Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1722 - SPECIAL MEDICAL ASSISTANCE COVERAGES AND PROGRAMS
Subchapter 12 - STATE PHARMACY ASSISTANCE PROGRAM
Section 17-1722-119 - Eligibility requirements

(1) Is a resident of Hawaii;

(2) Receives Medicare Part D Prescription Drug Benefits;

(3) Has countable income at or below one hundred fifty per cent of the federal poverty level for a household of applicable size; and

(4) Meets the asset test in accordance with the low income subsidy program addressed in subchapter 11;

(5) Is not receiving MMA prescription drug benefits through a retirement or union plan;

(6) Does not have public assistance prescription coverage other than Medicaid, Medicare and Hawaii Rx Plus;

(7) Is not enrolled in a private sector or government sponsored plan or any insurance providing payments for prescription drugs; and

(8) Is enrolled in a benchmark prescription drug plan established by CMS.