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STATE OF HAWAII Department of Human Services Med-QUEST Division MEDICAL HISTORY AND DISABILITY STATEMENT Instructions: It is very important that you read and answer all questions carefully. Your responses.

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The DHS 1128 Disability Report form shall be initiated whenan individual applies for medical assistance on the basis of blindness or disability and a determination is required, or by the health plans or by the Med-QUEST eligibility worker when there is reasonable indication that an indMdual receiving medical assistance ...

QUEST Integration provides Medicaid State Plan benefits and additional benefits (including institutional and home and community-based long-term-services and supports) based on medical necessity and clinical criteria to beneficiaries eligible under the state plan and to the demonstration populations.

Individuals can get insurance directly from HMSA or through the federal health insurance marketplace at HealthCare.gov . Depending on your financial situation, you may be eligible for financial help, which is only available through the federal marketplace.

If you need help with your renewal, call our Medicaid Assistance Center at 1-800-772-6841 (TTY 711) from 6 a.m. to 2 p.m., Monday through Friday. Each year, Med-QUEST will conduct a review to determine if you and/or your family members still meet QUEST Integration eligibility requirements.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232