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

There is more than one Hawaii Medicaid income limit, and which one applies to you depends on your age and situation. In 2026, a single aged, blind, or disabled applicant is tested first against an SSI-related income standard of $994 a month, and anyone over it can still qualify through the medically needy spend-down, which lets you keep $469 a month and turns the excess into care costs you pay. Either way, a $2,000 asset limit applies.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

Below are both sets of 2026 limits under Hawaii Med-QUEST, the state's Medicaid program: the MAGI standards for each group, what changes at 65, and then the ABD and long-term-care rules, from the asset limit and spend-down to home equity and spousal protections.

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 aged, blind, and disabled (ABD) track governs seniors, people with disabilities, and anyone seeking long-term-care coverage, and it is the track that carries an asset test. Med-QUEST calls these its MAGI-excepted standards, and its 2026 chart prints three of them, each belonging to a different pathway:1

• $994 a month, the Mandatory Categorically Needy standard ($1,491 for two). The SSI-related ABD figure, and where to start if you are 65 or older, blind, or disabled.1
• $469 a month, the medically needy income limit ($632 for two). Above the categorically needy standard there is no ceiling at all; what you have over $469 becomes a monthly spend-down.1
• $1,530 a month, the Optional Categorically Needy (Aged, Disabled) QMB/BHH standard ($2,075 for two), at 100% of Hawaii's own higher Federal Poverty Guidelines. This is the Medicare Savings Program number, not the long-term-care test, and the two are easy to confuse.1,7

On the ABD and medically needy spend-down pathways the asset limit is $2,000 for a household of one and $3,000 for two, plus $250 per additional person.1 The Medicare Savings Programs have rules of their own, covered in our Hawaii Medicare Savings Programs guide.

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.3 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 can 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 generally size the household by federal income-tax filing relationships, the tax household (people who don't file taxes follow separate non-filer rules), 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.8

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: the disregard is a deduction applied when income is tested, which is why the chart prints the higher figure as each group's maximum.2 Federally, though, the disregard is applied once, for the highest-standard group you could qualify under, not group by group.9

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.10,1 For the dollar column that matches your household size, work from Med-QUEST's own chart or call Med-QUEST at the number further down this page.2

Two of these figures deserve a note. The federal medicaid.gov table lists Hawaii's parents at 105% and its adults at 133% because it reports the parents figure after the disregard and the adult figure before it. It also rolls every child age band into one 308% ceiling, because Hawaii's children's band is CHIP-funded Medicaid rather than a separate CHIP program; the per-age splits come from Med-QUEST's chart.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 5.11

Parents and caretaker relatives: the 100% standard

This is the group a grandparent raising a grandchild would look to, and it is worth understanding how its limit is set, because the federal rule leaves the number to each state.

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, each state sets its own standard: no lower than its old cash-welfare (AFDC) income standard as of May 1, 1988, converted to a MAGI equivalent, and no higher than a ceiling tied to its 1996 AFDC standard (which may rise with inflation) or the levels it covered in 2010 or 2013.12 So the number a family should check is the state's own published standard, not the federal floor.12

Hawaii's published standard is 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 One condition comes with it: a parent or caretaker relative living with a child under 19 can be covered as an Adult only if that child has Medicaid, CHIP, or other minimum essential coverage, so expect to be asked about the child's coverage.9

Whether a particular grandparent counts as a caretaker relative is a determination Med-QUEST makes on the household's specific facts. Do not assume either way; ask the 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 64.2 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.9 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. (Only the Adult group closes: someone who also qualifies as a caretaker relative is still tested under MAGI, with no asset test.)3 Two things change at once:

• The income ceiling drops. The Adult group ran to an effective 138% of Hawaii's poverty guidelines.2 The SSI-related ABD standard is $994 per month for a household of one, which is the 2026 SSI Federal Benefit Rate itself, not a percentage of poverty.1,4 Being over it is not the end of the road, but it moves you onto the medically needy spend-down rather than straightforward eligibility.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 the $994 SSI-related standard, and a resource test that never applied to them is suddenly applied.2,1,4

The same cliff has a second trigger unrelated to 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.9

If this is your situation, the rest of this page is the track you land on, and the spend-down described next is why 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, and the ABD pathway follows Supplemental Security Income (SSI) rules. Being over the $994 categorically needy standard does not shut you out. Hawaii pairs those rules with a medically needy pathway, the state's version of a section 209(b) spend-down model. For an aged, blind, or disabled individual that program sets no maximum on income at all, which is what makes it a spend-down rather than a cut-off: whatever you have above the medically needy income limit of $469 a month for a household of one ($632 for two) becomes a monthly spend-down. You qualify for Medicaid by incurring and paying medical or care costs equal to that excess each month.1

The spend-down does not waive the asset test. What the medically needy program leaves unlimited is income, not resources. Hawaii's rules put a medically needy individual's countable assets under the same personal reserve as the rest of the ABD track, and Med-QUEST's 2026 chart sets the aged, blind, or disabled spend-down asset limit at $2,000 for a household of one and $3,000 for two, plus $250 per additional person. There is no asset-free medically needy pathway in Hawaii. If you are counting on spend-down, count the resources against $2,000 first: income planning will not save an application that fails the asset test.1

This is also why Hawaii does not require a Qualified Income Trust, also called a Miller Trust. Hawaii is not an income-cap state, so there is no income cliff to route around. A nursing-facility resident simply contributes income above their allowances toward the cost of care, so someone with substantial monthly income can still qualify, they just pay more of it in.1

Home equity: how much of the house stays exempt

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 For 2026 the federal range runs from a $752,000 minimum to a $1,130,000 maximum that a state may elect instead.5

Hawaii uses the minimum. Its rule (HAR §17-1725.1-59) bars long-term-care coverage when home equity exceeds $750,000, indexed each year to inflation, which for 2026 is the federal minimum of $752,000, not the $1,130,000 maximum. No Med-QUEST source we hold prints its own 2026 figure, so confirm it at 1-800-316-8005 before planning around it.1,13

The cap is about equity, the home's value minus what is still owed on it. It does not apply at all when a spouse, or a child under 21, blind, or disabled, lives in the home.5,1 An applicant over it can reduce equity with a reverse mortgage or home-equity loan, or seek an undue-hardship waiver.1

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

When Hawaii Medicaid pays for nursing-facility care, the resident contributes their income above certain protected allowances toward the cost of that care. What they keep for personal needs is a personal needs allowance of $75 per month ($150 for a couple), which Med-QUEST raised from $50 ($100 for a couple) effective October 1, 2024 for residents of certain long-term-care facilities, well above the $30 federal minimum.1,3 Federal law deducts it on top of other state-plan allowances, such as the at-home spouse's income allowance below.3,1 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, income alone does not disqualify someone; the asset limit and the look-back still can.1

The five-year look-back

Hawaii reviews asset transfers made in the 60 months before a long-term-care application.1,5 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, and Hawaii's rule also lets a penalty be waived for undue hardship.1,5 But anything done inside the five-year window deserves an elder-law attorney's review first, so 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 resource and maintenance-allowance figures for 2026:1,6,5

So a married couple is in a very different position from a single applicant. The $162,660 resource standard and the $4,066.50 maximum income allowance are not hard caps: a fair hearing or court order can allow more.6,1 Under current federal law these protections also cover a spouse whose partner gets home- and community-based waiver care, through September 30, 2027.1 And if the at-home spouse stays in the house, the home-equity limit does not apply.5

After death: estate recovery

Like every state, Hawaii runs a Medicaid estate-recovery program.1 Federal law requires a state to seek repayment from the estate of a recipient who was 55 or older when they received nursing-facility care, home- and community-based services, and related hospital and prescription-drug services, and lets a state choose to recover for more. Recovery has to wait until any surviving spouse has died, and cannot be made while a child under 21, or a blind or permanently and totally disabled child, survives. Every state must also offer an undue-hardship waiver.14 For how it 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, by phone, by mail, or by fax; a paper application goes to the Med-QUEST Division Eligibility Office nearest you.13

Long-term-care applicants add forms DHS 1100B, 1167, 1169, 1169A, 8003 and 8004 to the DHS 1100 application, and the care itself turns on a separate physician's evaluation of the level of care you need.13 Apply even if you think you are over the limit: between the spend-down pathway, the home-equity exemption, and the spousal protections, being over one number does not by itself disqualify you.

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.