QExA HAWAI’I QUEST Expanded Access for Healthy Long-Term Living

How to Get Care under QExA

Helpline Toll-Free 1-866-928-1959

Open 8 a.m. to 5 p.m. Monday through Friday

TTY Line Toll-Free : 1-866-928-1958

www.qexa.org

Congratulations!

You will soon begin receiving healthcare services through QUEST Expanded Access (QExA). This new Medicaid program is for seniors, 65 and older, and people of all ages with disabilities.

Please keep this brochure. It has lots of information on how to obtain medical treatment through your QExA health plan.

After you choose a health plan, we will send you a letter with the:

• Name of your health plan.
• Date your membership in your health plan begins.

You will continue receiving your Medicaid services as you do now until your health plan membership begins. Look for our next letter for more important information.

Your health plan will send you a Member handbook soon. If you have questions, call your health plan’s Member Services Hotline:

• EverCare:
Toll-free 1-888-980-8728
Toll-free TTY 1-888-685-8480

• ‘Ohana Health Plan:
Toll-free 1-888-846-4262
Toll-free TTY 1-877-247-6272

Getting the Care You Need

With QExA, you will receive medical treatment through the health plan of your choice. Your health plan will include a group of healthcare providers, such as doctors, hospitals, pharmacies and care facilities.

You choose a doctor, called a Primary Care Provider (PCP), who will take care of your medical needs. You, your doctor and your health plan will work together to help you stay healthy. If you have not picked your PCP, call your health plan’s Member Services phone number today.

QExA also coordinates extra Medicaid services, including dental services, school health services, mental health services and case management for clients with developmental and mental disabilities.

Your health plan’s Member Handbook has more information on where to go for services.

You can call your health plan:

• EverCare:
Toll-free 1-888-980-8728
• ‘Ohana Health Plan:
Toll-free 1-888-846-4262

Or call the toll-free QExA Helpline at 1-866-928-1959.

Working with Your PCP

As a member of QExA, you will receive medical services through the doctor you choose as your Primary Care Provider (PCP). When you are sick or need a check-up, you go to your PCP.

With QExA, you get to know your PCP and your PCP gets to know you and your health history. This way you can take care of health problems before they become serious.

If you need other medical services, your PCP arranges for your care. In most cases you will be sent to another doctor or facility that works with your health plan. This is called a referral.

There are some covered healthcare services that do not need a referral. To find out more, call your health plan’s Member Services phone number or the toll-free Helpline at 1-866-928-1959.

Extra Services in QExA

Service Coordinator

All QExA members have a Service Coordinator . Your Service Coordinator is not your doctor, but someone who works for your health plan and helps you by:

• Improving the way you get healthcare services.
• Taking a more active role in your care, such as working with your family and caregivers to make sure you get the care you need in the right setting.
• Explaining how to use your QExA benefits.
• Finding answers to your questions about healthcare or providers.

If you ever want a different Service Coordinator, just call your health plan to find a new one.

Outreach and Enrollment Counseling

QExA provides information and support to members through the toll-free Helpline and community-based activities. You can learn more and get your questions answered by:

• Calling the toll-free Helpline at 1-866-928-1959.
• Visiting us on the Internet at www.qexa.org.

It’s easy to find out more about QExA. You can:

CALL the Helpline Toll-Free 1-866-928-1959

Open 8 a.m. to 5 p.m. Monday through Friday

TTY Line Toll-Free : 1-866-928-1958

• VISIT us on the Internet at: www.qexa.org
• CALL the QExA health plans:

EverCare: Toll-free 1-888-980-8728 Toll-free TTY 1-888-685-8480

‘Ohana Health Plan: Toll-free 1-888-846-4262 Toll-free TTY 1-877-247-6272

QExA HAWAI’I QUEST Expanded Access for Healthy Long-Term Living

Sponsored by the State of Hawaii , Department of Human Services, Med-QUEST Division