Hawaii Medicaid Waiver Guide

What is Hawaii Medicaid?

Hawaii serves most children through a managed care demonstration waiver program, but does have one 1915(c) HCBS waiver. The HCBS waiver waives parental income. Hawaii provides home and community based services to most children who require at least an institutional level of care through their Medicaid demonstration program. For an overview of Hawaii Medicaid, see Quest Hawaii.

Types of Waiver Programs

Quest Hawaii – Quest Integration

• Description from medicaid.gov: Hawaii’s QUEST Integration program is a statewide section 1115 demonstration. The demonstration enables the state to operate QUEST, which provides Medicaid coverage for medical, dental, and behavioral health services through competitive managed care delivery systems. The QUEST program was designed to increase access to health care and control the rate of annual increases in health care expenditures. The demonstration also allowed the State to expand coverage beyond its Medicaid State plan. Through the demonstration, the state provides coverage to children and adults who are eligible under the Medicaid state plan as well as additional children and adults (including former adoption assistance children, certain parents, and certain individuals who receive home and community based (HCBS) services). All beneficiaries are eligible for state plan benefits (or, in the case of the Affordable Care Act childless adult group, approved benefits under the alternative benefit plan) as well as additional services based on medical necessity and clinical criteria (including HCBS), provided through an integrated managed care delivery system.
• Online State Information: Quest Integration Program
• Official Federal Information
• How to Apply: Call the helpline at 800-316-8005 or 211.

HCBS for People With DD

• Description from medicaid.gov: Provides adult day health (ADH), discovery & career planning (DCP), individual employment supports (IES), personal assistance/habilitation (PAB), residential habilitation (ResHab), respite, additional residential supports (ARS), assistive technology (AT), chore, community learning services (CLS), community navigator (CN), environmental accessibility adaptations (EAA), non-medical transportation (NMT), personal emergency response system (PERS), private duty nursing (PDN), specialized medical equipment and supplies (SMES), training and consultation, vehicle modifications (VM), and waiver emergency services for individuals with intellectual disabilities and developmental disabilities ages 0 – no max age.
• Online State Information: Developmental Disabilities Division Waiver Services and this specific information.
• Official Federal Information
• How to Apply: Contact the Developmental Disabilities Division or see this How to Apply page.

Other online resources for Hawaii:

• Hawaii Autism Foundation helps families find and fund solutions to their problems.
• Special Parent Information Network Hawaii can help you find great resources for your child.
• The ARC of Hawaii can help with advocacy and employment opportunities

Telephone Resources

• Developmental Disabilities Division phone numbers are your best place to call for all types of information.

Ordering Goally with a Medicaid Waiver

Talk with your case manager to see if the waiver program you have will cover Goally. If so, have your case manager email us at: [email protected] to place an order on your behalf.