The Hawaii Health Care Coverage Questionnaire is a form used by the Hawaii Department of Human Services to determine a person's eligibility for health care coverage. The questionnaire is intended to collect information on an applicant’s income, assets, and family size to determine if they are eligible for Medicaid or other health care coverage programs. Depending on the applicant’s circumstances, they may be asked to complete one of two types of questionnaires: the Long Form Health Care Coverage Questionnaire or the Short Form Health Care Coverage Questionnaire. The Long Form is designed for individuals and families that are not currently receiving health care coverage benefits, while the Short Form is for those who are already receiving benefits and need to update their information. Both forms require information such as the applicant’s name, address, contact information, and income information. Once completed, the form is sent to the Hawaii Department of Human Services for review and approval.
The Hawaii Health Care Coverage Questionnaire is a form used by the Hawaii Department of Human Services to determine a person's eligibility for health care coverage. The questionnaire is intended to collect information on an applicant’s income, assets, and family size to determine if they are eligible for Medicaid or other health care coverage programs. Depending on the applicant’s circumstances, they may be asked to complete one of two types of questionnaires: the Long Form Health Care Coverage Questionnaire or the Short Form Health Care Coverage Questionnaire. The Long Form is designed for individuals and families that are not currently receiving health care coverage benefits, while the Short Form is for those who are already receiving benefits and need to update their information. Both forms require information such as the applicant’s name, address, contact information, and income information. Once completed, the form is sent to the Hawaii Department of Human Services for review and approval.
