Hawaii’s Medicaid expansion eligibility and income limits are straightforward: adults ages 19 through 64 who live in Hawaii qualify for Med-QUEST if their household income is at or below 138% of the Federal Poverty Level, which works out to roughly $2,112 a month for a single person in 2026. There is no asset test, no premium, and no copayment. The state expanded coverage in January 2014 under the Affordable Care Act, closing the gap for adults who used to be shut out of Medicaid because they weren’t pregnant, disabled, or raising dependent children.
Who the Expansion Group Covers
The expansion category is for adults between 19 and 64 who are not pregnant and do not have Medicare. You need to be a Hawaii resident, meet the income limit, and satisfy citizenship or immigration rules. That’s it. Before 2014, most childless adults in this age range couldn’t get Med-QUEST no matter how little they earned. The expansion replaced the old categorical approach with a single income test.
Pregnant women, children, and people seeking long-term services qualify under different rules with different (usually higher) income limits, so if you fall into one of those groups the numbers below don’t apply to you.
2026 Monthly Income Limits
The cutoff is 138% of the Federal Poverty Level — the ACA’s statutory 133% threshold plus a mandatory 5-point income disregard that every state applies. Hawaii uses its own, higher poverty guidelines rather than the ones used in the 48 contiguous states, so the dollar figures here are Hawaii-specific.
Monthly income limits for the Low Income Adult category in 2026:
- 1 person: $2,112
- 2 people: $2,863
- 3 people: $3,614
- 4 people: $4,365
Each additional household member adds about $751 per month.1Hawaii Department of Human Services. 2026 MAGI Income Standards Chart These limits are drawn from Hawaii’s 2026 poverty guidelines, which put 100% FPL at $18,360 a year for a single person and $37,950 for a family of four.2Federal Register. Annual Update of the HHS Poverty Guidelines
What Counts as Income
Hawaii uses Modified Adjusted Gross Income, or MAGI, to test eligibility. MAGI starts from the adjusted gross income on your federal tax return and adds back a few items like tax-exempt interest and non-taxable Social Security benefits. For most applicants it comes down to wages, self-employment earnings, unemployment compensation, and taxable investment income. The state looks at the whole tax household, so a spouse’s income counts if you file jointly.3Centers for Medicare and Medicaid Services. Eligibility Policy
Some income is left out. A lump-sum payment only counts in the month you receive it. Scholarship and fellowship money used for tuition and educational expenses is excluded. So are Alaska Native Corporation distributions, certain trust distributions for American Indian and Alaska Native individuals, and student assistance under Bureau of Indian Affairs programs.4eCFR. Application of Modified Adjusted Gross Income (MAGI)
The biggest practical change from the pre-ACA system is that MAGI has no asset test. Your bank balance, retirement savings, car, and home don’t affect eligibility.3Centers for Medicare and Medicaid Services. Eligibility Policy If your monthly income is within the limit, savings cannot disqualify you.
Citizenship and Immigration Rules
U.S. citizens and nationals who live in Hawaii qualify for full Med-QUEST if they meet the income test. Lawful permanent residents also qualify, but those who entered the country on or after August 22, 1996 face a five-year waiting period for full benefits. During the wait, they can get coverage only for emergency medical conditions.
Citizens of the Compact of Free Association nations — the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau — are now eligible for full Med-QUEST. Congress restored their Medicaid eligibility effective December 27, 2020, treating COFA migrants as qualified non-citizens and exempting them from the five-year wait.5Hawaii Department of Human Services. Congress Has Restored Medicaid Eligibility for Citizens From One of the Compact of Free Association Nations Before that change, most COFA residents could only get emergency Medicaid or had to rely on state-funded coverage.6Centers for Medicare and Medicaid Services. Medicaid Eligibility for COFA Migrants SHO Letter
People who don’t meet citizenship or immigration requirements can still get Medicaid coverage for emergency medical conditions, including emergency labor and delivery. That coverage lasts only as long as the emergency and doesn’t include ongoing or preventive care.
How to Apply
The quickest route is the state’s MyBenefits portal at medical.mybenefits.hawaii.gov. You can also call Med-QUEST Customer Service at 1-800-316-8005, or print and mail the DHS 1100 paper application to the Med-QUEST Division Eligibility Office nearest you.7Hawaii Department of Human Services. Apply for Medicaid
Have your Social Security number, proof of Hawaii residency, and documentation of household income (recent pay stubs or a tax return) ready. The state verifies citizenship and immigration status electronically through federal databases in most cases. Incomplete applications slow everything down, so fill the form out in one sitting if you can.
Federal regulations give the state 45 days to decide a MAGI-based application.8eCFR. 42 CFR 435.912 – Timely Determination and Redetermination of Eligibility You’ll get an approval or denial by mail. If you’re denied, you have 90 days from the date on the notice to request a fair hearing.9Hawaii MyBenefits. Appeals
Apply Sooner Rather Than Later
Hawaii is unusual on retroactive coverage. Standard federal Medicaid rules let coverage reach back three months before the month you apply if you were eligible then, but Hawaii operates under a federal waiver that limits retroactive coverage to just 10 days before your application date for most applicants. The only exception is people applying for long-term services and supports, who keep the full three-month lookback.10Hawaii Department of Human Services. Section 1115 Demonstration Project Application Every week you delay applying is a week of coverage you can’t get back.
Higher Income Limits for Children and Pregnant Women
If you have kids or you’re pregnant, the 138% figure isn’t your limit. Children under 19 qualify at family incomes up to 313% of FPL, and pregnant women qualify up to 196% of FPL.1Hawaii Department of Human Services. 2026 MAGI Income Standards Chart Pregnant enrollees also keep coverage for a full 12 months after giving birth, regardless of income changes during that period, under Hawaii’s adoption of the American Rescue Plan Act postpartum extension. That extension is authorized through March 2027.11Hawaii Department of Human Services. State Plan Amendment 22-0009 A household might have one adult over the 138% limit and children or a pregnant spouse who still qualify, so it’s worth applying for the family even if the main earner doesn’t make the cutoff.