Hawaii Medicaid & Elder Care
Hawaii's Med-QUEST program provides comprehensive long-term care services for seniors through a managed care system, offering robust home and community-based support despite high care costs.
Medicaid Report Card
Overall State Performance Index
Based on CMS Nursing Home Compare + state Medicaid agency data
View Methodology arrow_forwardHawaii Monthly Costs
Hawaii's long-term care costs, particularly for nursing homes at approximately $18,000 per month, are significantly higher than the national average.
Waiver Programs
Hawaii QUEST Integration Program
Also called: QI Program, Med-QUEST
The Hawaii QUEST Integration Program is a Medicaid managed care program that delivers comprehensive medical, behavioral health, and long-term services and supports to eligible residents, including seniors. It provides home and community-based services to help individuals requiring a Nursing Facility Level of Care remain in their homes or other community settings.
- check_circle Adult Day Care
- check_circle Home Delivered Meals
- check_circle Personal Emergency Response Systems
- check_circle Respite Care
- check_circle In-Home Personal Care Assistance
- check_circle Assisted Living Services
- check_circle Skilled Nursing
- check_circle Transportation
- check_circle Medical Equipment and Supplies
- check_circle Case Management
insights Program Snapshot
- Functional criterion
- Nursing Facility Level of Care (NHLOC) or at risk of requiring it
- Administered by
- Hawaii Department of Human Services (Med-QUEST Division), services delivered via Managed Care Organizations
- Self-direction
- Available for some services, allowing participants to hire relatives including spouses and adult children.
- Recertification
- Annual (Form 1147 approved for up to 12 months)
2026 Eligibility Requirements
| Criteria | Individual Limit | Married (Both Applying) |
|---|---|---|
| Monthly Income | $1,530 | $2,075 |
| Asset Limit | $2,000 | $3,000 |
| Home Equity Limit | $1,130,000 | |
| Level of Care | Nursing Home Level of Care (NHLOC) | |
Estate Recovery Warning
Hawaii's Medicaid Estate Recovery Program is aggressive, seeking reimbursement for long-term care costs after a recipient's death. The state can place a lien on the home, though recovery is delayed for surviving spouses or certain children.
Spend-Down & Asset Protection
PROTECTED ASSETS
COMMON PITFALLS
- warning Look-back Period: Gifts or asset transfers for less than fair market value made within 60 months prior to applying for Nursing Home Medicaid or HCBS Waivers can trigger a penalty period of ineligibility.
- warning Excess Assets: Failing to spend down countable assets above the limit on non-countable items or services before applying.
- warning Joint Accounts: All assets of a married couple are considered jointly owned, regardless of whose name is on the account, and are counted towards the applicant's eligibility.
First Steps for Families
Locate your ADRC
Contact your local Hawaii Aging and Disability Resource Center.
Gather 5 years of records
Bank statements, deeds, asset transfers for the Medicaid look-back period.
Financial assessment
Consult a Medicaid planner if assets exceed $2,000.
How to Apply for Hawaii Long-Term Care Medicaid
Assess Level of Care
Obtain medical certification of Nursing Home Level of Care (NHLOC) through a functional assessment, typically using Form 1147.
Gather Records
Collect extensive financial documentation, including 60 months of bank statements, proof of income, and asset information.
Review Eligibility
Utilize Hawaii's Medically Needy Pathway if income exceeds the standard limits, allowing medical expenses to reduce countable income.
Submit Application
Apply online via the My Medical Benefits webpage, by phone at (800) 316-8005, or in person at a local Med-QUEST office.
Attend Interviews
Participate in required caseworker evaluations to verify information and assess eligibility.
Receive Determination
Await the final eligibility determination and, if approved, begin receiving benefits through your chosen managed care plan.
Documents You'll Need
Financial Verification
- 5 years of bank statements
- Stock/bond certificates
- Retirement account information
- Life insurance policies
Income Verification
- Social Security award letters
- Pension stubs
- VA benefit statements
- Other income sources
Medical/Identity
- Social Security card
- Medicare card
- Doctor's clinical assessments (Form 1147)
- Proof of age/disability
Property/Residency
- Home deed
- Vehicle registration
- Proof of Hawaii residency
- Trust documents (if applicable)
Frequently Asked Questions About Hawaii Medicaid
Does Hawaii Medicaid pay for assisted living?
Yes, Hawaii's Med-QUEST Integration Program covers assisted living services for eligible seniors who require a Nursing Facility Level of Care. However, it does not cover the costs of room and board in assisted living facilities. Services like personal care, skilled nursing, and adult day care are provided through managed care plans.
What is the Hawaii Medicaid income limit for seniors in 2026?
For most seniors seeking Home and Community-Based Services or Aged, Blind, and Disabled Medicaid in Hawaii, the individual income limit in 2026 is $1,530 per month. For Nursing Home Medicaid, there is no strict income cap; instead, beneficiaries must contribute nearly all their income, beyond a $75 personal needs allowance, towards their care costs.
How long is the HCBS waiver waitlist in Hawaii?
The waitlist status for Hawaii's Home and Community-Based Services (HCBS) through the QUEST Integration Program is unclear and subject to conflicting information. Some sources indicate no overall waitlist, while others suggest that managed care organizations may have limited slots or internal waitlists. For specific information, contacting the Med-QUEST Division at (800) 316-8005 is recommended.
Will Medicaid take my parent's house in Hawaii?
While a primary home is generally exempt from asset limits during a Medicaid recipient's lifetime (up to $1,130,000 in equity in 2026), Hawaii's Medicaid Estate Recovery Program (MERP) can seek reimbursement for long-term care costs after the recipient's death. This may involve placing a lien on the home. Recovery can be delayed if a surviving spouse or certain dependent children reside there.
Can I be paid to care for my parent through Hawaii Medicaid?
Yes, Hawaii's QUEST Integration Program offers participant-directed care for some long-term services, such as personal assistance. This allows eligible seniors to hire their own caregivers, including family members like spouses and adult children, to provide care. A financial management services agency handles the payroll and tax responsibilities.
Medicaid vs Medicare for long-term care in Hawaii?
Medicare is federal health insurance primarily for acute medical care and short-term rehabilitation, and it generally does not cover long-term custodial care in Hawaii. Medicaid (Med-QUEST) is a joint federal and state program for low-income individuals that *does* cover long-term care services, including nursing home care and home and community-based services, for those who meet financial and functional eligibility criteria.
TOPICAL GUIDES — HOW MEDICAID WORKS
EXPLORE HAWAII
Last updated: April 24, 2026. Sources: Hawaii Med-QUEST Division, CMS Nursing Home Compare, Genworth 2024 Cost of Care Survey. Eligibility rules are set by each state Medicaid agency and update annually. We cite the agency name, statute, or CMS data source for every figure on this page; see our methodology and editor.