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Medicare Advantage D-SNP Requirements In Hawaii

The Dual-Eligible Special Needs Plan (D-SNP) requires that you be enrolled in both Medicare and Medicaid. In Hawaii, less than 1% of Medicare Advantage candidates qualify for a D-SNP, so it is important to know whether or not you qualify and learn more about it.

What is a D-SNP?

Dual-Eligible Special Needs Plans provide extra cost coverage to those with limited incomes and 65 years or old or with a disability. These are the general requirements for both Medicare and Medicaid. If you are enrolled in Medicare, you can receive Medicaid coverage in Hawaii if you need health care/insurance assistance and in a financial situation that would be characterized as low income.

Income limits for Medicaid eligibility in Hawaii are $19,711 a year for an individual, $26,654 for 2, and $6,942 more per person in a household. Any income and all income is counted from every source, including (but not limited to) employment wages, alimony payments, Veteran’s benefits, pension payments, Social Security Income, IRA withdrawals, and stock dividends. Your assets are counted as well, but not all of them are included towards Medicaid eligibility.

Hawaii Medicaid Quest Description

In Hawaii, the Medicaid program is also called MedQuest, which stands for Quality care, Universal access, Efficient utilization, Stabilizing costs, and Transformation.

MedQuest serves low-income residents of Hawaii and provides nursing home care and a number of alternatives. These include Extended Care Adult Residential Care Homes (EC-ARCH), Community Care Foster Family Homes (CCFFH), and to a lesser extent, Assisted Living Facilities. In assisted living, MedQuest will pay for care services but not for monthly rent and meal costs.

MedQuest Eligibility

For those not in need of assisted living care, “regular” Medicaid for the financially needy, blind, or disabled has an income limit of $1,235 a month and $2,000 for single applicants. For married couples applying together, it is $1,670 a month and a $3,000 asset limit. For married couples with only one applying spouse, the monthly income limit is the same, but with a $2,000 income limit.

Hawaii offers a unique eligibility MedQuest program to those in need of long-term care. To receive specialized benefits for long-term care in an institutional or nursing home, there is no set income limit–the only requirement is that your entire income (aside from $50) goes towards your care, including married couples. The asset limit for this plan is $2,000 for individuals and a $4,000 split between spouses.

For those who do not want/need full nursing home-level care, MedQuest also offers coverage for home and community-based services. The income limit for this program is $1,235 a month for individuals and double that for married couples.

Find Out Your Medicare Options with Proinsurance Hawaii

Hawaii has unique yet often confusing Medicare options. Proinsurance Hawaii will help you find the coverage you need. To learn more about your dual-eligible options, give us a call today at 808-735-0106.