Hawaii Medicare Savings Programs can eliminate or sharply reduce Medicare premiums and cost-sharing for income-eligible seniors and people with disabilities. The broadest tier, QMB, covers the Part B premium and all Medicare cost-sharing through the state's Med-QUEST program.
What Are Medicare Savings Programs?
Medicare Savings Programs are Medicaid-administered benefits that pay a low-income Medicare beneficiary's premiums and cost-sharing. Under Title XIX of the Social Security Act, QMB, SLMB, and QI are mandatory eligibility groups every state must cover.
In Hawaii, the programs are administered by the Hawaii Department of Human Services (DHS) Med-QUEST Division. Hawaii is a Section 209(b) state, meaning it retains the right to apply certain Medicaid methodologies that differ from SSI rules. For MSPs specifically, however, Hawaii uses the federal-floor FPL-based income standards required by law. The 209(b) election affects other parts of Hawaii's Medicaid program (such as its medically needy spend-down approach for long-term care) but does not tighten MSP eligibility relative to other states.
Because MSPs use the SSI-related income methodology, two disregards reduce countable income before the test runs: a $20/month general income disregard applied first to unearned income, and a $65 + half of remaining earned income disregard for working beneficiaries. The income limits below already reflect the $20 disregard.
QMB: Qualified Medicare Beneficiary
QMB is the most comprehensive MSP tier. It covers:
- The Medicare Part A premium (most beneficiaries have premium-free Part A after 40 or more work quarters)
- The Medicare Part B standard premium ($185/month in 2026 per CMS)
- The Part A inpatient hospital deductible ($1,736 in 2026)
- The Part B annual deductible ($257 in 2026)
- All Medicare coinsurance and copays across every Medicare-covered service
2026 Hawaii QMB income limits: at or below $1,350/month for a single person, $1,823/month for a couple. These reflect 100% of the Federal Poverty Level with the $20 general income disregard applied.
Resource limit: $9,950 for one person, $14,910 for a couple. The primary home and one vehicle are fully excluded.
For a single Hawaii senior on Social Security, QMB can represent more than $3,000 in annual savings across premiums and cost-sharing. Every QMB enrollee is automatically deemed eligible for full Part D Extra Help.
| Household size | Monthly income limit | Resource limit |
|---|---|---|
| Single | $1,350 | $9,950 |
| Couple | $1,823 | $14,910 |
SLMB: Specified Low-Income Medicare Beneficiary
SLMB pays one benefit: the Medicare Part B premium. At the 2026 standard rate of $185/month, that is $2,220 per year returned to the beneficiary.
2026 Hawaii SLMB income limits: $1,351 to $1,616/month for a single person, $1,824 to $2,188/month for a couple.
Resource limit: same as QMB: $9,950 single, $14,910 couple.
SLMB does not cover deductibles or copays. For beneficiaries with limited medical utilization, the Part B premium elimination alone is the dominant savings, and SLMB delivers it.
SLMB enrollment also triggers automatic Part D Extra Help, reducing generic copays to $5.10 and brand-name copays to $12.65 on a benchmark Part D plan with no deductible and no premium.
| Household size | Monthly income range | Resource limit |
|---|---|---|
| Single | $1,351-$1,616 | $9,950 |
| Couple | $1,824-$2,188 | $14,910 |
QI: Qualifying Individual
QI covers the Part B premium only, the same as SLMB, at a higher income band: $1,617 to $1,816/month single, $2,189 to $2,459/month couple (2026 Hawaii figures).
Two structural differences from QMB and SLMB:
- First-come, first-served. QI is funded through a capped federal allotment. Hawaii allocates enrollment on a first-come, first-served basis, with preference given to prior-year enrollees. Unlike QMB and SLMB, which are entitlements, QI enrollment is not guaranteed once the allotment is exhausted.
- Mutually exclusive with full Medicaid. Anyone eligible for full-benefit Medicaid cannot be on QI. They would instead receive QMB-Plus or SLMB-Plus, which layer full Medicaid benefits on top of MSP protections.
QI enrollment also triggers automatic Part D Extra Help.
| Household size | Monthly income range | Resource limit |
|---|---|---|
| Single | $1,617-$1,816 | $9,950 |
| Couple | $2,189-$2,459 | $14,910 |
Full Program Comparison
| Program | Single income limit | Couple income limit | What it pays | Resource limit |
|---|---|---|---|---|
| QMB | Up to $1,350/mo | Up to $1,823/mo | Part A + Part B premiums + all cost-sharing | $9,950 / $14,910 |
| SLMB | $1,351-$1,616/mo | $1,824-$2,188/mo | Part B premium only | $9,950 / $14,910 |
| QI | $1,617-$1,816/mo | $2,189-$2,459/mo | Part B premium only (capped allotment) | $9,950 / $14,910 |
Income limits reflect 100% FPL (QMB), 100-120% FPL (SLMB), and 120-135% FPL (QI) with the $20 general income disregard applied.
Hawaii's 209(b) Status and MSP Eligibility
Hawaii elects Section 209(b), giving Med-QUEST authority to use methodologies that differ from SSI rules for certain Medicaid eligibility categories. In practice, 209(b) affects Hawaii's long-term care Medicaid program (which uses a medically needy spend-down rather than a Miller Trust) but does not change MSP income or resource standards. The federal statute sets MSP income limits at specific FPL percentages regardless of a state's 209(b) status, so Hawaii's QMB, SLMB, and QI thresholds match the federal floor.
Applicants who have been told they do not qualify for Medicaid under Hawaii's 209(b) methodology should still check MSP eligibility separately, since the two programs are evaluated under different rules.
The QMB Billing Prohibition
Federal law (42 USC 1396a(n)(3)(B)) prohibits any Medicare provider from billing a QMB enrollee for Medicare cost-sharing. This applies to both Original Medicare and Medicare Advantage providers, whether or not they contract with Med-QUEST.
If you receive a bill for a deductible, copay, or coinsurance as a QMB enrollee:
- Tell the provider you are enrolled in QMB and cite the federal law.
- Show your Med-QUEST eligibility notice or Medicare card with QMB indicator.
- Call 1-800-MEDICARE (1-800-633-4227) to file a complaint.
- Contact Hawaii SHIP (State Health Insurance Assistance Program) for free help disputing the charge.
Providers who have billed QMB enrollees must recall bills from collections and refund any amounts already collected.
Part D Extra Help / Low-Income Subsidy
Every Hawaii QMB, SLMB, and QI enrollee is automatically deemed eligible for full Part D Extra Help (Low-Income Subsidy, or LIS). No separate application is required.
Under the 2026 Part D benefit structure:
- $0 premium on a benchmark Part D plan
- $0 annual deductible
- $5.10 per generic prescription
- $12.65 per brand-name or preferred multi-source drug
- $0 in copays after the $2,100 annual out-of-pocket cap
For a beneficiary filling six prescriptions per month, Extra Help can reduce drug costs by $1,500 to $2,500 per year. The deeming flows from Med-QUEST to CMS monthly. If you are not already in a Part D plan, CMS will auto-assign you to a zero-premium benchmark plan.
Resource Counting: What's Excluded
Not counted:
- Primary residence, regardless of value
- One vehicle, regardless of value
- Household goods and personal effects
- Prepaid burial arrangements and a burial fund up to $1,500 per person
Counted:
- Checking and savings account balances
- Stocks, bonds, mutual funds, CDs
- A second vehicle or vacation property
- Non-exempt cash-value life insurance above $1,500
Hawaii's home equity exclusion for long-term care Medicaid is $1,130,000 (the highest in the nation) but the MSP resource test excludes the primary home entirely from the count, regardless of value.
How to Apply for Hawaii Medicare Savings Programs
Med-QUEST offers two primary channels:
Online via mybenefits.hawaii.gov Apply at mybenefits.hawaii.gov. Create an account, complete the Medicaid or MSP application, and upload supporting documents.
By phone Call Med-QUEST at 1-800-316-8005. Staff can assist with eligibility screening and application processing.
Through Social Security Applying for Part D Extra Help at SSA using Form SSA-1020 generates a mandatory referral to Med-QUEST under 42 USC 1320b-14. Your SSA filing date becomes the protected MSP filing date.
Documents to Gather Before Applying
- Medicare card (showing your Medicare Beneficiary Identifier)
- Social Security card or proof of SSN
- Most recent SSA benefit award or COLA letter
- Recent bank and investment account statements
- Pension or annuity income documentation, if applicable
- Proof of Hawaii residency
Processing Timelines and Effective Dates
Med-QUEST must process non-disability MSP applications within 45 days under 42 CFR 435.912.
- QMB: coverage begins the first day of the month after Med-QUEST approves the application. Federal law prohibits retroactive QMB coverage; apply early.
- SLMB and QI: up to three months of retroactive coverage is available if you were eligible during those months. File as early as possible even before all documents are gathered.
Frequently Asked Questions
A Hawaii Medicare beneficiary with monthly income at or below $1,350 (single) or $1,823 (couple) and countable resources at or below $9,950/$14,910. The primary home and one vehicle are excluded. QMB pays Part A and Part B premiums plus all Medicare deductibles, copays, and coinsurance.
No. Federal law sets MSP income limits at specific FPL percentages for all states, including 209(b) states. Hawaii's MSP income and resource limits match the federal floor. Someone turned down for other Medicaid categories under Hawaii's 209(b) methodology should still apply for MSP separately.
No. Every Hawaii QMB, SLMB, and QI enrollee is automatically deemed eligible for full Part D Extra Help. If you are not yet in a Part D plan, CMS will auto-assign you to a zero-premium benchmark plan.
Yes, for up to three months if you were eligible during that period. QMB has no retroactive coverage. File as early as possible to maximize the retroactive window.
Do not pay the bill. Federal law forbids Medicare providers from billing QMB enrollees for cost-sharing. Contact 1-800-MEDICARE and Hawaii SHIP for free help resolving the charge.
No. If you qualify for full-benefit Medicaid, you would be enrolled in QMB-Plus or SLMB-Plus rather than QI.
Learn More
- Hawaii Medicaid Eligibility and Income Limits
- How to Apply for Hawaii Medicaid
- Understanding the Personal Needs Allowance
Find personalized help applying for Hawaii Medicare Savings Programs 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.