Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1722 - SPECIAL MEDICAL ASSISTANCE COVERAGES AND PROGRAMS
Subchapter 8 - SPECIAL GROUP FOR INDIVIDUALS FORMERLY COVERED BY SHIP
Section 17-1722-64 - Cost share

Universal Citation: HI Admin Rules 17-1722-64

Current through August, 2024

(a) Individuals shall be responsible for paying a monthly cost share according to a schedule established by the department. The amount of the cost share will be based on the gross family income and the number of family members.

(b) The monthly cost share for members with income less than three hundred per cent of the FPL is as follows:

POVERTY LEVEL COST SHARE
100% or less $0
101% - 125% $10
126% - 150% $15
151% - 200% $20
201% - 250% $40
251% - 300% $60

(c) State emergency appointees and their eligible family members in the special group with income exceeding three hundred per cent of the FPL shall pay $73.50 in monthly cost share per family member.

(d) The cost share shall be paid to the department by the tenth day of the benefit month.

(e) A member who fails to to pay the cost share for two consecutive months shall be disqualified.

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