Hawaii Medicare Savings Programs 2026: QMB, SLMB & QI

In 2026, a single Hawaii resident with monthly income up to $1,550 can get the full Medicare Part B premium of $202.90 paid by the state's Qualified Medicare Beneficiary (QMB) program. QMB also covers the Part A and Part B deductibles, coinsurance, and copays. Hawaii runs its Medicare Savings Programs through Med-QUEST, and because Hawaii's federal poverty guidelines are higher than the contiguous 48 states, its income limits run higher too.1,2

What Are Medicare Savings Programs?

Medicare Savings Programs are Medicaid-administered programs that help people with limited income and resources pay Medicare costs. Under Title XIX of the Social Security Act, the Medicaid statute, QMB, SLMB, and QI are Medicaid eligibility groups. Enrolling in any one of them automatically qualifies you for Part D Extra Help. A fourth program, the Qualified Disabled and Working Individual (QDWI) program, pays the Part A premium for certain working people with disabilities who lost premium-free Part A; it does not bring Extra Help, and this guide covers the other three.1

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 may apply certain Medicaid methodologies that differ from Supplemental Security Income (SSI) rules. For Medicare Savings Programs specifically, Hawaii uses poverty-level income standards (100%, 120%, and 135% of the federal poverty level), calculated against Hawaii's own poverty guidelines, which run higher than the contiguous 48 states.1 The 209(b) election shows up elsewhere in Hawaii's Medicaid program, such as its medically needy spend-down for long-term care.4

Med-QUEST's 2026 income standards chart (effective 01/13/2026) publishes the underlying poverty-level figures: $1,530 single / $2,075 couple for QMB, $1,836 / $2,490 for SLMB, and $2,066 / $2,801 for QI. The limits Social Security lists for Hawaii, which this guide uses, add the $20 monthly SSI general income exclusion on top of those standards.1 Neither the income nor the resource figures are an absolute ceiling: states can effectively raise both the income and the resource limits by disregarding certain income and resources, and SSA tells staff to encourage people to apply even when income or resources appear somewhat higher.1

QMB: Qualified Medicare Beneficiary

QMB is the most comprehensive Medicare Savings Program tier. It covers:

• The Medicare Part A premium, if you have to pay one (most people pay no Part A premium because they or a spouse paid Medicare taxes long enough while working, generally at least 10 years)
• The Medicare Part B standard premium, $202.90/month in 2026
• The Part A inpatient hospital deductible, $1,736 per benefit period in 2026
• The Part B annual deductible, $283 in 2026
• Part A and Part B coinsurance and copays for Medicare-covered items and services. QMB does not cover Part D drug-plan copays; Extra Help limits those instead (see below).2,1

2026 Hawaii QMB income limits: up to $1,550/month for a single person and $2,095/month for a couple. That is Med-QUEST's 100%-of-poverty standard ($1,530 / $2,075 on its 2026 chart, figured on Hawaii's higher Federal Poverty Level) plus the $20 general income exclusion. Resource limit: $9,950 for one person, $14,910 for a couple.1 Your home and your motor vehicles don't count toward it under Hawaii's asset rule (see what counts, below).4

For a single Hawaii senior on Social Security, QMB pays that $202.90 monthly Part B premium in full and, on top of it, covers the Part A and Part B deductibles and coinsurance. Every QMB enrollee is automatically deemed eligible for full Part D Extra Help.2,1

SLMB: Specified Low-Income Medicare Beneficiary

SLMB pays one benefit: the Medicare Part B premium, $202.90/month in 2026. Eliminating that premium is the whole benefit, and you must have both Part A and Part B to qualify.2,1

2026 Hawaii SLMB income limits: above the QMB cutoff, up to $1,856/month for a single person and $2,509/month for a couple (Med-QUEST's 120%-of-poverty standard plus the $20 exclusion). Resource limit: same as QMB, at $9,950 single and $14,910 couple.1 A couple within a dollar or two of that line should ask Med-QUEST which figure it applies: $2,509 is Social Security's published limit, while Med-QUEST's $2,490 standard plus the $20 exclusion comes to $2,510, and neither source explains the gap.1

SLMB does not cover deductibles or copays.1 For beneficiaries with limited medical utilization, eliminating the Part B premium is the dominant savings, and SLMB delivers it.

SLMB enrollment also triggers automatic Part D Extra Help, capping generic copays at $5.10 and brand-name copays at $12.65 on a benchmark Part D plan that carries no deductible and no premium.3

QI: Qualifying Individual

QI covers the Part B premium only, the same as SLMB, at a higher income band: above the SLMB cutoff, up to $2,086/month single and $2,821/month couple in 2026 (Med-QUEST's 135%-of-poverty standard plus the $20 exclusion). The resource limit is again $9,950 single / $14,910 couple.1 As with SLMB, you must have both Part A and Part B to qualify.1

Three structural differences set QI apart from QMB and SLMB:

1. You must apply every year. Selection for QI in one year does not entitle you to continued assistance in any following year, so a QI enrollee reapplies annually to stay in the program.1
2. First-come, first-served. QI is paid out of a capped annual federal allocation to each state and granted first-come, first-served, with preference for people who received QI in the last month of the previous year.1 An otherwise-eligible applicant can be turned away when the state has no QI slots left, so apply early.5
3. Not for anyone with other Medicaid. QI is only for people who are not otherwise eligible for Medicaid under the state plan, though they may qualify for help from another Medicare Savings Program.1 Someone who qualifies for both a Medicare Savings Program and full Medicaid is QMB Plus or SLMB Plus, never QI.5

QI enrollment also triggers automatic Part D Extra Help.1

Full Program Comparison

Because the three programs share one resource test and sit on adjacent income bands, a reader who is just over the QMB line usually still lands in SLMB or QI. You do not fall off a cliff at the $1,550 QMB limit. You step down one rung on the same ladder.1

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 categories. In practice, Hawaii's long-term care Medicaid uses a medically needy spend-down rather than a Qualified Income (Miller) Trust.4 Medicare Savings Program limits are set another way: each program is defined by income as a percentage of the federal poverty level, and Hawaii's QMB, SLMB, and QI thresholds apply those percentages (100%, 120%, and 135%) to Hawaii's higher poverty guidelines.1

Applicants who have been told they do not qualify for Medicaid under Hawaii's 209(b) methodology should still check Medicare Savings Program eligibility separately, since the two programs are evaluated under different rules.

The QMB Billing Prohibition

Federal law prohibits Medicare providers and suppliers, including pharmacies, from billing a QMB enrollee for Medicare Part A and Part B cost-sharing. This applies to both Original Medicare and Medicare Advantage providers, not only those that accept Medicaid, and it holds even if Medicaid doesn't pay the provider in full. The one bill that can still come is a small Medicaid copayment, if one applies.6

If you receive a bill for a Medicare Part A or Part B deductible, copay, or coinsurance as a QMB enrollee, do not pay it.6 Instead:

• Tell the provider you are enrolled in QMB and that federal law bars billing you for Medicare Part A and Part B cost-sharing.6
• Show both your Medicare card and your Medicaid or QMB card; with Original Medicare, your Medicare Summary Notice also shows that you're in QMB.6
• Call 1-800-MEDICARE (1-800-633-4227), Medicare's official line for beneficiaries, for help with the bill.7
• Contact Hawaii's State Health Insurance Assistance Program (SHIP) for free help disputing the charge.

CMS tells providers to recall any bills for QMB cost-sharing, including bills turned over to collections, and to refund any QMB cost-sharing money already collected.6

Part D Extra Help / Low-Income Subsidy

Every Hawaii QMB, SLMB, and QI enrollee is automatically deemed eligible for full Part D Extra Help (the Low-Income Subsidy, or LIS). No separate application is required.1

Under the 2026 Part D benefit structure, full Extra Help means:

• $0 premium on a benchmark Part D plan
• $0 annual deductible
• At most $5.10 per generic prescription
• At most $12.65 per brand-name drug
• $0 in copays after out-of-pocket drug costs reach the $2,100 annual threshold3

Those copays are ceilings. An enrollee who also has full Medicaid pays no more than $1.60 and $4.90 with income at or below 100% of the poverty level, and $0 while living in an institution or getting home and community-based services. Because you are deemed eligible, CMS sends a notice that you don't need to apply.3

Resource Counting: What's Excluded

Hawaii's Medicaid asset rule (HAR §17-1725.1-26) lists what is exempt. If you are unsure how Med-QUEST will treat a particular item, ask before you rule yourself out.

Not counted:

• Any equity in your principal place of residence
• All motor vehicles, such as cars, trucks, vans, and motorcycles (boats and aircraft are the exception)
• Household goods of limited value that you need day to day, such as clothing, furniture, and appliances, plus personal effects
• One burial space per household member, and bona fide funeral or burial plans, if specifically designated for you or an immediate household member4

Counted: assets that are not on the exempt list, unless another rule excludes them, count toward the $9,950 / $14,910 limit.1,4

Long-term care Medicaid, unlike the Medicare Savings Programs, does apply a home equity limit. Hawaii's rule (HAR §17-1725.1-59) sets it at $750,000, indexed each year to the consumer price index; for 2026, CMS puts that indexed federal minimum at $752,000.4 Federal law would let a state go as high as $1,130,000, but Hawaii's rule tracks the minimum, and the limit does not apply at all when a spouse, a child under 21, or a blind or disabled child lives in the home.8,4 For Medicare Savings Programs the home is simply an exempt asset, whatever its value.4

How to Apply for Hawaii Medicare Savings Programs

Under federal rule 42 CFR 435.912, Med-QUEST has up to 45 days to decide an application that isn't based on disability (90 days for one that is), except in unusual circumstances, such as when an applicant delays a required step.9

Where to Get Help

Learn More

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.