SHOTT Patients

Welcome to the State of Hawaii Organ and Tissue Transplant (SHOTT) program. The SHOTT program is run by Koan Risk Solutions (Koan). It’s our honor to help you through your transplant journey.

What to Expect

Hawaii Medicaid (Med-QUEST) will decide if you can enter the SHOTT program. After, you will be moved from your current QUEST plan to SHOTT. The SHOTT program will pay for your medical costs. This includes care that is not directly related to your transplant.

You will receive a SHOTT card in the mail. You can show this card to medical providers. This is how they will know you are covered by SHOTT. You will also have a SHOTT case manager who will work with you while you are in the program.
When you enter the program, your case manager will set up a meeting. They will then explain SHOTT to you and do a health assessment. Your case manager will be available to help you 24 hours a day, 7 days a week.

Your SHOTT case manager will continue to work with you after your transplant to make sure you have everything you need. You will stay in the program until one year after your transplant. Then your case manager will help you move back to a QUEST plan of your choosing. There will be no break in health coverage. You won’t need to submit any additional paperwork.

What’s Covered

The SHOTT program will cover your medical needs. It will also cover travel and lodging if you need to get treatment somewhere else. Your case manager will make arrangements for you. If you have medical appointments on the mainland or on another island, you can get paid back for meals. Please see the SHOTT Travel, Transportation and Meal Reimbursement Policies and Procedures for more information.

Medications

The SHOTT program will also cover your medications. When you pick up your medications from the pharmacy, present your SHOTT card. If you have any problems, contact your case manager. Your case manager will work with your pharmacy to resolve the issue.

Over-the-counter medications will not be covered at most pharmacies. Your case manager will help you find a pharmacy that can provide these medications without charge.

Dental

Hawaii Dental Service (HDS) covers your dental services. If you need dental work for your transplant and it is not covered by HDS, let your case manager know.

What’s Not Covered

The SHOTT program cannot pay caregivers for caregiving services.

What You Need to Do

To stay in the SHOTT program, you need to ensure you have Hawaii Medicaid coverage. You may sometimes get an eligibility letter from Med-QUEST. Please read it and see if you have to respond.

Tell your case manager if you decide not to wait for a transplant or are no longer eligible to receive a transplant. They will help move you back to a QUEST plan.

You have rights and responsibilities while in SHOTT. Your case manager will explain them to you. You can also see the Rights & Responsibilities paper here. If you have questions, ask your case manager.

Finding a Provider

If you need to find a new medical provider, you can let your case manager know. They will help you. You can also use our guide to finding a provider.

Grievances and Appeals

You may sometimes be unhappy with your care or a denial of service. You can file a grievance (for treatment) or an appeal (for denial of service). To do this, please let your case manager know or call 808-469-4500. Your grievance or appeal will be taken seriously.

You will receive a written acknowledgment of your issue in five (5) working days and a written resolution in thirty (30) days. If you are still not happy, you can request a State Grievance Review or State Administrative Hearing with Med-QUEST.