Medicaid Unwinding in Hawaii: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in Hawaii are changing amid the end of the COVID-19 public health emergency (PHE) on May 11, 2023. This process is called the unwinding of Medicaid, and some people may lose coverage over the next year because of it.
Medicaid renewals were automatic during the PHE, which meant that enrollees had continuous coverage. As part of the unwinding process, automatic renewals for Medicaid and the Children’s Health Insurance Program (CHIP) stopped nationwide on March 31, 2023.
The Hawaii Department of Human Services (DHS) has started eligibility reviews through its Med-QUEST Division, which administers Medicaid and CHIP. If you’re enrolled in Medicaid or CHIP in Hawaii (also collectively called Med-QUEST), it’s important for the state to have your correct contact information. Otherwise, you could lose coverage if you can’t be reached when it’s your turn to renew.
The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020. From January 2020 to February 2023, the PHE was renewed a dozen times.
People who were enrolled in Medicaid at any point during the COVID PHE got to keep their coverage without having their eligibility reviewed. This is because all states — including Hawaii — and territories were required to provide continuous coverage during the PHE.
But the PHE officially ended on May 11, 2023, which was preceded by automatic Medicaid renewals stopping nationwide on March 31. Over the next year, 5 million to 14 million enrollees across the country could lose Medicaid coverage.
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The Hawaii Department of Human Services (DHS) and its Med-QUEST Division have resumed eligibility reviews for Medicaid and the Children’s Health Insurance Program (CHIP) through a process called redetermination. Residents who no longer qualify for coverage could be disenrolled as early as June 1, 2023.
Here’s what you need to know about changes to Medicaid in Hawaii — which, along with CHIP, is collectively referred to as Med-QUEST — and what to do if you lose coverage.
Why is Medicaid changing nationwide?
Now that the PHE has ended, COVID remains a public health priority — just not an emergency. As a result, Medicaid renewals are no longer automatic.
The processes of determining eligibility for and enrolling in Medicaid are returning to the way they were before the pandemic. These procedure changes are collectively being referred to as the unwinding of Medicaid.
The unwinding of Medicaid could affect millions of people across all states, Washington, D.C., and five U.S. territories.
What’s happening with Medicaid renewal in Hawaii?
Med-QUEST — which refers to Medicaid and CHIP in Hawaii — provides health insurance to more than 460,000 people, about one-third of the state’s total population and half of the children in the state.
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The Hawaii DHS’ Med-QUEST Division sent out letters informing enrollees about their redetermination dates in March 2023. Then, in April, the agency began reviewing enrollees’ eligibility, which it will continue doing through May 2024. According to a range of estimates from the Kaiser Family Foundation, 40,700 to 126,900 people in Hawaii will lose Medicaid or CHIP coverage during the unwinding process.
If you’re enrolled in Medicaid in Hawaii, it’s important for the Med-QUEST Division to have your correct contact information. Otherwise, you may not receive Medicaid renewal notices. You can confirm or update your address, phone number, email, and other contact information by:
Logging into your account on the Med-QUEST self-service portal
Calling the phone number of the back of your insurance card
Calling Med-QUEST at 1-800-316-8005
What to expect during the renewal process
Look for a pink envelope in the mail. Your renewal process may end or begin there, depending on whether you receive confirmation of automatic renewal or a request for more information.
Med-QUEST will try to automatically approve you for Medicaid coverage using the information they have on file. If the division has enough recent and reliable information to confirm your eligibility, then your coverage will be renewed and you won’t have to do anything further. In this case, you will receive a pink envelope with a letter confirming your renewed coverage.
If your Medicaid can’t be renewed automatically, Med-QUEST will send a pink envelope with a letter requesting more information. You should read the letter, follow the instructions, and submit any requested information with documentation by the deadline on the letter.
Your completed packet will be reviewed, then approved or denied. If your coverage is not renewed after you submit your renewal packet and documents, you will receive:
A notice telling you when your Medicaid will end
Information on how to appeal
Information on other health insurance options, including Affordable Care Act (ACA) plans
If you need to reach Med-QUEST by phone, call 1-800-316-8005.
Native Hawaiian/Pacific Islander health
It’s important to note that Hawaii residents who are citizens of Compact of Free Association (COFA) nations have access to Medicaid. These nations include:
Federated States of Micronesia
Republic of Marshall Islands
Republic of Palau
What should I do if I lose my Medicaid coverage in Hawaii?
As mentioned, now that the PHE has ended, the Med-QUEST Division will review the Medicaid eligibility of enrollees every year. If you are no longer eligible, you will lose your coverage. This could leave you temporarily without health insurance.
In order to receive Medicaid in Hawaii, you must meet all of the following criteria:
You must be a Hawaii resident.
You must be a U.S. citizen, permanent resident, or legal resident.
You must need assistance with access to healthcare or insurance coverage.
Your annual household income before taxes are withheld must be below the limit for your household size.
In Hawaii, you may also qualify for reasons other than and in addition to income, including if you are:
Pregnant
Responsible for the care of a child who is 18 or younger
Blind or a person with a disability
A household member of someone who has a qualifying disability
65 or older (under certain conditions)
Alternatives to Medicaid in Hawaii
If you choose not to reapply for Medicaid in Hawaii, or if you’re no longer eligible, you may qualify for other low-cost or free healthcare options. You can also use GoodRx coupons to save on your prescription medications. In addition, you may be able to take advantage of one of these other insurance options:
ACA marketplace plan: Through the ACA health insurance marketplace, you may be able to find an affordable health plan for $10 or less per month if you qualify for a premium subsidy. If you lose Medicaid coverage, you can purchase a plan during the unwinding special enrollment period from March 31, 2023 to July 31, 2024.
Employer plan: If you have a job, you may be able to get employer-sponsored health insurance.
Medicare: If you have a qualifying disability or condition — such as end-stage renal disease or ALS (amyotrophic lateral sclerosis), commonly referred to as Lou Gehrig’s disease — you can enroll in Medicare at any age.
Partner’s plan: If you have a spouse or domestic partner who has insurance, you may be able to join their plan during an open enrollment or special enrollment period.
Special plans: Short-term insurance can be a great choice if you anticipate a better option, like job-based health insurance, to be available soon. You may also consider alternative and limited-benefit plans, such as fixed indemnity, accident, cost-sharing, and catastrophic insurance plans.
Student health plan: If you’re enrolled in a college or university, you may be eligible for a campus health plan.
U.S. Department of Veterans Affairs (VA) benefits: If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services through the VA Pacific Islands Health Care System.
Hawaii Medicaid resources
Here are some sites where you can learn more about Medicaid in Hawaii and the upcoming changes related to the end of the PHE:
Hawaii Medicaid office: The Med-QUEST Division of the Hawaii DHS oversees Medicaid in Hawaii.
Hawaii Medicaid self-service portal: You can log in to your Medicaid account 24/7 through the Med-QUEST benefits portal to make sure your mailing address, email, and other contact information is correct.
Hawaii Medicaid FAQs and facts: Read the answers to frequently asked questions, quick facts, and unwinding documents.
The bottom line
Automatic Medicaid renewals stopped nationwide on March 31, 2023, in advance of the COVID-19 public health emergency (PHE) concluding on May 11, 2023. This change is part of a process that’s being called the unwinding of Medicaid.
In response, the Med-QUEST Division of the Hawaii Department of Human Services (DHS) resumed Medicaid eligibility reviews in April 2023 and plans to continue these audits through May 2024. Enrollees who are determined ineligible may be without coverage as early as June 1, 2023. According to estimates, up to 126,000 people in Hawaii could lose coverage during the unwinding process.
If you’re enrolled in Medicaid in Hawaii, update your contact information with Med-QUEST to ensure you receive your renewal notices. If you do lose coverage, you may be eligible for other health insurance options, such as Affordable Care Act (ACA) marketplace plans, job-based insurance, or Medicare.
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References
Administration for Strategic Preparedness and Response. (2020). Determination that a public health emergency exists.
Administration for Strategic Preparedness and Response. (2023). Renewal of determination that a public health emergency exists.
Benefits.gov. (n.d.). Hawaii Medicaid fee-for-service program.
Burns, A., et al. (2023). How many people might lose Medicaid when states unwind continuous enrollment? Kaiser Family Foundation.
Centers for Medicare & Medicaid Services. (2023). Temporary special enrollment period (SEP) for consumers losing Medicaid or the Children’s Health Insurance Program (CHIP) coverage due to unwinding of the Medicaid continuous enrollment condition – Frequently asked questions (FAQ).
Medicaid.gov. (n.d.). Renew your Medicaid or CHIP coverage.
Medicaid.gov. (n.d.). Unwinding and returning to regular operations after COVID-19.
State of Hawai‘’i Department of Human Services. (2023). Application and enrollment data update.
State of Hawai‘i Department of Human Services Med-QUEST Division. (n.d.). What is Medicaid.
State of Hawai‘i Department of Human Services Med-QUEST Division. (2021). Congress has restored Medicaid eligibility for citizens from one of the Compact of Free Association (COFA) nations residing in the United States.
State of Hawai‘i Department of Human Services Med-QUEST Division. (2023). Facts about Med-QUEST (Medicaid) in Hawaii.
State of Hawai‘i Department of Human Services Med-QUEST Division. (2023). Stay well stay covered.
Tolbert, J., et al. (2023). 10 things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
U.S. Department of Veterans Affairs. (2022). VA & TRICARE information.
