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

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 home-equity cap on an exempt residence, what a nursing-home resident keeps, and what a spouse at home is protected from.

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 get confused constantly.1

Each pathway applies an asset test. On the ABD and medically needy spend-down pathways it is $2,000 for a household of one and $3,000 for two, plus $250 per additional person; the Medicare Savings Programs use their own, higher resource limits.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.7

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.8 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 table lists Hawaii's parents and caretaker relatives at 105% and its adult group at 133%, which looks like a discrepancy but is not: medicaid.gov reports the parents figure after the disregard and the adult figure before it. That table also rolls children of every age band into a single Medicaid-and-CHIP ceiling of 308%, because Hawaii runs a Medicaid-expansion CHIP rather than a separate program; the per-age-band splits (191%, 139%, 133%) 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 5.9

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.10 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.10

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 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 64.11,2 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.3 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 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.3

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. 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

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. In strict income-cap states, an applicant a dollar over the limit is locked out unless they route the excess through a special trust. Hawaii has no such cliff. 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 that cap is $752,000 unless the state elects a higher amount, up to a maximum of $1,130,000.5

Which figure Hawaii has elected is not something we can source. The federal bulletin that publishes the range records no state's election, and we hold no Med-QUEST, Hawaii Administrative Rules, or state-plan document that names Hawaii's, so we will not print a number we cannot stand behind. Given Hawaii's home values that is not an academic gap, so ask Med-QUEST at 1-800-316-8005 before planning around either end of the range.1

Two things to keep straight. The cap is about equity, the home's value minus what is still owed on it, not the sale price. And it is generally waived entirely when a spouse, or a minor, blind, or disabled child, lives in the home. 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 small personal expenses like clothing, a haircut, or a phone.1,12 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.1,5 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. 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 community spouse can hold up to $162,660 in countable assets and 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.6

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.1,5 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 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, 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. Apply even if you think you are over the limit: between the spend-down pathway, the home-equity exemption, 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.