Starting Jan. 1, 2026, federal law requires Dual Eligible Special Needs Plan (DSNP) members to receive their DSNP and QUEST benefits from the same health insurer. This is to ensure better coordinated care and services.
DSNP members who get their Medicare and QUEST benefits from different health insurers will be disenrolled from their DSNP plan on Jan. 1, 2027, if they remain unaligned.
To comply with the federal mandate and reduce the number of members at risk of losing their DSNP plan, Med-QUEST Division will conduct a one-time QUEST reassignment to move each unaligned member’s QUEST plan to align their DSNP health plan.
Members receiving long-term services and supports (LTSS) and/or enrolled in Community Care Services (CCS) will be excluded from QUEST reassignment to prevent potential disruption in care. But they’ll still need to align their plans.
Learn more about the federal and state health care changes and how to prevent potential disruptions in your health plan benefits below.
What’s Hawaii’s one-time QUEST reassignment?
To comply with the federal mandate and to reduce the number of potential DSNP disenrollments, Med-QUEST will do a one-time QUEST reassignment to move each unaligned member’s QUEST plan to the same health insurer as their DSNP plan. Those receiving LTSS and/or enrolled in CCS will be excluded from the reassignment.
The QUEST reassignment will occur in August 2026 with an effective date of Oct. 1, 2026.
Who’ll be impacted during QUEST reassignment?
QUEST reassignment impacts DSNP members who receive their QUEST and Medicare benefits from two different health insurers. Those who receive LTSS or enrolled in CCS for behavioral health services are excluded from this one-time reassignment. However, they must still align their plans before Jan. 1, 2027, or they’ll be disenrolled from their current DSNP plan.
What will happen to DSNP members who don’t align their QUEST and Medicare benefits under one health insurer before Jan. 1, 2027?
Members will be disenrolled from their current DSNP plan if they don’t take action to align their QUEST and Medicare plans before Jan. 1, 2027.
These members will have a special enrollment period to select alternative Medicare coverage, such as Original Medicare, another Medicare Advantage plan, or a different Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP).
How can I align my QUEST and Medicare benefits to one health insurer?
If you have HMSA QUEST (Medicaid) but your Medicare benefits are from a health plan other than HMSA, contact us to enroll in HMSA Akamai Advantage® Dual Care (PPO D-SNP) at no cost. You can enroll:
- Online at hmsa.com/dualcare.
- In person at an HMSA Center near you to meet with a Medicare specialist.
- By phone at 808-948-6871 or 1-800-693-4672 toll-free. For TTY, call 711.
To learn more or request more information about HMSA Akamai Advantage Dual Care, visit hmsa.com/dualcareinfo.
Why should I enroll in HMSA Akamai Advantage Dual Care?
HMSA Akamai Advantage Dual Care coordinates your Medicare and HMSA QUEST benefits in one plan at no additional cost. You’ll get:
- A $125 monthly allowance for over-the-counter (OTC) health products, food, and home utilities.*
- $0 dental cleanings, exams, X-rays, fillings, dentures, and more.
- $0 eye exam and $300 annually toward eyeglasses and contact lenses.
- $0 generic prescription drugs.
- $0 Silver&Fit® fitness center membership and home fitness program.
With this plan, you’ll also get a health coordinator who can help you with your health care.
What happens if I’m disenrolled from my DSNP plan?
If you don’t select alternative coverage by the disenrollment date, your coverage will revert to Original Medicare.
Will I be notified if I’m disenrolled from my current DSNP plan?
Yes. Your current DSNP health insurer will send you a letter notifying you of your disenrollment from your current DSNP plan 30 days before your plan end date.
Will I be notified if my QUEST plan is moved to another health insurer?
Yes. Hawaii’s Med-QUEST Division will send you a letter notifying you that your QUEST plan was moved to another health insurer.
Will impacted members be able to opt out of QUEST reassignment?
Yes, impacted members will have the opportunity to opt out of QUEST reassignment. However, members will still need to align their QUEST and DSNP plans before Jan. 1, 2027, to avoid being disenrolled from their current DSNP plan. Med-QUEST will provide more information about the opt-out option in the coming months before reassignment.
What’s the process to opt out of QUEST reassignment?
Members can opt out by calling the state’s Med-QUEST Division at 808-524-3370 or 1-800-316-8005 toll-free.
Members who opt out of the QUEST reassignment will still need to align their DSNP and QUEST plans before Jan. 1, 2027, or they’ll be disenrolled from their DSNP plan and must then select alternative Medicare coverage, such as Original Medicare, another Medicare Advantage plan, or a different FIDE SNP.
When will QUEST reassignment be implemented?
Here’s the QUEST reassignment timeline in 2026:
- June–July: Member opt-out period.
- July: Med-QUEST processes opt-out requests. Requests received after July 31 will not be processed.
- August: Med-QUEST completes QUEST reassignment and sends plan change confirmation letters to members.
- October: HMSA QUEST enrollment changes for reassigned members take effect.
Will I be able to keep my HMSA QUEST health coordinator if I enroll in HMSA Akamai Advantage Dual Care?
Yes. The heath coordinator you have now will continue as your health coordinator when you’re enrolled in HMSA Akamai Advantage Dual Care.
Who can I call if I have more questions or want to learn more?
- Med-QUEST Hawaii: Call 808-524-3370 or 1-800-316-8005 toll-free.
- Hawaii State Health Insurance Assistance Program (SHIP): Call 808-586-7299 or 1-888-875-9229 toll-free. TTY: 1-866-810-4379.
*The Food and Home Utilities allowance is a special supplemental benefit available only to chronically ill members with eligible chronic conditions, including diabetes, high blood pressure (hypertension), high cholesterol (hyperlipidemia), cardiovascular and other heart disorders, and stroke. Other conditions may be eligible. For the full list of eligible chronic conditions, see hmsa.com/ExtraBenefits-DualCare. All applicable eligibility requirements must be met before the benefit is provided. Not all members qualify. This benefit is only available on HMSA Akamai Advantage Dual Care (PPO D-SNP).