Med-QUEST Determinations

The Department of Human Services (DHS) Med-QUEST Division (MQD) helps low-income adults and children obtain health coverage through managed care plans.  On October 1, 2013, in compliance with mandates of the Affordable Care Act (ACA), the DHS launched an on-line system that simplifies the application and eligibility determination process.

Beginning May 2014,  Hawaii determination data is posted monthly.  This revised time line aligns with required reporting to the federal Centers for Medicare and Medicaid Services (CMS).

October 2014 is the first month since implementation of  the ACA that the MQD is performing annual renewals for the single month.  Between April and September 2014, the MQD was renewing eligibility concurrently for at least two separate months.  Renewals are calculated as part of eligibility determinations.

For the period of December 2014

Calls to MQD Call Center                 7,998

Applications

  • On-line                                  3,309
  • Paper                                       3,989
  • Phone                                        759

Individuals determined Medicaid Eligible (excludes CHIP)

  • MAGI                                                 27,924
  • Non-MAGI                                     6,032
  • Determined CHIP Eligible       2,781

Individuals determined Medicaid Ineligible (excludes CHIP)          10,319
(Applications sent to Hawaii Health Connector for tax incentive and cost-share determinations)
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For the Period of April – December 2014 

Calls to MQD Call Center                                       68,431

Applications

  • On-line                                                             21,551
  • Paper                                                                36,225
  • Phone                                                                 2,633

Individuals determined Medicaid Eligible (excludes CHIP)

  • MAGI                                                                    212,304
  • Non-MAGI                                                          30,621
  • Determined CHIP Eligible                            23,783

Individuals determined Medicaid Ineligible                       148,622

(Applications sent to Hawaii Health Connector for tax incentive and cost-share determinations)

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NOTES:  

  • Calls reflect the number of calls received by the MQD Call Center.  (Excludes calls to MQD eligibility units)
  • Eligibility determinations are made at the end of each week, and reported the following week.  This number does not necessarily reflect to-date enrollment numbers
  • Medicaid determinations = MAGI + non-MAGI eligible determinations (Excludes CHIP)
  • Total eligible and ineligible count = Medicaid + CHIP
  • These figures do not include state funded programs