Med-QUEST Division (MQD): HeHawaii alth Insurance & Long-Term Care for Low-Income Adults and Families

The State of Hawaii Med-QUEST Division (MQD) gives eligible low-income adults and children get right of entry to to Hawaii fitness and clinical insurance through managed care Hawaii plans.   The QUEST program is designed to offer Quality care, Universal get entry to, Efficient usage, Stabilizing expenses, and to Transform the manner fitness care is provided to recipients.

Grievance Hotline  Call Hawaii 692-8094.  Leave a message in conjunction with your name and call smartphone wide variety.  A body of workers person from our Med-QUEST Division will call you back inside 24 hours or the next business day.

The Department of Human Services Med-QUEST Division (MQD) has released, QUEST Integration, a more affected person-centric Medicaid application to higher serve clients. QUEST Integration successfully combines and replaces the QUEST and QUEST Expanded Access (QExA) packages.

The blessings of QUEST Integration include greater fitness plan picks for aged, blind or disabled individuals, and a greater capacity for a beneficiary to stay with the equal health plan upon turning 65 or developing a disability. Additionally, eligible beneficiaries will advantage expanded access to home and community-based totally offerings to prevent decline to institutional degree of care. QUEST Integration also reduces administrative burden by using growing a single controlled care software.

Step 1: Learn About Your Choices

Choosing a health plan is crucial. You’ll get all your fitness care offerings from a single fitness plan. The health plan permit you to locate docs, hospitals, and pharmacies.

When you’re choosing a health plan, it’s an amazing concept to look if you can:Keep seeing your cutting-edge doctors.Go to the clinic, care facility, or pharmacy you opt for.

The fitness plans taking part in QUEST Integration are AlohaCare, Hawaii Medical Service Association (HMSA), Kaiser Foundation Health Plan (Oahu & Maui handiest), ‘Ohana Health Plan and UnitedHealthcare Community Plan.  (See beneath for touch statistics).  If there’s a Hawaii selected provider you want to see, go to the QUEST Integration fitness plans’ web sites, or call to ask if the provider is of their community.

If your contemporary issuer doesn’t take delivery of QUEST Integration (Medicaid) medical insurance, call your fitness plan to help you discover some other medical doctor or provider.

United Healthcare Community Plan

When you grow to be eligible for Medicaid, the Department of Human Services assigns you to a fitness plan proper away. You can live with the health plan that Med-QUEST assigned to you or you may select a one of a kind fitness plan.

If you live with your assigned health plan, you don’t ought to do anything.

If you pick a exclusive fitness plan, you must:Tell Med-QUEST Enrollment Services Section of your new choice inside fifteen days of receiving a choice notice from them.Your new health plan will start on the primary day of the following month. Until then, you’ll live with the fitness plan you have been assigned.

If you live along with your assigned fitness plan or select a distinctive health plan, you can alternate plans as soon as inside 60 days of the day you are enrolled in QUEST Integration. Once the 60-day duration ends, you can change your fitness plan only during open enrollment.

How many health plans can I pick from?

Your five choices for a QUEST Integration health plan are:Aloha CareHMSAKaiser Permanente (Oahu and Maui best)‘Ohana Health PlanUnited Healthcare Community Plan

After you select a QUEST Integration health plan, your plan will mail you:ID cards for each member of the family.Instructions to select a number one care company (PCP).Health plan obligations, offerings, and benefits guide with facts on:Interpretation and translation offerings.Prior acclaim for care and different offerings.Services the plan doesn’t cover due to ethical or religious reasons.The criticism and attraction manner.

Make positive you convey your QUEST Integration fitness plan ID card and Medicaid ID card always. You’ll want your ID cards to get health care offerings.

Getting care before you receive your fitness plan member ID card

You’ll get a notice inside the mail that tells you about the fitness plan you’re enrolled in. Take the notice with you on your medical doctor or other carrier company to get hospital therapy. Once you get your fitness plan ID card, you can use your card to get offerings.

Choosing a primary care company (PCP)

Your fitness plan will mail you a welcome packet. Inside the packet you’ll find a shape asking you to choose a number one care provider (PCP). Your PCP will see you for everyday checkups or whilst you’re ill. When you want a consultant or different scientific offerings, your PCP will set up it for you. If you want help finding a PCP or professional, ask your fitness plan for assist.

If you obtained offerings before you obtain the Med-QUEST enrollment notification, inform your PCP or different service company. Your health plan may cover a number of those offerings.

You’ll have 15 days to pick out your PCP. If you don’t let your health plan recognize of your choice inside that time, they’ll assign you a PCP. You can exchange your PCP at any time.

Primary & Acute Care ServicesDialysisMedical transportation servicesDurable clinical gadget and clinical resources with prosthetics and orthoticsOutpatient clinic servicesEmergency and publish stabilization servicesPhysician servicesFamily planning servicesPregnancy-related servicesFluoride varnish for childrenPrescription drugsHabilitation servicesPreventive servicesHome fitness servicesRadiology, laboratory, and other diagnostic servicesHospice servicesRehabilitation servicesInpatient clinic scientific and surgical servicesSmoking cessation servicesInpatient health facility maternity and new child care servicesUrgent care servicesMedical services associated with dental needsVision and listening to servicesBehavioral Health ServicesAcute inpatient medical institution for behavioral fitness servicesServices from qualified experts like psychiatrists, psychologists, counselors, social people, registered nurses, and othersAmbulatory intellectual health servicesSubstance abuse remedy programsPrescribed pills consisting of medication management and patient counselingMethadone treatment services, which consist of the provision of methadone or a suitable alternative (e.g., LAAM)Psychiatric or psychological evaluation  Long Term Services & Support (LTSS)Nursing facilityHome- and community-based services along with:ChoreAdult day healthPersonal careAdult day carePersonal emergency reaction systemSkilled nursingResidential care like Community Care Foster Family Home or Expanded Adult Residential Care Home

Does QUEST Integration cowl scientific and bills I already have?

If you utilized medical offerings going on a maximum of 10 calendar days before the date we receive your utility, the ones offerings may be included if a medical provider furnished the scientific service. Make sure which you take a look at off the box asking approximately brilliant medical bills whilst you publish your software.

After I pick out my scientific plan, will I have to stay in that plan for all time?

No. You might also alternate your medical plan as soon as a year all through the “Annual Plan Change Period,” with modifications powerful January 1. Except in the course of this annual plan change length and a few exceptions, you have to live on your scientific plan as soon as you have selected them.

Are you beneath 21 years of age? Get free bodily exams!

The Early Periodic Screening, Diagnostic, and Treatment (EPSDT) application we could kids and teens beneath 21 get unfastened:Complete medical and dental tests;Developmental, autism, and lead screening;Hearing, imaginative and prescient, and laboratory checks; andImmunizations and tuberculosis skin tests.

The note here will affords more statistics about different included services that you could take advantage of, along with autism offerings. You’ll also get help putting in place appointments and arranging transportation. Call your health plan for extra statistics.

If you could’t get an appointment with your PCP, you may go to an pressing care middle. Urgent care centers can deal with you for an illness or injury that calls for immediately care, however isn’t extreme enough to go to an emergency room. You don’t want an appointment to be dealt with at an urgent care center.

Each fitness plan has its very own after-hours care nurse line, wherein you may get clinical recommendation and steering. The lines function 24 hours an afternoon, seven days every week.

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