Serving patients across all of Hawaii

Welcome to the Modivcare Facility web site for Hawaii. This site hosts information and forms that medical facilities in HI can use to schedule transportation for their Medicaid members.

If you have general questions, please review the HI Facility Brochure and Frequently Asked Questions (FAQ). Also, please be aware that Modivcare is only responsible for certain types of non-emergency medical transportation in the state. The documents on this site include forms used to request transportation services as well as an informational brochure you can provide to your Medicaid members.

The forms on this site are stored in PDF format. Your computer must have Adobe Acrobat Reader installed for you to be able to read and print the forms. If you do not have a copy of Adobe Acrobat, you can download it for free at www.get.adobe.com/reader/.

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UnitedHealthcare Medicaid:
 
Go to HMSA Resources 
UnitedHealthcare Medicare National:
 
 

Forms

Please click on the title that corresponds to the document you would like to view.

The forms on this site are stored in PDF format. Your computer must have Adobe Acrobat Reader installed for you to be able to read and print the forms. If you do not have a copy of Adobe Acrobat, you can download it for free at www.get.adobe.com/reader.

Member FAQs