under the Medicaid Fee-For-Service Program. If the dentist will not see Medicaid patients, you will have to find a dentist who does see Medicaid patients.
- You will use the Medicaid ID card mailed to you when you enrolled to get treatment from a Medicaid dentist.
Do not throw away or lose the Medicaid ID card.
Persons under age 21 also receive full dental coverage, while individuals age 21 and over are covered for dental emergencies only under the Medicaid Fee-For-Service Program.