Medicaid for nursing home and home care in Hawaii

Who qualifies

You must be 65 or older, blind, or disabled, and meet Med-QUEST's income and asset rules. You must also be found to need long-term care. Med-QUEST does not publish separate, higher income limits for long-term care. It uses the aged, blind and disabled rules below.

Limits for 2026

Hawaii uses its own poverty guideline, which is higher than on the mainland.

If your income is higher: Medically Needy spenddown

If your income is over the limit but your assets are within it, you may still qualify through the Medically Needy Spenddown.

It works like this:

1. Med-QUEST lets you keep a set amount to live on, the medically needy income level: $469 a month for one person, or $632 for two.
2. Income above that amount is your spenddown.
3. When your medical and care costs are more than your spenddown, Medicaid helps with the rest.

What long-term care covers

QUEST Integration long-term care can include, but is not limited to:

• Adult day care
• Personal care and chore help
• Skilled nursing
• Care in a Community Care Foster Family Home (CCFFH)
• Care in an Expanded Adult Residential Care Home (E-ARCH)
• Nursing home care

What you keep and what you pay

If you live in a care facility, most of your income goes toward the cost of your care. You keep a personal needs allowance of $75 a month. This amount was set by a state plan change approved in 2024.

Bills from before you applied

If you ask for long-term care, Medicaid may help pay medical bills from up to three months before the date you applied. Tell Med-QUEST about any unpaid bills from those months.

How to apply

1. Apply for Med-QUEST. Apply online at mybenefits.hawaii.gov, call the Med-QUEST Call Center at 1-800-316-8005 (TTY 711), or download and send the Medicaid application form.
2. Show your care needs. Work with your doctor to have your level of care evaluated.
3. Tell Med-QUEST about past bills. List any unpaid medical bills from the three months before you applied.

After you are approved: your home and your estate

• Home lien: If you live in a nursing home and are not expected to return home, the state may place a lien on your home.
• Estate recovery: After you die, the state may seek to recover what Medicaid paid from your estate if you were 55 or older or lived in a nursing home. It waits while your spouse is alive, and does not recover while a child under 21, or a blind or disabled child, survives. Your family can ask for a hardship waiver.

Things people miss

• Not applying because income is "too high." The spenddown is designed for people whose care costs are more than their extra income.
• Forgetting unpaid bills. Up to three months of past bills may be covered.
• Assets over the limit. The spenddown does not help if your assets are over $2,000 (one person). Ask for free help before you give anything away.

Free help

• Aging and Disability Resource Centers (ADRC): Statewide line 808-643-2372 (TTY 808-643-0889), or www.hawaiiadrc.org. County offices: Honolulu 808-768-7700; Hawaii County 808-961-8626; Maui 808-270-7774; Kauai 808-241-4470.
• Kupuna Care: A state program for people 60 and older who need help with daily tasks. Ask your ADRC.
• Hawaii SHIP: Free Medicare help at 1-888-875-9229.

See also paying for a nursing home, Medicare and all benefits in Hawaii.

Phone numbers: Free help lines for Hawaii agencies

Check what you may qualify for