Med-QUEST Income Limits in Hawaii (2026)

Med-QUEST covers roughly 380,000 Hawaiians, about 27% of the state's population, making it the backbone of healthcare access for low- and moderate-income residents across all six islands. Hawaii was a healthcare coverage pioneer long before the Affordable Care Act: the state's QUEST Integration Section 1115 demonstration waiver, approved by the federal government in 1994, was the first in the nation to deliver comprehensive Medicaid benefits through capitated managed care plans. When the ACA expansion took effect on January 1, 2014, Med-QUEST simply extended that managed-care infrastructure to newly eligible adults. The 2026 Hawaii Federal Poverty Level, $18,360 for a single person (about 15% higher than the 48 contiguous states to reflect Hawaii's elevated cost of living), sets every income threshold on this page.

Med-QUEST eligibility divides into four main groups. First, expansion adults and parents (138% Hawaii FPL, covering residents aged 19 to 64 whether or not they have dependent children). Second, pregnant women (196% Hawaii FPL with 12 months of mandatory postpartum coverage following delivery, a permanent federal requirement since 2022). Third, children under age 19 through QUEST Integration at a generous 313% Hawaii FPL, one of the highest children's Medicaid thresholds in the country. Fourth, aged, blind, and disabled adults under SSI-related rules, which carry an asset test and use the SSI countable-income standard rather than MAGI. Hawaii does not operate a separate CHIP program: children who qualify at up to 313% FPL are enrolled directly into QUEST Integration Medicaid, and there is no gap between Medicaid and a state CHIP tier.

The household-size table below shows the 2026 Med-QUEST income limits across all three primary MAGI populations using Hawaii's higher FPL base. If your household income is above the relevant Med-QUEST threshold but below 400% Hawaii FPL, you likely qualify for ACA marketplace subsidies. Note that Hawaii's marketplace subsidies expired as enhanced premium tax credits lapsed on January 1, 2026, following the expiration of Inflation Reduction Act provisions, so the cliff between Medicaid and marketplace coverage has returned. Residents 65 and older with limited income should review the Medicare Savings Programs section below: Med-QUEST runs QMB, SLMB, and QI programs for Medicare beneficiaries with income and assets below state thresholds.

Med-QUEST (Hawaii Medicaid) income limits by household size (2026)

The 2026 Med-QUEST (Hawaii Medicaid) income guidelines below are based on the 2026 Hawaii Federal Poverty Level ($18,360 for 1 person, higher than the 48 contiguous states). Adult column = QUEST Integration expansion group (138% Hawaii FPL, adults 19-64 with or without dependent children). Children column = QUEST Integration for children under 19 (313% Hawaii FPL, one of the highest children's Medicaid thresholds nationally). Pregnancy column = Med-QUEST for Pregnant Women (196% Hawaii FPL, with 12 months postpartum coverage). Add $6,530 of annual income per additional household member beyond 8.

Med-QUEST (Hawaii Medicaid) eligibility requirements (non-income)

Beyond income, Med-QUEST applicants must meet the following non-income requirements. The items below apply across the MAGI categories that handle the vast majority of applications: expansion adults, parents, children, and pregnant women. Aged, blind, and disabled (ABD) applicants and those seeking long-term care or home and community-based services (HCBS) have additional financial eligibility rules including an asset test.

• Hawaii residency: the applicant must currently live in Hawaii with the intent to remain. There is no minimum duration-of-residence requirement, but Med-QUEST requires a Hawaii address and may request documentation such as a lease, utility bill, or postmarked mail.
• U.S. citizenship or qualifying immigration status: U.S. citizens, lawful permanent residents (after the federal 5-year bar in most cases), refugees, asylees, and certain other immigration categories qualify. Pregnant women and children under age 19 are generally exempt from the 5-year bar under federal CHIPRA rules. Undocumented adults do not qualify for full Med-QUEST MAGI coverage but may receive coverage for emergency medical conditions.
• Social Security Number: a Social Security Number (or proof of application for one) is required for every household member applying for Med-QUEST coverage. Exceptions exist for individuals applying only for emergency medical services.
• Household composition and MAGI rules: Med-QUEST uses Modified Adjusted Gross Income (MAGI) household rules, counting the applicant, their spouse, and all tax dependents as part of the household. Parents applying for the parent/caretaker category must have a dependent child under age 19 living in the home. Expansion adults 19 to 64 do not need a dependent child.
• Asset test for MAGI populations: there is NO asset test for expansion adults, parents, children, and pregnant women under MAGI rules. Asset tests (generally $2,000 for an individual, $3,000 for a couple) apply only to aged, blind, and disabled adults using SSI-related income rules and to applicants in long-term care or HCBS waiver programs.
• Other insurance coverage: Med-QUEST applicants are not required to be uninsured. Med-QUEST coordinates as the payer of last resort when other coverage exists. Low-income Medicare beneficiaries can qualify for Med-QUEST Medicare Savings Programs even if they have Medicare Parts A and B.

What income counts for Med-QUEST (Hawaii Medicaid)

Med-QUEST uses Modified Adjusted Gross Income (MAGI) rules for expansion adults, parents, children, and pregnant women. MAGI income is the household's projected annual income for the current year, based on the federal tax-return definition, before most deductions but after a few specific adjustments allowed by federal Medicaid rules. The 5% federal MAGI disregard may apply on top, effectively raising the published threshold slightly for some applicants. Aged, blind, and disabled (ABD) applicants and those in long-term care or HCBS programs use SSI countable-income rules instead of MAGI.

Income sources included

• Wages, salaries, tips, and overtime pay (gross, before payroll deductions and income taxes)
• Net self-employment earnings and 1099/gig-work income (gross revenue minus allowable business expenses; use Schedule C or equivalent)
• Social Security retirement and survivor benefits (SSDI disability benefits are also counted); note that SSI payments are excluded
• Unemployment compensation (counted as income in the month received)
• Pensions, annuities, and retirement-account distributions (including IRA, 401k, and 403b withdrawals)
• Alimony received under divorce decrees finalized before January 1, 2019 (post-2018 alimony agreements are excluded under the TCJA tax treatment)
• Rental income, interest, dividends, and capital gains (included under the MAGI definition from the federal tax return)

Income sources excluded

• Supplemental Security Income (SSI) payments: SSI is excluded from MAGI income entirely. Do not confuse SSI with SSDI (disability); SSDI is counted, SSI is not.
• Child support received by the applicant household (excluded under federal MAGI rules)
• Veterans Affairs (VA) disability compensation and most VA pension payments
• Workers' compensation payments and most other injury-settlement payments
• Federal tax refunds and refundable tax credits (Earned Income Tax Credit, Child Tax Credit refund portion)
• SNAP (food assistance) benefits, TANF cash assistance, and most other need-based public benefits
• Loans, gifts, and one-time inheritances (these are not income under MAGI rules, though they may count as resources for SSI-related and long-term care categories)

How to apply for Med-QUEST (Hawaii Medicaid) in Hawaii

Med-QUEST applications go through KOLEA, Hawaii's secure online Medicaid eligibility portal, operated by the Hawaii Department of Human Services Med-QUEST Division. KOLEA accepts applications 24 hours a day, 7 days a week and provides a real-time eligibility screening tool. You can also apply by phone, by mail, or in person at any Med-QUEST Division Eligibility Office on Oahu, Maui, Hawaii Island, or Kauai.

1. 1. Gather your documents before starting: photo ID for the head of household, Social Security Numbers or cards for all household members applying for coverage, proof of Hawaii residency, proof of citizenship or immigration status, and recent income verification (pay stubs, self-employment records, or SSA benefit letter).
2. 2. Go to medical.mybenefits.hawaii.gov to access the KOLEA portal. Create a secure account, then select 'Apply for Health Coverage' to start the Med-QUEST application. Alternatively, call 1-800-316-8005 (Monday through Friday, 7:45 a.m. to 4:30 p.m. Hawaii time) to apply by phone.
3. 3. Complete the application by listing every household member, reporting all income sources for the past 30 days (or the most recent 12 months for self-employment), and uploading supporting documents. KOLEA's real-time screener will indicate which programs you appear eligible for as you enter information.
4. 4. Submit the application and save your confirmation number. If you cannot upload documents online, mail or fax them to your nearest Med-QUEST Division Eligibility Office; the application form lists office addresses by island.
5. 5. Respond promptly to any Med-QUEST Division requests for additional information or verification. The division will contact you by mail or phone if a document is missing or illegible. Failing to respond within the notice deadline is the most common reason Med-QUEST applications are denied.
6. 6. Wait for the eligibility determination notice. Standard Med-QUEST applications are decided within 45 days. Pregnancy applications receive priority processing and are typically decided within 15 days under federal expedited rules. Applicants may qualify for Presumptive Eligibility, which can start coverage immediately while the full application is processed.

Official portal: medical.mybenefits.hawaii.gov (KOLEA)

Documents needed

• Photo ID for the head of household (Hawaii driver's license, state ID, U.S. passport, tribal ID, or military ID)
• Social Security Numbers or cards for every household member applying for Med-QUEST coverage
• Proof of Hawaii residency (utility bill, lease or rental agreement, bank statement, postmarked mail, or letter from a shelter or housing program)
• Proof of U.S. citizenship or qualifying immigration status (U.S. birth certificate, passport, naturalization certificate, permanent-resident card, asylee letter, or visa documentation)
• Last 30 days of pay stubs for each employed household member (or 12 months of bank statements and records for self-employment and 1099 income)
• Social Security Administration benefit letter (if receiving SSDI, SSI, or Social Security retirement or survivor benefits)
• Proof of pregnancy from a healthcare provider (clinic note, hospital letter, or lab report) if applying for Med-QUEST for Pregnant Women
• For aged, blind, or disabled applicants and those seeking long-term care or HCBS services: bank statements, investment and retirement account statements, vehicle titles, life insurance policy documents, and proof of any disability determination (SSA award letter or state determination)

Processing timeline: Standard Med-QUEST applications are decided within 45 days of receipt. Pregnancy applications are processed within 15 days under federal expedited-processing rules, and Presumptive Eligibility may start coverage immediately. Applications for aged, blind, and disabled adults requiring a disability determination may take 60 to 90 days. Once approved, Med-QUEST will mail an enrollment packet with plan options available in your island service area.

Common reasons applications get denied

• Income above the threshold for the applicant's population group (the single most common reason; adults are denied if MAGI income exceeds 138% Hawaii FPL, which is $25,337 per year for a single person in 2026).
• Failure to provide requested documentation within the notice deadline (missing pay stubs, missing residency proof, missing immigration documents, or missing pregnancy verification).
• Federal 5-year bar for newly arrived lawful permanent residents applying as adults; pregnant women and children under age 19 are generally exempt from the 5-year bar under federal CHIPRA rules.
• Residency verification failure (no utility bill, lease, or other Hawaii address documentation in the applicant's name at the time of application).
• Asset test failure for aged, blind, or disabled applicants (countable resources exceed $2,000 for an individual or $3,000 for a couple after exempt assets like the primary home and one vehicle are excluded).

Children's coverage in Hawaii: QUEST Integration covers kids to 313% Hawaii FPL

Hawaii does not operate a separate CHIP program. Instead, children under age 19 qualify directly for QUEST Integration Medicaid at the generous threshold of 313% of the Hawaii Federal Poverty Level. For 2026, that is $57,467 per year for a one-person household or $118,784 per year for a family of four ($9,899 per month). This threshold is among the highest children's Medicaid coverage limits in the nation. Children in families with income over 313% Hawaii FPL can purchase coverage through the Hawaii Benefit Exchange or employer-sponsored insurance. Apply through the KOLEA portal at medical.mybenefits.hawaii.gov, which automatically evaluates children's eligibility at the higher 313% threshold.

Compare Medicaid and CHIP income limits across all 50 states

If you are 65 or older with limited income: Med-QUEST Medicare Savings Programs

Med-QUEST runs three Medicare Savings Programs (MSPs) for low-income Medicare beneficiaries in Hawaii. The Qualified Medicare Beneficiary (QMB) program covers individuals with income up to 100% Hawaii FPL ($1,530 per month for one person in 2026) and pays Medicare Parts A and B premiums, deductibles, and coinsurance. The Specified Low-Income Medicare Beneficiary (SLMB) program covers individuals up to 120% Hawaii FPL ($1,836 per month) and pays Part B premiums only. The Qualifying Individual (QI) program covers individuals up to 135% Hawaii FPL ($2,066 per month) and also pays Part B premiums from a federally capped block grant. All three MSPs have an asset test (approximately $9,660 for an individual or $14,470 for a couple in 2026). MSP enrollment automatically qualifies you for the federal Extra Help program, which covers Medicare Part D drug costs. Hawaii dual-eligible beneficiaries (those enrolled in both Medicare and Med-QUEST) may also qualify for Special Needs Plans (D-SNPs) offered by QUEST Integration managed care plans, which coordinate benefits between both programs.

Read the Medicare eligibility guide

Frequently Asked Questions