Medicaid appeals in Hawaii: hearing deadline and keeping benefits
Med-QUEST (Hawaii Medicaid, QUEST Integration managed care): you have 90 days to ask for a fair hearing.
For eligibility or fee-for-service coverage actions, your Medicaid is reinstated and continued (Aid Paid Pending) if Med-QUEST receives your hearing request within 15 calendar days of the date of the notice.
Checked against official sources: October 30, 2026.
Appeal deadlines are strict. If you are near a deadline or your care is urgent, call free help today.
Medicaid (Med-QUEST (Hawaii Medicaid, QUEST Integration managed care)) denials in Hawaii
- Medicaid agency
Hawaii Department of Human Services, Med-QUEST Division
- Who holds the hearing
Hawaii Department of Human Services, Administrative Appeals Office (AAO)
- Hearing deadline
90 days
The date of the notice (Med-QUEST must RECEIVE the request within 90 calendar days; if day 90 is a weekend or holiday, the next working day)
- How to ask for a hearing
- Phone: Call Med-QUEST: Oahu 808-524-3370, Neighbor Islands 800-316-8005 (TTY 711)
- Mail: Mail the request to your Med-QUEST eligibility office (the address on your notice)
- In person: At a Med-QUEST eligibility office
- Form: DHS 1161 Request for a Hearing form, or other commonly available electronic means
humanservices.hawaii.gov · 808-524-3370; 800-316-8005
- What to include
Your name, whether you disagree with an action by the Med-QUEST office (denied application, ended coverage, spenddown, cost share or enrollment fee) or by your managed care health plan (service denied or ended), an explanation, whether you want Aid Paid Pending, and your signature, date and mailing address. A representative must attach proof of authority.
Source: for example form DHS 1121
- Keeping your benefits during the appeal
For eligibility or fee-for-service coverage actions, your Medicaid is reinstated and continued (Aid Paid Pending) if Med-QUEST receives your hearing request within 15 calendar days of the date of the notice. For a managed care health plan's denial, ask within 10 calendar days of the date of the plan's notice. Mark "Yes" for Aid Paid Pending on the form. If the decision goes against you, or you withdraw, you must repay the coverage you received during that time.
Law: HAR 17-1703.1-5(b); DHS 1161 Request for a Hearing (Rev. 12/18); HAR 17-1703.1-4, 17-1703.1-5, 17-1703.1-11, 17-1703.1-16
- When the hearing is held
If a final decision is not made and carried out within 90 days of the hearing request, Hawaii rules provide for aid paid pending from the 91st day in some cases.
Law: HAR 17-1703.1-16; HAR 17-1703.1-4, 17-1703.1-5, 17-1703.1-11, 17-1703.1-16
- Faster (expedited) hearing
If the normal hearing time would jeopardize your life or health or your ability to attain, maintain or regain maximum function, ask for an expedited hearing. The department decides within 3 working days whether to grant it; if granted, the hearing is decided no later than 3 working days after the department gets the request. Managed care members must first finish the health plan's expedited appeal.
Law: HAR 17-1703.1-4, 17-1703.1-5, 17-1703.1-11, 17-1703.1-16
Medicaid health plan (managed care) in Hawaii
- Appeal to the plan first
If your QUEST Integration health plan denies or ends a service, appeal to the plan first. After the plan's grievance and appeals process is finished, Med-QUEST must receive your hearing request within 90 calendar days of the date of the notice. To keep services during the hearing, ask within 10 calendar days of the plan's notice. For an urgent case, you must use the plan's expedited appeal first.
- Then a state hearing
90 days
The date of the notice, after you finish the health plan's grievance and appeals process
Law: HAR 17-1703.1-4(b)(3), 17-1703.1-5(b)(2), 17-1703.1-11(d); HAR 42 CFR 438.402, 438.408
Write my appeal: free letters
Sources
The official sources for Hawaii are listed on the Hawaii page.