Med-QUEST: Hawaii's Medicaid program
Med-QUEST is Hawaii's Medicaid program. Many Hawaii Medicare beneficiaries also qualify for Med-QUEST, creating "dual-eligible" status with significantly expanded benefits and reduced out-of-pocket costs.
Quick contact: Med-QUEST eligibility line: 1-800-316-8005 · General: 1-877-628-5076 · Apply online at mybenefits.hawaii.gov
What Med-QUEST stands for
Med-QUEST is an acronym: Quality care, Universal access, Efficient utilization, Stabilizing costs, and Transforming health care. It's administered by the Hawaii Department of Human Services through the Med-QUEST Division (MQD).
Hawaii's Medicaid program is unlike any other state's. In 1994, Hawaii became the first state in the country to receive approval for a comprehensive Section 1115 Medicaid demonstration waiver — the original QUEST program. In January 2015, that program merged with the QUEST Expanded Access program for aged, blind, and disabled members to become QUEST Integration (QI), the comprehensive managed care program that covers all Med-QUEST beneficiaries today.
Who qualifies for Med-QUEST in 2026
Hawaii uses higher Federal Poverty Level figures than most states because of the higher cost of living. Med-QUEST income limits are updated each February (most states update January 1).
| Group | Income limit (Hawaii FPL) |
|---|---|
| Children (ages 0–18) | Up to 308% FPL |
| Pregnant women | Up to 191% FPL |
| Parents and ACA expansion adults | Up to 138% FPL (~$2,251/month single) |
| Aged, Blind, Disabled (ABD) | ~$1,530/month single |
| HCBS Waiver | ~$1,530/month (applicant only) |
| Nursing Home Medicaid | No cap — Share of Cost model |
Asset limits apply only to ABD applicants: $2,000 for an individual, $3,000 for a couple. Most other Med-QUEST categories have no asset test.
Med-QUEST and Medicare together — "dual eligible"
If you have Medicare and also qualify for Med-QUEST, you are a dual-eligible beneficiary. This status comes with significant advantages:
- Med-QUEST pays your Medicare Part B premium ($202.90/month in 2026)
- Med-QUEST covers Medicare deductibles, copays, and coinsurance you'd otherwise pay
- You automatically qualify for Extra Help (Low-Income Subsidy) which caps prescription costs at $0–$11.20 per fill
- You can enroll in a Dual-Eligible Special Needs Plan (D-SNP) with $0 premium and additional benefits
- You get a quarterly Special Enrollment Period to change Medicare plans
Important 2027 change: Starting January 1, 2027, dual-eligibles must enroll with the same insurer for both their Med-QUEST plan and their Medicare D-SNP. This federal alignment rule is being phased in throughout 2026 — talk to a Sage PLUS counselor or licensed agent before AEP if this affects you.
How to apply for Med-QUEST
- Online: Apply at mybenefits.hawaii.gov (24/7)
- Phone: Call 1-877-628-5076 to apply by phone
- In person: Visit a local Med-QUEST office — locations on every island
Free language services are available in Tagalog, Ilocano, Japanese, Chinese, Korean, Hawaiian, Marshallese, Chuukese, and other Pacific languages.
QUEST Integration health plans
Med-QUEST uses managed care — when you enroll, you choose one of the participating QI health plans, which then becomes your provider network. Plans available statewide include AlohaCare, HMSA, Kaiser Permanente, Ohana Health Plan, and UnitedHealthcare Community Plan, with availability varying by island.
Long-term care through Med-QUEST
Med-QUEST is the largest payer of long-term care in Hawaii. The QI program covers:
- Nursing home care — for those who meet a nursing-home level of care
- Home and Community-Based Services (HCBS) — personal care, adult day care, homemaker services, and case management to help kupuna age in place
- Community Care Foster Family Homes — small group homes
- Assisted living — for those who qualify medically and financially
COFA migrants and Med-QUEST
Hawaii is one of few states that uses Medicaid funds to help cover premium costs for residents who aren't U.S. citizens but are citizens of Compact of Free Association (COFA) nations — the Marshall Islands, Federated States of Micronesia, and Palau. This is unique to Hawaii and reflects the state's significant COFA migrant population.
Frequently asked questions
Yes — this is called dual-eligible status. Med-QUEST will pay your Medicare premiums, deductibles, and copays, and you'll automatically qualify for Extra Help with prescription costs. Most dual-eligibles also enroll in a D-SNP for $0-premium expanded benefits.
For aged, blind, or disabled (ABD) Medicaid in Hawaii in 2026, the income limit is approximately $1,530/month for a single applicant. Hawaii's limits are higher than most states because of the higher cost of living. Call Med-QUEST at 1-800-316-8005 for a screening.
Med-QUEST cannot force the sale of your home while you're alive. After death, the state may seek estate recovery for nursing-home costs paid, but Hawaii's home equity exemption is up to $1,130,000 in 2026 and there are protections for surviving spouses, minor children, and disabled adult children.
Apply online at mybenefits.hawaii.gov, by phone at 1-877-628-5076, or in person at a local Med-QUEST office. Free interpreter services are available in many languages.
Medicare is federal health insurance for people 65+ and certain people with disabilities — it has the same rules in every state. Med-QUEST is Hawaii's state Medicaid program for low-income residents. They work together for dual-eligibles, with Med-QUEST filling Medicare's coverage gaps.