Hawaii dhs enrollment form 2026

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  1. Click ‘Get Form’ to open the Hawaii DHS Enrollment Form in our platform.
  2. Begin by entering your Provider ID number and Tax ID number in the designated fields. Ensure that both numbers match the records in the HPMMIS database for successful verification.
  3. Next, provide your personal information including First Name, Last Name, Title, and contact details. This information is crucial for account creation and future communications.
  4. Select whether you are creating an Individual Account or a Master Account. If you are unsure, refer to the guidelines provided within the form.
  5. Once all fields are filled out correctly, review your entries for accuracy. Click ‘Submit’ to finalize your application. You will receive a confirmation email once your account is created.

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Medicaid provides free or low-cost health coverage to low-income individuals and their families. In Hawaii, Medicaid is called QUEST Integration. QUEST Integration is managed by Hawaiis Department of Human Services Med-QUEST Division.
Income Asset Limits for Eligibility Feb. 2025 Jan. 2026 Hawaii Medicaid Long-Term Care Eligibility for Seniors Type of MedicaidSingleMarried (both spouses applying) Income Limit Asset Limit Institutional / Nursing Home Medicaid No hard limit* $3,000 Home and Community Based Services $1,499.17 / month $3,0001 more row Jan 20, 2025
Apply for Medicaid Call Med-QUEST Customer Service: 1-800-316-8005 toll-free TTY users, call 1-855-889-4325 toll-free or 711. Fillable PDF Application. Fill out the application as completely as possible. Print the completed application then mail or fax to the Med-QUEST Division Eligibility Office nearest you.

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