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Insurance & Coverage Guide

Hawaii Medicaid Autism Coverage

Hawaii's Med-QUEST covers ABA for children under 21 through EPSDT with prior authorization. Long-term community services for individuals with IDD are funded through the I/DD Waiver. Luke's Law (Act 235 of 2015) requires state-regulated plans to cover autism services for children.

Quick Answer

Hawaii's Med-QUEST covers ABA for children under 21 through EPSDT with prior authorization. Long-term community services for individuals with IDD are funded through the I/DD Waiver. Luke's Law (Act 235 of 2015) requires state-regulated plans to cover autism services for children.

  • ABA benefit: covered under EPSDT for under 21 (via epsdt).
  • HCBS waivers: 1 relevant waiver option listed on this page.
  • Commercial insurance: Hawaii has a state autism insurance mandate.

Medicaid ABA Coverage

Yes — EPSDT

Under 21 (via EPSDT)

Insurance Mandate

Yes

HCBS Waivers

1 available

Waitlist: Managed via DDD registry

Editorial Review

This page summarizes public Medicaid, waiver, and insurance-mandate information reviewed by the Autism Hearts editorial team.

Medicaid benefits, managed-care rules, and waiver waitlists can change quickly, so families should verify eligibility, prior authorization, and enrollment steps with the administering agency before relying on this page.

Last reviewed 2026-04-21 by Autism Hearts Editorial Team

Hawaii Commercial Insurance Mandate

Statute
Luke's Law (Act 235)
Year enacted
2015

Covered services

ABA therapyDiagnostic evaluationsRelated autism services

Self-funded employer plans (often from large employers) are regulated by federal ERISA law, not state mandates, and may be exempt. Always confirm your plan type on your Summary of Benefits and Coverage.

Medicaid ABA Therapy Benefit

Covers ABA
Yes
Age limit
Under 21 (via EPSDT)
Prior auth required
Yes

Med-QUEST covers medically necessary ABA for children under 21 through EPSDT. Services are delivered through Med-QUEST's contracted managed care health plans.

Hawaii HCBS Waivers

I/DD Waiver

Covers autism

Individuals with intellectual and developmental disabilities, all ages

Waitlist:Managed via DDD registry
Apply via:Developmental Disabilities Division (DDD)

Katie Beckett / TEFRA Option

Not available

Hawaii does not operate a standalone Katie Beckett / TEFRA program. The I/DD Waiver's institutional level-of-care criteria can provide Medicaid access to some children who would otherwise exceed income limits.

Early Intervention (Birth–3)

Early Intervention Section (EIS)Hawaii's IDEA Part C program. Children under 3 with developmental delays can access services without a formal autism diagnosis.

Official Sources

Use these primary sources when you need to confirm current Medicaid rules, waiver access, or state-agency guidance in Hawaii.