Proposed Medicaid Eligibility & Benefits Changes
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The Department of Human Services Med-QUEST Division announced new eligibility and benefits guidelines that will affect certain QUEST programs.
The tentative effective date for the announced changes is July 1, 2012.
The announced changes come as a result of budget reductions enacted as a part of the Hawai‘i state budget for the 2011-2012 fiscal year and, to a greater extent, by the economic difficulties facing the state and the entire nation. These economic circumstances compelled the Department of Human Services to make difficult choices concerning Med-QUEST programs.
Prior to announcing the new eligibility and benefits guidelines for QUEST programs, the Department of Human Services engaged healthcare providers and members of the public through various community forums and discussions. Comments and suggestions proposed during this dialogue greatly influenced the decisions ultimately made by the Department. Even so, we are cognizant that any reductions made to medical assistance program eligibility and benefits have unavoidable negative impacts on the clients we are committed to serve.
Beginning in 2012, all medical assistance programs will be consolidated into the following three benefits packages:
QUEST Expanded Access (QExA)
All QUEST Expanded Access (QExA) program enrollees will continue to receive the same benefits package as currently provided, except for certain limitations on chore services and non-emergency ground transportation.
All QUEST program members age 20 and under will receive the QUEST-Keiki benefits package. With the exception of certain reductions in non-emergency transportation services, the QUEST-Keiki benefits package provides the same benefits package as currently provided to QUEST program members age 20 and under.
All QUEST, QUEST-ACE, and QUEST-Net programs adult members will receive the QUEST-Adult benefits package.
Additional information regarding specific changes to program eligibility and benefits are explained in the frequently asked questions guide below.
QUEST ELIGIBILITY AND BENEFITS CHANGES FOR 2012
- Med-QUEST Division Status Update, April 2012
- Sample Notice
- PROPOSED PHASE-OUT PLANS SUBMITTED TO THE CENTER FOR MEDICARE AND MEDICAID SERVICES
FREQUENTLY ASKED QUESTIONS