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Hawai‘i, we’ve got you covered

No-cost health coverage from UnitedHealthcare Community Plan. Learn about UnitedHealthcare Medicaid Med-QUEST health plans we offer in Hawai‘i.

Helping people is at the heart of all we do

Everyone deserves affordable health care. At UnitedHealthcare Community Plan, we are dedicated to helping people live healthier lives.

We offer a variety of programs for you and your family to get healthy — and stay healthy. We cover adults, kūpuna, people with disabilities, hāpai moms and keiki.

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Medicaid plans

UnitedHealthcare Community Plan QUEST Integration Program

The QUEST Integration program is a Hawai‘i Medicaid Managed Care program administered by the State of Hawai'i, Department of Human Services, Med-QUEST Division. Eligibility for this program is determined by the State of Hawai‘i. We provide health coverage for members of Hawai‘i Medicaid. With UnitedHealthcare Community Plan, you will receive all of your regular Medicaid benefits. We are pleased to serve our members.

Dual Special Needs plans

Dual Special Needs plans (also called Dual Health plans or D-SNPs for short) are for people who have both Medicaid and Medicare. Dual plans cover most doctor visits, hospital stays and prescription drugs. They offer many extra benefits beyond those you get with either Original Medicare or Medicaid.

See why Hawai‘i chooses UnitedHealthcare

  • Large variety of network providers
  • No-cost virtual visits
  • Mail-order prescription medications
  • Basic dental and vision coverage
  • Behavioral Health Services
  • Programs to support healthy pregnancies 

Take action to prevent the flu. A seasonal flu shot has been shown to prevent flu illnesses, doctor visits and hospitalizations, and can be lifesaving for children. UnitedHealthcare covers pneumonia, influenza, and shingles shots.

1Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Other hearing exam providers are available in the UnitedHealthcare network. The plan only covers hearing aids from a UnitedHealthcare Hearing network provider.

Value added benefits

  • Pregnant women and children
  • Single Adults, families and Kupuna
  • Those who meet income requirements
  • Children and Adults with Disabilities
  • Those who have a long term disability due to age, illness or injury
  • Open to all ages

 

How to Contact Us

Call Member Services: Toll-Free 1-888-980-8728

7:45am – 4:30pm, local time Monday - Friday

Email:  communityplanhi@uhc.com

Featured programs

New On-Demand Self Care for $0.

You can get the Self Care app from AbleTo at no cost. Self Care offers you:

  • Meditation tools to help you relax
  • Mood and habit tracking so you can find patterns and see how your behaviors affect your mood
  • Guides around topics that matter most to you
  • Optional weekly check-ins to unlock personalized content

To get started, visit ableto.com/begin

UnitedHealthcare® mobile app

Get information on-the-go with the UnitedHealthcare mobile app. Download the UnitedHealthcare mobile app to your Apple® or Android® smartphone or tablet and see how easy it is to find nearby doctors, view the Member Handbook, find help and support in your community, or view your ID card.

Healthy First Steps/Hāpai Mālama

Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up. We will help you:

We will help you:

  • Choose a pregnancy provider and a pediatrician (child’s doctor)
  • Schedule visits and exams and arrange rides to your visits
  • Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life

Medicaid: More for You in 2024

Some of the benefits you may qualify for include:

  • Pre-and postnatal care for pregnant individuals and newborns
  • A large provider network
  • Vison and dental coverage
  • Mail order prescription drug coverage
  • Mental health coverage
  • Substance use disorder treatment services
  • People who may be dealing with stress, depression, anxiety or using drugs or alcohol

Behavioral Health Services

Behavioral health is as important as physical health. That’s why we have coverage for both.

Required care is 100% covered with no co-pay, including testing and diagnosis, behavioral therapy and medication.

Mental health services can help you with personal problems that may affect you and/or your family. These problems may be stress, depression, anxiety or using drugs or alcohol. We can help. 

Did you lose your job recently?

More people now qualify for QUEST (Medicaid). See if you can too. No copays for covered services.

Visit medical.mybenefits.hawaii.gov for more information on eligibility or to apply.

Virtual visits with Doctor Chat

It’s not always easy to visit a doctor in person. Virtual visits (or telehealth) let you talk to a doctor 24/7 using your computer, tablet or smartphone. Telehealth is a good option to treat common conditions that have standard treatments. Here are some examples:

  • Cold, flu, and fever
  • Cough, aches, and sore throat
  • Allergies, skin rash, and irritation
  • Urinary tract/bladder infection
  • Ear infections
  • Sinus infections
  • Migraine/headache
  • And more

Transportation

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Our Med-QUEST plan provides unlimited round trips to and from health care locations. That includes rides to:

  • Doctor or therapy visits
  • Health departments
  • Vision clinics
  • Urgent care centers
  • Pharmacies

 

A healthier life is in your future

Keeping a healthy weight. Stopping unhealthy habits. Doing what’s needed to keep you and your family healthy. It all may seem impossible at times. But we have programs that can help. Our UnitedHealthcare Healthy Behaviors program gives you access to a personal health coach and resources to help with things like:

  • Losing weight
  • Quitting smoking
  • Substance abuse
  • Pregnancy and newborn care (UnitedHealthcare Healthy First Steps®)

Our health coaches work with you and your doctor(s) to help you set goals and track progress. You’ll also have the chance to get rewards when you reach certain milestones.

What is Medicaid Med-QUEST?

Med-QUEST (Quality, Universal Access, Efficiency, Sustainability, Transformation) is a division of the Department of Human Services that provides healthcare benefits to Hawai’i residents who are eligible for Medicaid.

The Med-QUEST Division provides health care benefits to Hawai‘i residents who are eligible for Medicaid through QUEST.

With QUEST, all eligible members of your family can choose a health plan that fits their health care needs.

And when you reach age 65 and transition into Medicare or if you develop a disability, you won’t need to change your health plan. You can stay in the same health plan.

You can choose traditional Medicare or a different Medicare Advantage plan. All QUEST health plans offer Medicare plans and many provide extra benefits at no cost. Using the same health plan for Medicare and Medicaid may help you coordinate services, get more benefits, and lower your drug costs. Visit medicare.gov to learn about your options.

Who is eligible for Medicaid Med-QUEST?

To qualify for Medicaid, potential members or their children must:

  • Be a Hawai‘i resident
  • Be a U.S. citizen or a legal resident
  • Meet certain resource and income limits
  • People whose Medicaid eligibility is based primarily on their income will be eligible under the following Federal Poverty Level (FPL) thresholds:
    • Children – up to 313% FPL
    • Pregnant Women – up to 196% of the FPL
    • Parent/Caretaker relatives – up to 105% of the FPL
    • Adults under the age of 65 (not receiving Supplemental Security Income or Medicare)– up to 138% of the FPL

People who are 65 and over, or blind or disabled, may have eligibility determined using the following income and asset thresholds:

  • Income up to 100% of the FPL and up to $2,000 in assets for a single person household or up to $3,000 for a household of two; or
  • If income is greater than 100% of the FPL and assets up $2,000 for a single person household or up to $3,000 for a household of two, may be eligible for medical assistance under the Medically Needy Spenddown program, provided he or she has medical expenses greater than the determined spenddown amount.

What documents are needed to apply for Medicaid Med-QUEST?

When applying for services, potential members will need to take or mail (if available) the following documents:

  • Pay stubs or other papers to show all family members' monthly income.
  • Social Security numbers for all individuals who want Medicaid (not required for children less than 6 months of age).
  • Papers that show family resources for all individuals who want Medicaid (for example: bank records, make, model, and year of your vehicles). This is not needed if they are applying because someone is pregnant or if they are applying only for children (age 18 or younger).
  • Legal resident papers if the potential member is not a U.S. citizen and he/she wants Medicaid for them self.
  • Proof of residence (for example: gas, electric, or water bill, letter from his/her landlord). This is not needed if applying only for children (age 18 and younger).
  • Information about any job-related health insurance available to your family.
  • NOTE: Potential members may ask a friend or other person you choose to be their "authorized representative" to apply for him/her. He/she may also ask for a language or a sign interpreter to help him/her apply. Ask for an interpreter when calling to set up an appointment.

HealthTalk member newsletter

Our HealthTalk newsletter is now online. The newsletters are a great way to learn about our health plan and important health topics.

You can read it whenever, wherever you want. Check back quarterly for a new edition.

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