Med-QUEST Eligibility for Seniors Over 65 in Hawaii

Two Separate Programs Under One Roof

Med-QUEST administers both full Medicaid coverage (QUEST Integration) and the Medicare Savings Programs (QMB, SLMB, QI) for Hawaii seniors. These are different programs with different income limits, different benefits, and different application rules — but they run through the same agency and the same forms. The confusion between them is the most common obstacle families face.

Full Medicaid (QUEST Integration for seniors) covers medical, behavioral health, dental, vision, and long-term care services through a managed care plan. For seniors aged 65 and older, eligibility follows the Aged, Blind, and Disabled (ABD) rules — not the MAGI rules used for working-age adults under ACA expansion. ABD Medicaid has both an income test and an asset test.

Medicare Savings Programs cover only Medicare premiums and, for QMB, Medicare deductibles and coinsurance. The income limits are higher than full Medicaid, and thousands of Hawaii seniors qualify for MSP who do not qualify for full QUEST Integration coverage.

2026 Income Limits for Hawaii Seniors

Med-QUEST updates its income standards each February, using Hawaii's federal poverty guidelines (about 15% higher than the mainland). The $20 general income disregard is applied when Med-QUEST calculates countable income.

For MSP programs, 2026 individual countable-income limits are:

• QMB: $1,530/month
• SLMB: $1,836/month
• QI: $2,066/month

Resource limit for all three: $9,950 individual, $14,910 couple. Home, one vehicle, household goods, and burial arrangements are exempt.

Full QUEST Integration Medicaid for ABD seniors uses a lower income standard — the SSI-related threshold, which is significantly below MSP levels. Seniors whose income exceeds the full Medicaid limit can still qualify for MSP, and many do. A senior with $1,600/month in Social Security income would not qualify for full Medicaid but would qualify for SLMB, saving $202.90/month in Part B premiums.

The Asset Test Confusion

ACA expansion Medicaid for adults under 65 has no asset test — eligibility is income-only. But the ABD category for seniors 65 and older retains the asset test. Families who helped a younger relative enroll in Medicaid and encountered no asset questions are often surprised when the same forms ask for bank statements and investment records for a senior parent.

For MSP programs specifically, the $9,950/$14,910 resource limit is relatively generous. It excludes the primary home entirely (regardless of equity), one vehicle, household goods and personal items, burial spaces, irrevocable prepaid funeral contracts, term life insurance, and qualifying burial funds up to $1,500 per spouse. Countable assets include bank balances, CDs, stocks, bonds, retirement accounts that are not paying regular mandatory distributions, and real property other than the primary home.

Joint bank accounts with an adult child are presumed to belong entirely to the senior unless the child provides documentation showing their own deposits. This trips up families who added a parent to a joint account for convenience — the full balance counts toward the senior's resource limit unless rebutted with bank records.

How to Apply

The application uses DHS 1100 (the general health coverage application) plus DHS 1100B (the supplemental form for non-MAGI applicants). Both are required — Med-QUEST cannot process an MSP determination without the DHS 1100B, which collects Medicare claim numbers, income sources, and asset details.

Applications can be submitted online at medical.mybenefits.hawaii.gov, by phone at 1-800-316-8005, by fax or mail to the island eligibility office, or in person. Med-QUEST must issue a decision within 45 days of receiving a signed application.

Our Hawaii Medicare Savings Programs & Extra Help Guide walks through eligibility for each tier using Hawaii's actual dollar figures, explains how Med-QUEST calculates countable income (including the earned-income deductions that can lower a working senior's countable amount), and includes a printable worksheet to determine which program your parent qualifies for before filing.

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