Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1720 - BENEFITS PACKAGE
Subchapter 2 - SCOPE AND CONTENT OF SERVICES
Section 17-1720-6 - Covered services
Current through August, 2024
(a) The services minimally required to be provided by each participating health plan are described in section 17-1720-10 and shall be known as the standard benefits package.
(b) The standard benefits package is based on a twelve-month benefit period. Service limits are prorated for any benefit period less than twelve-months. If an enrollee changes health plans during a benefit period, the remaining unused service limits will be covered by the new health plan for the duration of the benefit period.
(c) Based on clinical eligibility and medical necessity, a participating health plan may provide services described in section 17-1720-14 to an enrollee.
(d) Based on level of care eligibility, the enrollee shall be provided services described in sections 17-1720-18 or 17-1720-22 by the health plan.
(e) A health plan may, at the health plan's option, or as otherwise required by the contract between the health plan and the department or the state plan, provide medically necessary services which exceed the requirements of the standard benefits package.
