Hawaii Medicaid Income Limits 2026: MAGI, ABD, Med-QUEST

There are two Hawaii Medicaid income limits, and which one applies to you depends on your age and situation. In 2026, a single aged, blind, or disabled applicant has a monthly income standard of $1,530, set against Hawaii's own higher Federal Poverty Guidelines rather than the lower mainland numbers, plus a $2,000 asset limit.1 Med-QUEST's other coverage groups, including adults under 65 who are not enrolled in Medicare, are tested on modified adjusted gross income (MAGI) instead: a percentage of poverty, running to an effective 138% FPL for the Adult group, with no asset test at all.2,3

This guide covers both sets of 2026 Hawaii Medicaid income limits under Hawaii Med-QUEST, the state's Medicaid program: the MAGI standards for each coverage group, what changes on your 65th birthday, and then the ABD and long-term-care rules in full, including the asset limit, the medically needy spend-down, the unusually high home-equity allowance, what a nursing-home resident keeps, and what a spouse at home is protected from.

Two Hawaii Medicaid income limits: MAGI and the ABD track

Hawaii Medicaid applies two different income tests, and the one that governs you depends on your age and situation, not on which number you find first.

The $1,530 standard above is the aged, blind, and disabled (ABD) figure. It is the test for seniors, for people with disabilities, and for anyone seeking long-term-care coverage, and it carries the $2,000 asset limit.1

The other test is MAGI, or modified adjusted gross income. It governs Med-QUEST's remaining coverage groups: adults under 65 who are not enrolled in Medicare, parents and caretaker relatives, pregnant women, and children. Two rules separate it from the ABD track:

• MAGI applies no asset test. Federal law bars a state from applying any assets or resources test to the MAGI groups, and expressly excepts the ABD and long-term-care pathways from that bar, which is why those pathways keep a resource test.3 A working-age adult reading the $2,000 asset limit on this page is reading the wrong test.
• MAGI counts a different household. The MAGI groups size the household by federal income-tax filing relationships, the tax household, rather than by the rules the ABD groups use. So which people, and whose income, get counted can differ for the same family depending on which pathway they apply through.5

Hawaii's MAGI income limits for 2026

Med-QUEST publishes its MAGI income standards as percentages of the federal poverty level (FPL), effective January 13, 2026. The chart carries two columns per group: a base standard, and a maximum that adds Hawaii's 5-percentage-point FPL income disregard. Both numbers below are real, and they are not in conflict: the disregard is a deduction applied when income is tested, so the higher figure is the level at which eligibility actually runs out.2

These are percentages, not dollars, on purpose. Hawaii runs on its own higher Federal Poverty Guidelines rather than the guidelines used in the 48 contiguous states and the District of Columbia, so a percentage that converts to one dollar figure on the mainland converts to a higher one here.6 For the dollar column that matches your household size, work from Med-QUEST's own chart or call the number at the bottom of this page.2

Two of these figures deserve a note. The federal medicaid.gov eligibility table lists Hawaii's parents and caretaker relatives at 105% and its adult group at 133%, which looks like a discrepancy against the state chart but is not: medicaid.gov reports the parents figure after the disregard and the adult figure before it. And that table reports a single combined Medicaid-and-CHIP ceiling of 308% for children of every age band, because Hawaii runs a Medicaid-expansion CHIP rather than a separate CHIP program. The per-age-band children's splits (191%, 139%, 133%) come from Med-QUEST's chart, which breaks out the Medicaid-only levels the federal table rolls together.2

The children's levels sit above the federal floor. Federal law makes coverage of children under 19 mandatory to at least 133% FPL, and lets states go higher, which Hawaii does for infants and for children ages 1 through 5.7

Parents and caretaker relatives: the 100% standard

This is the group a grandparent raising a grandchild would look to, and it is worth understanding why its limit is low in most of the country and comparatively generous in Hawaii.

Parents and other caretaker relatives are a federally mandatory Medicaid group, but the floor Congress set for them is not a percentage of poverty. Under 42 CFR 435.110, a state must cover them at least up to the state's own cash-welfare (AFDC) income standard, converted to a MAGI equivalent, and the statute freezes that group to the state's pre-1996 AFDC eligibility rules.8 That standard was never re-indexed to poverty, which is why in many states a working parent is over the Medicaid income limit at a strikingly low income.8

Hawaii sets its standard well above that federal floor, at 100% FPL (105% with the disregard).2 And because Hawaii covers the Adult group, a caretaker under 65 who is over the 105% caretaker limit is not out of options: the Adult standard runs to an effective 138% FPL.2

Whether a particular grandparent counts as a caretaker relative for a grandchild is a determination Med-QUEST makes on the specific facts of the household. Do not assume the answer either way; ask the Med-QUEST call center listed below.

Turning 65 can end coverage when nothing else changed

Hawaii has adopted the ACA Medicaid expansion. It is not among the ten states that declined it, and Med-QUEST's chart carries an Adult standard for ages 19 through 64.9,2 That makes the following transition apply here in full force.

The new adult group is written narrowly. It covers individuals under 65 years of age, not pregnant, and not entitled to or enrolled in Medicare, at 133% FPL, which the 5-percentage-point MAGI disregard lifts to an effective ceiling of 138% FPL.10 Being a MAGI group, it applies no asset test.3

On the 65th birthday, that pathway closes, and the same person is assessed on the SSI-related ABD track instead. Two things change at once:

• The income ceiling drops. The Adult group ran to an effective 138% of Hawaii's poverty guidelines.2 Hawaii's ABD standard is 100% of those same guidelines, $1,530 per month for a household of one.1 (Nationally, the SSI-related yardstick is the SSI Federal Benefit Rate, $994 per month for an individual in 2026; Hawaii's ABD standard is set against its own poverty guidelines instead, which is why the Hawaii figure runs higher.)4,1
• An asset test appears. The MAGI groups are barred from applying one.3 The ABD track applies the SSI resource standard, $2,000 for an individual and $3,000 for a couple.4

So a 64-year-old covered as an Adult at an income just under the group's 138% ceiling, with modest savings above $2,000, can be over both tests the day they turn 65, without a dollar of income or savings changing: the ceiling falls from an effective 138% FPL to 100% FPL, and a resource test that never applied to them is suddenly applied.2,1,4

The same cliff has a second trigger that has nothing to do with age. The new adult group also excludes anyone entitled to or enrolled in Medicare, so a person under 65 who reaches Medicare through disability leaves the 138% no-asset-test group the same way.10

If this is your situation, the rest of this page is the track you land on, and the medically needy spend-down described next is the reason the landing is softer in Hawaii than in most states.

Hawaii Medicaid income limits: how the income test actually works

Hawaii Medicaid is run by the Department of Human Services through its Med-QUEST Division. For seniors and people with disabilities, the income test is the aged, blind, and disabled (ABD) pathway, which follows Supplemental Security Income (SSI) rules and is set at 100% of Hawaii's Federal Poverty Guidelines. For 2026, that standard is $1,530 per month for a household of one. Because Hawaii uses its own higher poverty guidelines than the 48 contiguous states, this figure runs above the comparable mainland number.1

Being over $1,530 does not shut you out. Hawaii pairs its ABD rules with a medically needy pathway, the state's version of a section 209(b) spend-down model. Under the medically needy program, an aged, blind, or disabled individual has no resource cap, and income above the medically needy income standard (a low monthly figure, commonly cited at about $469 for a household of one) becomes a monthly spend-down rather than a disqualification. Once you have incurred that much in medical or care costs in a given month, the Medicaid program covers the rest of that month.1

This is the reason Hawaii does not require a Qualified Income Trust, also called a Miller Trust. In strict income-cap states, an applicant even one dollar over the limit is locked out unless they route the excess through a special trust. Hawaii has no such cliff. If your income is high, you spend down; you are never simply too rich for long-term-care Medicaid. For nursing-facility residents, the same logic applies in reverse: a resident contributes income above their allowances toward the cost of care, so even someone with substantial monthly income can qualify, they just pay more of it in.1

The $1,130,000 home-equity allowance

When someone applies for long-term-care Medicaid, their primary residence is an exempt asset, so it does not count toward the $2,000 limit, but federal law caps how much equity in that home can stay exempt.4,1 States may set that cap anywhere between a federal floor and a federal ceiling, and most states use the lower figure, around $752,000 for 2026.

Hawaii elects the higher federal limit. For 2026, equity in the primary residence is exempt up to $1,130,000.1 Given Hawaii's home values, that difference is not academic. A family whose home would push them over the equity cap in many mainland states can keep that same home exempt under Med-QUEST.

Two things to keep straight. The allowance is about equity, the home's value minus what is still owed on it, not the sale price. And the cap is generally waived entirely when a spouse, or a minor, blind, or disabled child, lives in the home, in which case there is no equity ceiling at all. The figure matters most for a single applicant, or a couple where neither spouse will remain in the house.

Long-term care: what a nursing-home resident keeps

When Hawaii Medicaid pays for nursing-facility care, the resident contributes almost all of their monthly income toward the cost of that care. What they keep is a personal needs allowance of $75 per month ($150 per month for a couple both in long-term care), set by Med-QUEST and raised from the prior $50 effective October 1, 2024, money reserved for the resident's own small expenses like clothing, a haircut, or a phone.1,11 For the national picture on how that allowance works and how it is calculated, see our explainer on the Medicaid personal needs allowance.

The same $2,000 asset limit ($3,000 for a couple where both apply) governs nursing-home applicants.4 Because Hawaii uses spend-down rather than a hard income cap, the income side is rarely what disqualifies someone; the asset side and the look-back are where applications more often run into trouble.

The five-year look-back

Hawaii reviews asset transfers made in the 60 months before a long-term-care application.1,12 Giving away money or property for less than fair market value during that window, gifting a grandchild a down payment, or signing a house over to a child for a dollar, can trigger a penalty period during which Medicaid will not pay for long-term-care services, even though you would otherwise be eligible.

There are legitimate exceptions, transfers between spouses, transfers to a disabled child, and certain caregiver-child home transfers among them, along with legitimate planning approaches. But anything done inside the five-year window deserves an elder-law attorney's review first. If long-term care is on the horizon for someone in your family, talk to a professional before moving assets. For the broader toolkit, see our guide to Medicaid planning strategies.

Protecting the spouse who stays home

When one spouse needs long-term care and the other remains at home, federal spousal-impoverishment rules keep the at-home spouse from being left destitute. Hawaii applies the federal framework for 2026:1

So a married couple is in a very different position from a single applicant. The community spouse can hold up to $162,660 in countable assets and keep a monthly income allowance in the federal range while the other spouse receives Medicaid-funded care, and if that spouse stays in the home, the equity cap drops away entirely.1

After death: estate recovery

Like every state, Hawaii runs a Medicaid estate-recovery program. After a recipient who was 55 or older and received long-term-care services dies, the state may seek repayment from the estate, unless the recipient is survived by a spouse or a minor, blind, or disabled child. Federal exceptions apply, and an undue-hardship waiver exists.1,13 For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in Hawaii

Hawaii Medicaid is administered by the Med-QUEST Division of the Department of Human Services. You can apply online through Hawaii's benefits portal or by phone to the Med-QUEST call center.1

Before you apply, have ready proof of income (benefit award letters or pension statements, pay stubs), a list of assets and account balances, proof of Hawaii residency, and proof of citizenship or qualified immigration status. Long-term-care applicants also go through a level-of-care assessment to confirm they need nursing-facility-level services. Apply even if you think you are over the limit. Between the spend-down pathway, the high home-equity allowance, and the spousal protections, many people who assume they are disqualified are not.

Learn More

Find personalized help working through Hawaii Med-QUEST eligibility for your family at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.