Medicaid Fee-For-Service
The Medicaid FFS Program is the traditional Medicaid Program that has provided medical coverage to low-income Hawaii residents since January 1966. The program provides coverage for individuals who are age 65 and over, or under age 65 who are blind or disabled. All other individuals are covered by QUEST.
Eligibility
- Be a Hawaii resident
- Be a U.S. citizen or legal immigrant and
- Provide proof of their citizenship
- Provide proof of their identity
- Provide a Social Security Number
- Not reside in a public institution
- Be age 65 and older
- If under age 65, must be certified to be blind or disabled by the State or the Social Security Administration
- Meet an asset test
- Meet an income test
Financial Responsibility for Support
Asset
The asset standard is $2,000 for a household of one, $3000 for two, and $250 for each additional family member.
Income
The income standards depend on factors such as age, blindness, disability, pregnancy, living arrangements, and household size. The standards are based on the Federal Poverty Levels (FPL) and the payment levels of the SSI or the Temporary Assistance to Needy Families (TANF) programs. Since the FPL, SSI and TANF levels may be adjusted annual cost of living increases, individuals should contact the Med-QUEST Division to obtain the current income standards.
Covered Services
- Inpatient and outpatient hospital and clinical services (including X-ray and laboratory examinations)
- Physicians’ services
- Nursing facility and home health services
- Drugs not covered by Medicare Part D
- Biological and medical supplies (medical equipment and appliances)
- Podiatry (foot care)
- Whole blood
- Eye examinations, refraction and eyeglasses
- Dental services (individuals age 21 and older have an annual payment limit for non-emergency services.)
- Family planning services
- Psychiatric/psychological services
- Diagnostic, screening, preventive and rehabilitative services
- Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services
- Prosthetic devices, (including hearing aids)
- Transportation to, from, and between medical facilities, (including inter-island or out-of-state air transportation, food, and lodging as necessary)
- Respiratory care services
- Hospice care services
In addition to the coverage listed above, blind or disabled individuals under age 21 receive Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) health services. These services include:
- Complete medical and dental exams;
- Hearing and vision tests, laboratory tests;
- Immunizations and skin tests for tuberculosis (TB);
- Assistance with necessary scheduling and transportation upon request.
- Unlimited mental health benefits