Hawaii Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Hawaii.
7.6 million Medicaid long-term care recipients nationwide
Hawaii Med-QUEST Division
Processing Time
30-60 days; may have waiting lists for HCBS enrollment due to caps
Hawaii Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Hawaii, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Hawaii follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$1,500/month (HCBS waivers)
Married Couple (One Applying)
$3,000/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$162,660 (community spouse)
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Hawaii Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $12,167/month average (semi-private), $12,197/month (private) (the average monthly nursing home cost in Hawaii).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Hawaii
Nursing Home Care
Medicaid pays 100% of nursing home costs in Hawaii once eligibility is established. The average monthly cost is $12,167/month average (semi-private), $12,197/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Med-QUEST Assisted Living Services: Med-QUEST pays for non-medical services and supports for frail seniors residing in assisted living residences, including memory care units for persons with Alzheimer's disease or related dementia. Covers personal care and supportive services but does not cover room and board costs.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Hawaii offers 2 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
QUEST Integration (QI) Program
Hawaii's Medicaid managed care program providing medical care, behavioral health services, and long-term services and supports (LTSS) including nursing facility care. Serves frail seniors with comprehensive coordination of care. May have enrollment caps and waiting lists.
Program Details →Home and Community-Based Services through Med-QUEST
Provides non-medical services and supports in nursing homes, community care foster family homes, and assisted living residences. Participants can reside at home, with loved ones, in assisted living (including memory care units), or in Community Care Foster Family Homes (CCFFH). Requires nursing facility level of care.
Program Details →How to Apply for Medicaid in Hawaii
Hawaii Medicaid applications typically take 30-60 days; may have waiting lists for HCBS enrollment due to caps. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Hawaii through:
- Online through KOLEA at medquest.hawaii.gov
- Call 1-877-628-5076 for phone application
- In-person at Med-QUEST eligibility branch offices on each island
- Mail application to Med-QUEST Division
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Hawaii from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Hawaii-Specific Programs and Resources
Medicare Savings Programs (QMB)
Qualified Medicare Beneficiary program covers Medicare Part A and Part B premiums and some out-of-pocket costs including deductibles, copays, and coinsurance. Income limit: $1,520/month individual, $2,047/month couple. Resource limit: $9,990.
Learn MoreKOLEA Online Application System
Hawaii's online portal for Medicaid applications providing streamlined access to benefits enrollment and case management.
Learn MoreNeed Help with Hawaii Medicaid?
Contact Hawaii Med-QUEST Division for specific questions about eligibility, application status, or covered services.