Medicare and Med-QUEST: QUEST Integration and the Medicare Savings Programs

Some people in Hawaii qualify for both Medicare and Med-QUEST — often called being “dual eligible.” When that happens, Medicare pays first, and Med-QUEST may help with costs Medicare leaves behind, like premiums, deductibles and coinsurance, plus services Medicare does not cover at all, such as long-term care at home or in a care home.

How Medicaid works for seniors in Hawaii

Hawaii’s Medicaid program is Med-QUEST, administered by the Med-QUEST Division of the Department of Human Services. Eligibility for adults 65 and over is based on income and resources under the state’s aged-and-disabled rules, and it is determined by Med-QUEST — not by an insurance agency. You apply online at mybenefits.hawaii.gov, by phone at 1-800-316-8005, or on paper at the Med-QUEST eligibility office on your island. Once eligible, you receive your benefits through QUEST Integration, Hawaii’s Section 1115 managed-care program, in which a health plan coordinates Medicaid services, including long-term services and supports, while Medicare continues to pay first for medical care.

Programs that can lower your costs

• Medicare Savings Programs (MSPs) — QMB, SLMB and QI — pay the Part B premium ($202.90 in 2026) and, for QMB, Medicare’s deductibles, copays and coinsurance as well. Income limits are set against Hawaii’s federal poverty level, which is higher than the mainland’s, and change each year. You apply through Med-QUEST, and you do not have to be on full Medicaid to qualify.
• Extra Help (Low-Income Subsidy) lowers what you pay for Part D premiums, deductibles and copays. If you qualify for an MSP or Med-QUEST you get Extra Help automatically; otherwise apply through Social Security.
• Dual Special Needs Plans (D-SNPs) are Medicare Advantage plans designed for people with both Medicare and Medicaid; they coordinate the two programs, usually at $0 plan premium, and often add extras while keeping your Med-QUEST benefits intact. In Hawaii, HMSA’s Akamai Advantage Dual Care is a D-SNP that is part of the state’s Medicaid managed-care program, so the two sides can be aligned; other carriers may offer D-SNPs on some islands.

Free, unbiased state counseling on all of this is available from Hawaii SHIP — the Hawaii State Health Insurance Assistance Program, run by the Executive Office on Aging — at 1-888-875-9229. When you are ready to talk through the Medicare side, we are here at (702) 706-6564.

How we help

We help you understand whether a D-SNP is available and a good fit where you live, how a Medicare Savings Program and Extra Help could reduce your costs, and how to keep your Med-QUEST benefits working alongside Medicare. Eligibility decisions rest with Med-QUEST and CMS; our job is to make the Medicare side clear.

ECOS Medicare Solutions is a private insurance agency and is not connected with or endorsed by Med-QUEST, the Hawaii Department of Human Services, or the federal Medicare program.