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The HMSA Plan for QUEST Members

The QUEST program provides comprehensive medical and behavioral health benefits for QUEST-eligible Hawaii residents.

When you select HMSA, you will be asked to choose a primary care physician. A primary care physician is your personal doctor who provides your care and refers you to specialists when needed. Your primary care physician must be on your island.

If you have trouble finding the right care or if you do not have a regular doctor, HMSA can help. With our large network of providers, we can help find someone who is right for you and your family.

For more information, call HMSA at 948-6486 or 1 (800) 440-0640 toll-free.

Features

  • Medical and behavioral health benefits for eligible children and adults.
  • A primary care physician to coordinate your care.

Eligibility

Individuals age 19 and older must:

  1. Be a U.S. citizen or qualified alien.
  2. Be a resident of Hawaii.
  3. Provide a Social Security number.
  4. Be under age 65.
  5. NOT be a resident of a public institution.
  6. NOT be certified as blind or disabled.
  7. NOT be eligible for or receive health insurance from their employer (except for individuals covered under Section 1931 of the Social Security Act, GA financial assistance recipients, and Transitional Medical Assistance).
  8. Meet an asset and income test.

Individuals under age 19 must:

  1. Be a U.S. citizen, qualified alien or legal immigrant.
  2. Be a resident of Hawaii.
  3. Provide a Social Security number.
  4. NOT be certified as blind or disabled.
  5. NOT be a resident of a public institution.
  6. Meet an income test.

Income Limits

Adults must not have countable family income that is more than 100 percent of the current Federal Poverty Level (FPL). Children under age 19 must not have countable family income that is more than 200 percent FPL. Pregnant women must not have countable family income that is more than 185 percent FPL. (The pregnant woman’s household size includes the unborn child.)

Asset Limits

You cannot have more countable assets than these amounts:

  • $2,000 for a household of one.
  • $3,000 for a household of two.
  • $250 for each additional person.
  • Asset limits do not apply to individuals under age 19 or to pregnant women for the duration of the pregnancy plus 60 days.
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