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The HMSA Plan for QUEST-Net Members

The QUEST-Net program provides medical and behavioral health coverage to individuals previously enrolled in QUEST or Medicaid Fee-For-Service but who become ineligible because their income or assets exceeded program limits. QUEST-Net provides a limited benefit package for eligible adults; children receive the same benefits as in QUEST.

Maternity benefits are not included for individuals age 21 or older. But, if you become pregnant and your family’s income does not exceed 185 percent of the Federal Poverty Level (FPL) for a family size that generally includes the number of unborn children expected, you may be eligible to receive coverage under Hawaii QUEST at no cost.

Features

  • Limited benefit package for eligible adults 21 years and older.
  • Individuals under age 21 receive the same benefits as in QUEST.

Eligibility

For Individuals Under Age 19

Prior QUEST or Medicaid Fee-For-Service coverage is not a prerequisite for an individual under age 19 to participate in the QUEST-Net program. These individuals must meet the following QUEST-Net requirements:

  • Not eligible for or covered by any other medical insurance including Medicare or military coverage such as CHAMPUS.
  • Have income within the QUEST-Net limits.

For Individuals 19 Years and Older

QUEST-Net individuals must be QUEST or Medicaid Fee-For-Service recipients who became ineligible because their assets or income exceeded allowable limits. These individuals must meet the following QUEST-Net requirements:

  • Not eligible for health insurance from their employer, with the exception of a financial assistance recipients.
  • Not eligible for or covered by any other medical insurance including Medicare or military coverage such as CHAMPUS.
  • Have assets and income within the QUEST-Net limits.

Income Limits

Monthly income does not exceed 300 percent of the current FPL.

Asset Limits

Individuals who have assets that exceed the asset limit will be ineligible for QUEST-Net. This provision does not apply to individuals under age 19. Countable assets include cash, bank accounts, stocks, bonds, real property, and other personal property. Exempt assets include the home property, motor vehicles, clothing and household furnishings, and appliances.

The asset standards are $5,000 for a household of one, $7,000 for two, and $500 for each additional family member.

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