FAQ's Regarding the Loss or Potential Loss of Health Insurance
Can I still continue my health coverage if I just lost my job?
Contact your health plan to see if COBRA coverage is a benefit provided in your current health plan. COBRA is a federal law that gives some employees and their dependents the option to continue health insurance. Your health plan must give you a notice stating your right to choose to continue coverage under the plan. You will have 60 days from the date of the notice to choose COBRA coverage or lose all rights to benefits. For more information on COBRA contact the U.S. Department of Labor, Employee Benefits Security Administration (EBSA, formerly known as the (PWBA) Pension and Welfare Benefits Administration) at 1-866-444-3272 or log on to www.dol.gov/ebsa/welcome.html.
My COBRA benefits are going to run out. What do I need to do?
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) you have 60 days from the termination of your health coverage to enroll in a new health plan. Failure to do so will affect coverage for pre-existing conditions. For more information on HIPAA contact the Centers for Medicare and Medicaid Services (formerly HCFA), San Francisco Regional Office at (415) 744-3501 or visit www.cms.hhs.gov/hipaa/.
I was seeing a doctor for a heart condition before I lost my job. Can I be denied coverage because of my pre-existing medical condition?
HIPAA limits the use of pre-existing condition exclusions. However, HIPAA does not control the amount an insurer may charge for coverage for a pre-existing condition.
I can’t get COBRA benefits. What can I do to obtain coverage until I find employment?
If your spouse’s employer offers health coverage you may be able to qualify for coverage under your spouse’s employer plan, or you may apply for individual coverage with a health plan.
If you are not eligible for COBRA coverage and cannot get coverage through your spouse, you may be eligible for Hawaii Med-QUEST. However, you must apply for Hawaii Med-QUEST no later than 45 days from the time you lose your benefits. For information on eligibility requirements, call 524-3370 on Oahu or 1-800-316-8005 toll-free from the Neighbor Islands, or logon to www.med-quest.us.
How does Hawaii Med-QUEST work?
If you are eligible for Hawaii Med-QUEST, you will choose one medical plan and one dental plan to serve you and any family members who are in the program with you.
Some medical plans have a limit on the number of members they can accept. If the plan you want is already full, you will have to choose a different plan. If you do not make a choice, you will be assigned to a medical and dental plan.
Three medical plans are participating. AlohaCare, HMSA, Kaiser Permanente.
Dental coverage through Medicaid, provides emergency dental care for individuals age 21 and older, and full dental care for individuals under age 21. Any provider participating with Medicaid can be seen.
What are the Med-QUEST monthly gross income limits?
The Med-QUEST income levels vary depending upon the number of people in your household. For example, there are different income levels if you are the only one in your household, if you are pregnant, if you have a family of 2, 3, or 4, etc.
You should call 524-3370 on Oahu or 1-800-316-8005 toll-free from the Neighbor Islands for further information on eligibility requirements and income limits.
Does Med-QUEST have an asset limit?
Yes. The asset limit is currently $2000.00 for a household of one, $3000.00 for a household of two, and $250.00 for each additional person. You should call Med-QUEST at 524-3370 on Oahu or 1-800-316-8005 toll-free from the Neighbor Islands for information on what qualifies as an asset.
Where can I get information about signing up for Med-QUEST?
The State Med-QUEST office. You may call 524-3370 on Oahu or 1-800-316-8005 toll-free from the Neighbor Islands for information regarding Med-QUEST.
Will I have to pay for coverage under Hawaii Med-QUEST?
No, but if you become self-employed, you and your spouse may each be required to pay 50% of the Hawaii Med-QUEST monthly premium.
Will I have to make out-of-pocket payments for medical services I received under Med-QUEST?
No, but if any adult member becomes self-employed he or she may have to make co-payments for some services.
What should I do if I don’t qualify for any of the programs or can’t afford any health insurance?
There are several community health centers that provide health and social services at a reasonable cost, including primary, preventive and dental care. For a listing of primary care clinics in your area, call the Aloha United Way hotline at 211 (toll free from all islands) or logon to www.coveringkids.com.
Even if I can’t get medical insurance for myself and my spouse, I’m worried about my children. Are there any programs providing health insurance for kids?
Yes. Hawaii Covering Kids is a project that was created to help children and youth eligible for Med-QUEST (managed care Medicaid) and Medicaid-Fee-for-Service with health insurance enrollment process. These programs include State CHIP (Children’s Heath Insurance Program) and the Immigrant Children’s Program. State CHIP is not a separate health insurance program. It expanded Med-QUEST and Medicaid Fee-for-Service health insurance for children and youth.
Med-QUEST and Medicaid Fee-for-Service are government programs that offer free health insurance for uninsured children who are under nineteen years old, meet family income levels, are residents of Hawaii, and U.S. citizens, legal immigrants, refugees, or citizens of the Marshall Islands, Federated States of Micronesia, or Palau.
Med-QUEST-Net is a program for people who no longer qualify for Med-QUEST or Medicaid Fee-for-Service due to income limits. A person must already be enrolled in one of those programs and meet a different family income level to be eligible. The monthly fee for Med-QUEST-Net is currently $61.80.
For more information or a referral, call the Aloha United Way hotline at 211 (toll free from all islands) or logon to www.coveringkids.com
What is the Med-QUEST monthly income level to qualify for health insurance for my children?
It depends on the number of people in the household. The income level for a single parent with one child is different from the income level for a household of 3 or a household of 4, etc. Please call the Aloha United Way hotline at 211 (toll free from all islands) or log on to www.coveringkids.com for more information.