Modivcare in Hawaii: HMSA and ʻOhana QUEST Rides (2027)

Hawaii’s QUEST plans each hire their own ride broker, and Modivcare books for two of them. The Hawaii guide covers the PUC certificate, HOKU enrollment, insurance minimums, and the other brokers, and the Modivcare page covers its signup form and requirements in every state. This page covers how Modivcare runs HMSA and ʻOhana rides in Hawaii: which members and islands, the forms that decide each ride, how much notice trips come with, and who to call.

Which QUEST members Modivcare books

As of October 2026, Med-QUEST’s ride page lists Modivcare for two of the five QUEST Integration plans:

• HMSA. Modivcare’s HMSA guide, dated June 15, 2026, covers the whole state: Niihau, Kauai, Oahu, Maui, Lanai, Molokai, and Hawaii Island, in all four counties. It sets no mileage limit on ground or air trips.
• ʻOhana Health Plan. Modivcare’s Hawaii page says it arranges ʻOhana rides on Oahu, Maui, Molokai, Lanai, Kauai, and East and West Hawaii, through December 31, 2026.

Size is the reason to care. Med-QUEST’s enrollment report dated July 9, 2026 counts 202,341 HMSA members and 27,637 ʻOhana members in June 2026, out of 396,361 people in QUEST managed care. HMSA alone holds about half of all QUEST members, the most of any plan.

The other three plans use other brokers. AlohaCare rides go through Transdev Health Solutions, and Kaiser Permanente and UnitedHealthcare rides go through MTM Health. Modivcare’s Hawaii page also notes it handles only certain kinds of rides; emergency ambulance trips go through 911.

ʻOhana’s last months with Modivcare

ʻOhana Health Plan leaves QUEST after December 31, 2026, and its members choose a new plan from October 1 to 20, 2026, for coverage starting January 1, 2027. Those who pick HMSA, or are assigned to it, stay with Modivcare, and the rest move to Transdev or MTM Health; see ʻOhana Health Plan leaving QUEST. One contract rule matters for trips off-island at year end: under section 4.6 of the QUEST Integration contract, a plan that loses a member who is on another island or the mainland must bring the member home and hand off care.

How Modivcare decides the ride for an HMSA member

Modivcare starts every HMSA member at a default mode, and a form moves them up:

• Mass transit first, on Oahu only. TheBus, Skyline, and Handi-Van are the default when the member’s home and appointment are each less than half a mile from a stop.
• Ambulatory everywhere else. Members who cannot use transit start at ambulatory, and since transit counts only on Oahu, that includes everyone on the neighbor islands. Modivcare counts a sedan, van, taxi, rideshare, or boat or ferry as ambulatory.
• Higher modes need a form. Wheelchair, bariatric wheelchair, and stretcher rides need a Medical Necessity Form, and so do commercial flights, mileage reimbursement, and ambulatory rides above transit.

The standalone medical necessity form, dated July 3, 2025, is filled out by a medical care provider such as a physician, physician assistant, nurse practitioner, or health coordinator. It asks whether the member can walk half a mile, can be driven by family, can ride transit only with a companion, can transfer without help, and can sit up alone. It also records the wheelchair type (manual, electric, or scooter) and whether the need is permanent or ends on a set date. Offices send it through TripCare, by email to HIExceptions@modivcare.com, or by fax to (866) 475-5745.

Two rules shape what you carry. Members bring their own wheelchairs, child safety seats, boosters, and medical equipment, and Modivcare does not supply wheelchairs. Stretcher riders can bring oxygen they manage themselves at 2 liters or less and battery equipment the member or caregiver runs, while anyone who needs monitoring or suctioning goes by ambulance. A member with a portable ventilator in a gurney vehicle is screened by phone first. See bariatric transportation for the larger chairs.

Who rides along

HMSA allows one adult escort for a member under 18 without a form, and any escort for an adult member needs a Medical Necessity Form. Minors may ride alone if they are a parent, pregnant, or emancipated, or if they are 14 to 17 and going to reproductive health care, mental health treatment, or counseling. Every other minor rides with a person who can legally sign consent forms. See escorts and caregivers.

Trips Modivcare does not book for HMSA

• Emergency room trips, except a scheduled admission. Trips between emergency rooms are out too, but a ride home from the ER is allowed.
• Pharmacy stops on the way to or from an appointment.
• Adult day care, unless the member’s HMSA health coordinator starts a prior authorization first.

How much notice HMSA trips come with

Routine booking runs weekdays from 7:45 a.m. to 4:30 p.m. Hawaii time, with urgent trips and hospital discharges taken around the clock every day of the year. Under the June 2026 guide, the notice depends on the trip:

Trip	Notice Modivcare needs
Routine ground ride on the same island	At least 2 business days, no limit on how early
Air travel to another island or the mainland	At least 7 business days
Ambulatory or wheelchair discharge	Requested on the day of discharge; Modivcare has 4 hours to find a ride
Gurney or bariatric discharge	May be requested 1 day before
Dialysis, wound care, chemotherapy, radiation, urgent care	No advance notice

Because those treatment trips need no notice, same-day HMSA dialysis and cancer rides can land on your schedule. If you have a van free in the afternoons on a neighbor island, tell Modivcare which hours. For the rules behind fast hospital pickups, see hospital discharge transportation, and for repeat treatment rides, dialysis transportation.

Inter-island travel and the ground legs

Since July 1, 2025, medical offices and facilities submit every HMSA inter-island air request through TripCare, Modivcare’s online request system. Inter-island travel needs no plan approval, though the flight needs a Medical Necessity Form. Mainland travel also needs HMSA’s prior authorization. Meals and lodging go in with the air request, and a member on an approved overnight trip can get a ride to a grocery store, arranged by Modivcare’s Air Ops team.

For a ground company, a flight can bring rides at both ends. The TripCare request records any ground ride the trip needs: a set pickup time or a will-call return, the level of service, whether the stop is a home or a facility, and whether the member needs a gurney or oxygen. When a member misses a flight, the facility line sends the call to Air Ops, and after hours an after-hours team picks it up, so expect airport pickups to move.

Standing orders, will-call returns, and changes

Modivcare’s Hawaii facility FAQ, on the page that serves ʻOhana members, sets these rules:

• Standing orders cover members with three or more trips a week to the same place, such as dialysis, wound care, mental health, adult day care, and medication management. Modivcare rechecks each one every quarter. HMSA has its own standing order form on its facility page.
• Will-call returns. Once the member or facility calls Ride Assist, the transportation provider has up to one hour to arrive.
• Discharges. The provider has up to four hours to respond and pick up.
• Wheelchair trips may go out with just a driver and no attendant, unless the member asked for help when booking.
• Preferred providers. A facility may ask for your company, and Modivcare notes it, but assignment follows its routing rules, including provider compliance, and nothing is guaranteed.

Network providers run from the daily manifest Modivcare sends. If a member or facility tells only you about a change to a standing order, the trip may still go to another provider, so send riders to Modivcare’s line for every change.

What Hawaii adds before you join Modivcare

Hawaii’s Public Utilities Commission requires a motor carrier certificate from anyone who carries people for pay on a public highway, except exempt services such as taxis, and its FAQ puts processing at 6 to 12 weeks or longer, including a 20-day intervention period. Med-QUEST then enrolls you in HOKU as provider type 28, asking for proof of auto liability insurance, a PUC license for Oahu providers, a fingerprint-based background check, and a W-9, and the federal application fee is $750 for 2026. The QUEST Integration contract requires every network provider to be enrolled with the state, and the Hawaii guide walks through both steps.

When you price a Modivcare agreement, build Hawaii’s general excise tax into the rate. Med-QUEST’s Health Plan Manual, revision 26.3, tells plans not to pay GET as a separate charge on NEMT, because it is already part of the NEMT and taxi meter rates. For Modivcare’s form, training, and insurance list, see the Modivcare page.

Who to call

For	Contact
HMSA member rides	1-800-440-0640, TTY 1-866-288-3133
HMSA facilities and medical offices	833-283-6566, fax 866-475-5745
HMSA Medical Necessity Forms	HIExceptions@modivcare.com or fax (866) 475-5745
HMSA air travel and urgent flight changes	AirOps@modivcare.com, 866-379-5228
ʻOhana reservations, through December 31, 2026	1-866-790-8858
ʻOhana facility bookings and standing orders	866-475-5744, fax 866-475-5745
ʻOhana Ride Assist	1-866-481-9699
Med-QUEST provider enrollment	1-833-909-3630

What to do first

1. File for the PUC certificate early, since it sets the pace, unless you run an exempt taxi company.
2. Enroll in HOKU as provider type 28 with your PUC license, insurance, fingerprint check, and W-9.
3. Fill out Modivcare’s provider form and say which islands you serve. Ask which islands and service levels it is short on.
4. Meet the facilities you serve, and walk their staff through the Medical Necessity Form and TripCare, since a missing form keeps a member at the bus or ambulatory level.
5. Sort your ʻOhana riders before January 1, 2027, and join Transdev and MTM Health for those who leave Modivcare.