Hawaii Medicare Savings Programs 2026: QMB, SLMB & QI

In 2026, a single Hawaii resident with monthly income at or below $1,530 can get the full Medicare Part B premium of $202.90 paid by the state's Qualified Medicare Beneficiary (QMB) program. QMB also erases every Medicare deductible, copay, and coinsurance charge. 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 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 eligibility groups every state must offer. Enrolling in any one of them automatically qualifies you for Part D Extra Help.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 the federal-poverty-level income standards required by law, calculated against Hawaii's own poverty guidelines, which run higher than the contiguous 48 states. The 209(b) election affects other parts of Hawaii's Medicaid program, such as its medically needy spend-down for long-term care, but does not tighten Medicare Savings Program eligibility relative to other states.3

The income figures below are Hawaii's gross poverty-level standards, published by Med-QUEST. When Med-QUEST runs the actual test, it first applies the SSI-related $20/month general income disregard to unearned income (and an additional earned-income disregard for people who work), so a household can have somewhat more income than the chart figure and still qualify. Treat the numbers as the starting standard, not a hard cutoff.1

QMB: Qualified Medicare Beneficiary

QMB is the most comprehensive Medicare Savings Program 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, $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
• All Medicare coinsurance and copays across every Medicare-covered service2

2026 Hawaii QMB income limits: at or below $1,530/month for a single person, $2,075/month for a couple, per Hawaii Med-QUEST's 2026 income standards chart (effective 01/13/2026). These reflect 100% of Hawaii's higher Federal Poverty Level. Resource limit: $9,950 for one person, $14,910 for a couple; the primary home and one vehicle are fully excluded.1

For a single Hawaii senior on Social Security, QMB pays that $202.90 monthly Part B premium in full and, on top of it, erases every Medicare deductible and coinsurance charge. Every QMB enrollee is automatically deemed eligible for full Part D Extra Help.2

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.2

2026 Hawaii SLMB income limits: above the QMB cutoff, up to $1,836/month for a single person and $2,490/month for a couple (100-120% of Hawaii's FPL). Resource limit: same as QMB, at $9,950 single and $14,910 couple.1

SLMB does not cover deductibles or copays. 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, cutting generic copays to $5.10 and brand-name copays to $12.65 on a benchmark Part D plan that carries no deductible and no premium.4

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 $2,066/month single and $2,801/month couple in 2026 (120-135% of Hawaii's FPL). The resource limit is again $9,950 single / $14,910 couple.1

Two structural differences set QI apart from QMB and SLMB:

1. 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, so apply early.
2. 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 Medicare Savings Program protections.1

QI enrollment also triggers automatic Part D Extra Help.

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 $1,530 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, 209(b) affects Hawaii's long-term care Medicaid program, which uses a medically needy spend-down rather than a Qualified Income (Miller) Trust, but does not change Medicare Savings Program income or resource standards. Federal law sets those limits at specific poverty-level percentages regardless of a state's 209(b) status, so Hawaii's QMB, SLMB, and QI thresholds simply apply those percentages to Hawaii's higher poverty guidelines.3

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 (42 USC 1396a(n)(3)(B)) prohibits any Medicare provider from billing a QMB enrollee for Medicare cost-sharing, under any circumstances. This applies to both Original Medicare and Medicare Advantage providers, whether or not they contract with Med-QUEST.1

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

• Tell the provider you are enrolled in QMB and cite the federal law.
• Show your Med-QUEST eligibility notice or your Medicare card with the QMB indicator.
• Call 1-800-MEDICARE (1-800-633-4227) to file a complaint.
• Contact Hawaii's State Health Insurance Assistance Program (SHIP) for free help disputing the charge.

Providers who have billed QMB enrollees must recall the 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 (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
• $5.10 per generic prescription
• $12.65 per brand-name or preferred multi-source drug
• $0 in copays after out-of-pocket drug costs reach the $2,100 annual cap4

The deeming flows from Med-QUEST to CMS each month. 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 modest burial fund

Counted:

• Checking and savings account balances
• Stocks, bonds, mutual funds, and CDs
• A second vehicle or vacation property
• Non-exempt cash-value life insurance above the SSI exclusion

Hawaii's home equity exclusion for long-term care Medicaid is $1,130,000, the highest in the nation, but the Medicare Savings Program resource test excludes the primary home entirely, regardless of value.3

How to Apply for Hawaii Medicare Savings Programs

Med-QUEST must process a non-disability Medicare Savings Program application within 45 days under 42 CFR 435.912. There is no cost to apply, and you can start before you have gathered every document.

Where to Get Help

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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.