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Charter flight for patients needing off-island care set for July 21

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Cargo space from Hawaii to American Samoa available
Source: Governor’s Office press release
Any extra seats will go to college bound students first, then military and others

Pago Pago, AMERICAN SAMOA — In response to the Governor and the Lieutenant Governor’s concern over the growing number of patients requiring off-island care, the American Samoa Medicaid State Agency has chartered a Hawaiian Airlines plane for the transport of Medicaid patients to Hawaii as approved by the LBJ Off-Island Medical Referral Committee.

The charter has been confirmed for Tuesday, July 21. The purpose of the charter flight is to provide transportation to LBJ OMR approved patients for medically necessary treatment not available on island. Many of the patients were previously referred to New Zealand but due to the border closures as a result of the COVID pandemic, all NZ referrals were suspended. Currently, only emergency cases are allowed into NZ, requiring Medicaid to redirect referrals to Hawaii—pending acceptances. There are conditions that all medical referral patients must meet in order to travel on the charter flight. All medical referral patients must have accepting physicians in the US to be approved to board the charter flight.   

If there are seats available after Medicaid patients are accommodated on the medical charter, Medicaid will make available the remaining seats to the Attorney General’s Office for screening of college students. The AG’s office will vet college bound students for the charter. After students are accommodated on the charter flight, any remaining seats will be given to the Department of Homeland Security to accommodate other passengers and military personnel.

Just before press time last night, Samoa News was notified by the American Samoa Medicaid State Agency that anyone who wants to send cargo on the charter from Hawaii, please let Medicaid know. The plane is available for cargo transport from Honolulu to Pago. Cargo will have to be paid by sender.

Because this is a special charter flight authorized under the AS Medicaid State Plan and subject to Medicaid reimbursement policies, non-medical passengers (i.e. any passenger not referred and approved by the LBJ OMR Committee) will be subject to a cost-share airfare not eligible for Medicaid coverage. Any previously purchased ticket on a regular Hawaiian Airline flight cannot be applied to the charter flight.

Following is guidance on the priority of the Medicaid charter. All medical and non-medical passengers must comply with Medicaid referral and cost-share policies in order for passengers to be confirmed on the charter manifest by July 17, 2020.

For more information on medical patients, please contact the LBJ Off-Island Referral Office or the Medicaid office at 699-4777. For more information on student passengers, please contact the Office of the Attorney General at 633-4163. All others, please contact the Office of Homeland Security at 699-0414.


1.    All patients must have proper referrals as approved by the LBJ Off-Island Referral Committee—referrals must be medically necessary care not available on island.
2.    All referral patients must have confirmed acceptance by an off-island provider (hospital or physician).
3.    All referral patients must complete Medicaid prescreening, receive final approval and Letter of Guarantee from the Medicaid office. **Medicaid staff will be stationed at the LBJ hospital to process referrals for the charter.
4.    All patients and escorts must sign a waiver for medical and accommodations coverage.
5.    All patients and escorts must be COVID tested 72 hours prior to departure. Test will be arranged through LBJ & DOH.
6.    Cut-off date to get on the medical charter list is Friday, July 10, 2020. Deadline for confirmation of acceptance and appointments is Wednesday, July 15, 2020.
7.    Non-US Nationals are not eligible for federal claiming and they or LBJ must cover their airfare. **Airfare cost-share will be finalized by July 10, 2020.

For off-island college students wishing to be considered for the Medicaid charter flight, please email all of the below-mentioned documents to Audreena Sualevai at or call 633-4163. Due to limited space, only college bound students who are able to provide the following documents are eligible for consideration—no escorts for students are allowed.

1.    A letter of acceptance or scholarship letter to a college or university in the United States;
2.    Proof of enrollment at a college or university in the United States; and
3.    Proof that said college or university is open for in person attendance (instead of online classes)
Review Process –

1.    Upon providing all of the aforementioned documents, student packets will be reviewed and approved.
2.    Upon approval, student must see the Medicaid office to obtain a payment clearance form to pay their one-way ticket at the Office of Treasury.
3.    Students must obtain a receipt of payment and MUST provide a copy to the Medicaid office and the AG’s office in order to confirm their seat on the charter manifest.
4.    Students must submit a negative COVID-19 test from DOH 3 days prior to departure and provide COVID clearance to the Medicaid office.

All other military personal and other passengers that are not medical or are not college bound students must contact the Office of Homeland Security to be screened for the charter flight. The list will be provided to the Governor for final approval before informed to pay their cost share.

**All non-medical passengers are responsible for their cost-share airfare. Once approved by the Governor, all passengers, must see the Medicaid office to obtain a payment form to submit payment to the Department of Treasury. Copy of payment receipts must be given to the Medicaid office. Non-payment will result in a passenger being dropped from the charter list by July 17, 2020.