Medicaid Office

Hawaii Medicaid Income Limits

Updated August 2026

Hawaii's income limits for children are among the highest in the country — covering children up to 308% FPL. This is a consequence of both Hawaii's high cost of living (HHS sets a separate, higher federal poverty guideline for Hawaii each year) and the state's historically progressive approach to health coverage, predating the ACA by decades through the 1974 Prepaid Health Care Act. The 2026 FPL for a single person in Hawaii is $18,360/year ($1,530/month) — higher than the $15,960 used in the 48 contiguous states.

308% FPL

Children (QUEST Integration)

138% FPL

Adults 19–64 (expansion)

191% FPL

Pregnant women

$18,360

2026 FPL, household of 1 (HI)

Med-QUEST income limits by coverage group (2026)

Adults 19–64 (ACA expansion)

FPL %
138% FPL
Approx. monthly limit (household of 1)
~$2,111/mo
Approx. monthly limit (household of 4)
~$4,364/mo

Children under 19 (QUEST Integration)

FPL %
308% FPL
Approx. monthly limit (household of 1)
~$4,712/mo
Approx. monthly limit (household of 4)
~$9,741/mo

Pregnant women

FPL %
191% FPL
Approx. monthly limit (household of 1)
~$2,922/mo
Approx. monthly limit (household of 4)
~$6,040/mo

Parents and caretaker relatives

FPL %
105% FPL
Approx. monthly limit (household of 1)
~$1,607/mo
Approx. monthly limit (household of 4)
~$3,321/mo

Aged, Blind, and Disabled (ABD) — community

FPL %
SSI-linked
Approx. monthly limit (household of 1)
~$1,530/mo
Approx. monthly limit (household of 4)
—

No asset test for MAGI-based Med-QUEST coverage

MAGI-based Med-QUEST — covering adults under the expansion, children, and pregnant women — has no asset test. Savings, vehicles, and home equity are not counted. This is standard for all ACA expansion coverage.

Aged, Blind, and Disabled (ABD) Medicaid and long-term care programs operate under different financial rules, including resource limits and spousal impoverishment protections under federal law (42 U.S.C. § 1396r-5). The countable resource limit is $2,000 for a single applicant and $3,000 for a couple, for both regular ABD Medicaid and HCBS waiver programs. For 2026, the Community Spouse Resource Allowance (CSRA) maximum is $162,660 and the Monthly Maintenance Needs Allowance (MMNA) is $4,066.50.

Hawaii operates a Medicaid estate recovery program. The state may seek reimbursement from the estate of a member who received nursing facility or certain long-term care services at age 55 or older. Consult a Hawaii-licensed elder law attorney before making asset transfers if a family member may need long-term care Medicaid.

Hawaii has no separate CHIP program — children are integrated into Med-QUEST

Hawaii does not operate a separately branded CHIP program. Children up to 308% FPL are covered under QUEST Integration alongside adults and other eligibility groups. The same application, the same managed care plans, and the same benefits structure apply. There is no additional premium or cost-sharing tier for children between the Medicaid limit and 308% FPL — coverage is treated as Medicaid throughout. This integrated structure reflects Hawaii's long history of universal coverage policy dating to the 1974 Prepaid Health Care Act.

Medicare Savings Programs (QMB) in Hawaii

Hawaii's cost of living pushes its federal poverty guidelines above the figures used in the 48 contiguous states, and that adjustment carries through to the Medicare Savings Programs the same way it carries through to every other Med-QUEST income limit on this page. A single Hawaii resident can have income up to roughly $1,550/month and still qualify for QMB — noticeably higher than the standard threshold used almost everywhere else.

QMB

Situation
Individual
Monthly income limit
~$1,550/mo

QMB

Situation
Married couple
Monthly income limit
~$2,095/mo

SLMB

Situation
Individual
Monthly income limit
~$1,856/mo

SLMB

Situation
Married couple
Monthly income limit
~$2,510/mo

QI

Situation
Individual
Monthly income limit
~$2,086/mo

QI

Situation
Married couple
Monthly income limit
~$2,821/mo

QMB is the strongest of the three Medicare Savings tiers: it pays the Part A premium for anyone who owes one, the full Part B premium ($202.90/month in 2026), and all of Medicare's deductibles, coinsurance, and copayments. A married couple can qualify with income up to roughly $2,095/month.

SLMB and QI follow the same higher Hawaii scale but cover less: both pay the Part B premium only, nothing else. Hawaii's SLMB limit runs to approximately $1,856/month for an individual and $2,510/month for a couple; the QI limit reaches about $2,086/month individual and $2,821/month couple. QI has capped annual funding and is first-come, first-served — enrollees must reapply every year.

Federal law bars providers from billing a QMB enrollee for Medicare cost-sharing under any circumstances, and QMB, SLMB, and QI enrollees are all automatically enrolled in Extra Help, capping Part D drug costs at no more than $12.65 per covered prescription in 2026. Apply through Med-QUEST — Hawaii's Medicaid agency — at medquest.hawaii.gov, not through Medicare.

Med-QUEST (Hawaii Medicaid)

Visit the official Hawaii Medicaid website

Income Limits in Nearby States

Idaho Montana Nevada New Mexico Oregon

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Current income cutoffs by state and household size, tied to the Federal Poverty Level.

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QMB Program

What the QMB program covers, what a QMB card proves, and how to apply.

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