Hawaii Medicaid, known as Med-QUEST, provides health coverage to low-income residents across the islands.
It helps children, pregnant women, adults, parents, seniors, and people with disabilities access medical care, prescriptions, and long-term services.
In 2025, income limits play a key role in eligibility, as they tie to the federal poverty level and adjust yearly.
This article breaks down limits by group, explains how they work, and guides you through applying and staying covered.
Look at the visual PDF for details and the most important summary of this article:
What Is Hawaii Medicaid (Med-QUEST)?
Hawaii’s Medicaid program, called Med-QUEST, is run by the state Department of Human Services.
It covers a wide range of people, including adults aged 19-64, children up to 18, pregnant women, parents and caregivers, seniors 65 and older, and those with disabilities.
Hawaii expanded Medicaid in 2014 under the Affordable Care Act, opening doors for more working adults.
Benefits include doctor visits, hospital stays, mental health care, prescriptions, dental for kids, and long-term support like nursing homes or home aides. It’s free or low-cost based on income, with no premiums for most groups
Hawaii Medicaid Eligibility Overview
To qualify for Med-QUEST, you must meet these basics:
– Residency: Live in Hawaii and intend to stay.
– Citizenship/Immigration: U.S. citizen, national, or qualified immigrant (like a lawful permanent resident with five years in the U.S.). Some non-citizens get emergency care.
– Income: Based on federal poverty level (FPL), with limits varying by group. Hawaii’s FPL is higher than the mainland’s due to cost of living.
– Household Size: Counts you, your spouse, and tax dependents; unborn children add to the count for pregnant women.
– Age-Specific Groups: Kids under 19 have higher limits; adults 19-64 qualify via expansion; seniors and disabled often need medical proof.
– Medical Need: For disability or long-term care groups, show need through doctor assessments or daily living challenges.
Hawaii Medicaid Income Limits Table and 2026 Chart
Here are 2025 limits by group. Tables show monthly and annual amounts for household sizes 1-8.
These include the 5% disregard where it applies. Add $553 monthly ($6,636 annually) per extra person beyond 8 for most MAGI groups.
Adults (19–64) – Medicaid Expansion (138% FPL Effective)
Covers childless adults and some parents.
| Household Size | Monthly Limit | Annual Limit |
|---|---|---|
| 1 | $2,069 | $24,828 |
| 2 | $2,797 | $33,564 |
| 3 | $3,525 | $42,300 |
| 4 | $4,253 | $51,036 |
| 5 | $4,981 | $59,772 |
| 6 | $5,709 | $68,508 |
| 7 | $6,437 | $77,244 |
| 8 | $7,165 | $85,980 |
Children (0–18) – CHIP/Medicaid (Up to 313% FPL Effective for Under 1; Varies by Age)
Kids 0-1: 313% FPL; 1-5: 196%; 6-18: 144%. CHIP kicks in above Medicaid levels up to 313% total.
For Children Under 1 (313% FPL):
| Household Size | Monthly Limit | Annual Limit |
|---|---|---|
| 1 | $4,693 | $56,316 |
| 2 | $6,344 | $76,128 |
| 3 | $7,995 | $95,940 |
| 4 | $9,646 | $115,752 |
| 5 | $11,297 | $135,564 |
| 6 | $12,948 | $155,376 |
| 7 | $14,599 | $175,188 |
| 8 | $16,250 | $195,000 |
For Children 1-5 (196% FPL):
| Household Size | Monthly Limit | Annual Limit |
|---|---|---|
| 1 | $2,939 | $35,268 |
| 2 | $3,973 | $47,676 |
| 3 | $5,007 | $60,084 |
| 4 | $6,041 | $72,492 |
| 5 | $7,074 | $84,888 |
| 6 | $8,108 | $97,296 |
| 7 | $9,142 | $109,704 |
| 8 | $10,176 | $122,112 |
For Children 6-18 (144% FPL):
| Household Size | Monthly Limit | Annual Limit |
|---|---|---|
| 1 | $2,159 | $25,908 |
| 2 | $2,919 | $35,028 |
| 3 | $3,679 | $44,148 |
| 4 | $4,438 | $53,256 |
| 5 | $5,198 | $62,376 |
| 6 | $5,957 | $71,484 |
| 7 | $6,717 | $80,604 |
| 8 | $7,476 | $89,712 |
Pregnant Women (Up to 196% FPL Effective)
Covers prenatal care; unborn child counts as +1 in household.
| Household Size | Monthly Limit | Annual Limit |
|---|---|---|
| 1 | $2,939 | $35,268 |
| 2 | $3,973 | $47,676 |
| 3 | $5,007 | $60,084 |
| 4 | $6,041 | $72,492 |
| 5 | $7,074 | $84,888 |
| 6 | $8,108 | $97,296 |
| 7 | $9,142 | $109,704 |
| 8 | $10,176 | $122,112 |
Parents & Caregivers (105% FPL Effective)
For those with dependent kids under 19.
| Household Size | Monthly Limit | Annual Limit |
|---|---|---|
| 1 | $1,575 | $18,900 |
| 2 | $2,128 | $25,536 |
| 3 | $2,682 | $32,184 |
| 4 | $3,236 | $38,832 |
| 5 | $3,790 | $45,480 |
| 6 | $4,344 | $52,128 |
| 7 | $4,898 | $58,776 |
| 8 | $5,452 | $65,424 |
Seniors & Disabled (ABD Medicaid) (100% FPL for Optional Categorically Needy)
Lower limits; assets count. Monthly income up to $1,500 for one person. For medically needy path: $469/month single, $632 couple (spend down excess on bills).
| Household Size | Monthly Income Limit | Annual Income Limit | Asset Limit (Individual) | Asset Limit (Couple) |
|---|---|---|---|---|
| 1 | $1,500 | $18,000 | $2,000 | N/A |
| 2 | $2,027 | $24,324 | N/A | $3,000 |
Long-Term Care (Nursing Home / HCBS Waiver)
No hard income limit for nursing homes (pay toward care after $75 personal allowance).
For HCBS: $1,500/month single.
Assets: $2,000 single, $3,000 couple.
Spousal rules protect non-applicant: Up to $3,948/month income allowance, $157,920 assets.
Home equity cap: $1,097,000.
| Category | Monthly Income Limit (Single) | Asset Limit (Single) | Spousal Income Allowance | Spousal Asset Allowance |
|---|---|---|---|---|
| Nursing Home | No limit (pay liability) | $2,000 | Up to $3,948 | Up to $157,920 |
| HCBS Waiver | $1,500 | $2,000 | Up to $3,948 | Up to $157,920 |
What Counts as Income in Hawaii Medicaid?
For most groups (MAGI), use tax rules:
- – Wages and salaries.
- – Self-employment net profit.
- – Tips and bonuses.
- – Unearned income like interest, dividends, alimony.
- – Benefits such as unemployment, Social Security (taxable part).
What doesn’t count:
- – Tax refunds.
- – Child support received.
- – Gifts or loans.
- – Some scholarships.
- – VA Aid & Attendance (for long-term care).
For non-MAGI (seniors/disabled), nearly all income counts except Holocaust payments or specific VA extras.
Household Size Rules in Hawaii
Household size follows tax rules: you, spouse, and anyone you claim as a dependent.
For Medicaid, include non-tax dependents if they live with you and you provide over half their support.
Examples:
- – Single parent with two kids: Size 3.
- – Married couple, one pregnant, one child: Size 4 (unborn counts as 1).
- – Grandparent caring for grandchild (claims as dependent): Size 2.
- – Unmarried partners: Usually separate households unless filing jointly.
Pregnancy adds 1 (or more for multiples). If rules confuse you, use Hawaii’s online eligibility tool.
How to Apply for Hawaii Medicaid (Step-by-Step)
1. Gather docs: ID (birth certificate, driver’s license), Social Security number, income proof (pay stubs, tax returns), residency proof (utility bill), immigration papers if needed.
2. Apply online via KOLEA portal at medquest.hawaii.gov
3. Or mail a form to your local Med-QUEST office (find at humanservices.hawaii.gov).
4. Or visit in-person at a Department of Human Services office.
5. Submit and wait: Decisions take 45 days for most, 90 for disability claims.
Call 1-800-316-8005 for help.
Renewal Requirements (2025)
- Renew yearly to keep coverage.
- Prepare income updates, address changes, household shifts.
- Miss it? Coverage ends; reapply to restart.
- Automatic renewals happen if data matches state records, no action needed.
Get notices 45 days before the due date.
Common Reasons Hawaii Medicaid Applications Get Denied
– Income exceeds limits.
– Wrong household size reported.
– Missing or incomplete documents.
– Immigration status doesn’t qualify.
– No response to follow-up requests.
– Assets over cap for seniors/disabled.
FAQs for Hawaii Medicaid Income Limits
Does Hawaii consider rent or expenses in the income limit?
No, limits use gross income minus standard deductions. Expenses like rent don’t subtract directly, but medically needy paths allow spend-down on bills.
Is Hawaii Medicaid free?
Yes for most, no premiums or copays for kids, pregnant women, or expansion adults. Some groups pay small copays for services.
How often do income limits change?
Yearly, in January, based on FPL updates.
Can undocumented immigrants get Medicaid in Hawaii 2025?
No full coverage, but emergency services yes. Kids and pregnant women may qualify regardless under some rules.
What if I make slightly over the limit?
The 5% disregard might help. Or use medically needy spend-down. Check Marketplace subsidies instead.
Can I stay on Medicaid if I move to the mainland?
No, reapply in new state. Coverage ends when you leave Hawaii.
Do assets count for all groups?
No, only for seniors, disabled, and long-term care. Most others ignore assets.
What if I’m pregnant and over the limit?
You get a higher threshold (196% FPL), and the unborn counts in household size.
How does disability affect eligibility?
Proves medical need; income/assets apply via ABD path.
Can I work and keep Medicaid?
Yes, especially in expansion, up to 138% FPL for adults.
Final thoughts
Hawaii Medicaid covers residents from kids to seniors if income fits FPL-based limits, like 138% for adults, up to 313% for young children. Key thresholds: $2,069 monthly for a single adult, $4,693 for an infant’s household of one. Apply online via KOLEA, renew yearly, and gather docs to avoid denials. For help, call 1-800-316-8005 or visit medquest.hawaii.gov
