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Learn About Requirements for Medicaid in Hawaii

UPDATE: For the year 2020, no significant changes are expected to be made to Medicaid insurance.

What are the requirements for Medicaid in Hawaii? Hawaii Medicaid eligibility requirements establish guidelines for approving eligible applicants. Those wondering how to qualify for Medicaid in Hawaii will find that eligibility qualifications greatly depend on personal and financial variables, alike.

The Medicaid application guidelines for one coverage group are not the same for another. For example, a candidate who is eligible for Medicaid that is a pregnant woman may not continue to be eligible for the same program after delivery.

Hawaii Medicaid benefits eligibility groups must meet particular prerequisites including income thresholds.

Who meets the requirements for Medicaid in Hawaii?

Hawaii Medicaid eligibility requirements help the Med-Quest division of the Department of Human Services determine who is eligible for Medicaid benefits. What are the Medicaid application guidelines for state health care candidates, exactly?

The state selects those eligible for Medicaid programs by looking at the personal characteristics of applicants as well as financial indicators. These factors make up the all-encompassing requirements for Medicaid and whom the state accepts to cover in terms of health care services.

Determining how to qualify for Medicaid in Hawaii begins by finding out to which coverage group the applicant belongs. Hawaii Medicaid benefits eligibility groups include children, the elderly, pregnant females, caretakers and residents affected by blindness or disability.

What are the requirements for Medicaid in Hawaii? Interested applicants must look at both the personal Medicaid requirements and the Medicaid income requirements for the coverage group in which they correlate.

Medicaid eligibility requirements in HI require candidates to be United States citizens, nationals or qualifying noncitizens. Lawfully present immigrants are eligible for emergency or non-emergency health care coverage depending on their status. Permanent residents with green cards for five years or longer, refugees and asylees are eligible for non-emergency health care coverage.

On the other hand, Hawaii waives the five-year period for qualified non-citizens who are pregnant women and children. Only residents of Hawaii qualify for Medicaid benefits and receive 100 percent coverage. Moreover, there is not a required residency period, and eligible applicants can sign up the day they move to the state.

Medicaid eligibility for seniors applies to residents 65 years of age and older. Medicaid benefits eligibility for children includes an age cap at 19 years of age, while adults fall between both seniors and children. In addition, Medicaid qualifications for caretakers, guardians and parents require having a minor living in the household.

In any case, all Medicaid applicants must meet certain income and asset levels to become eligible. Download our helpful guide to learn about the different requirements for Medicaid.

What Are the Income Requirements for Medicaid in Hawaii?

Medicaid eligibility requirements in Hawaii include household earnings and asset assessment for most health care coverage programs. What are the income requirements for Medicaid made up of, exactly? Applicants must consider the coverage group in which they are part of in addition to the number of household members residing in the home.

These factors contribute to the Medicaid application guidelines and help officials provide health care coverage to households with a true financial need. Income thresholds are higher in Hawaii (and Alaska) than in the other U.S. states.

Although each Hawaii Medicaid benefits eligibility group each has a different income requirement, all earnings reference the Federal Poverty Level (FPL). The Med-Quest division determines who is eligible for Medicaid by comparing applicants’ household earnings and size, as well as assets.

Candidates who want to know how to qualify for Medicaid should reference the current Federal Poverty Levels and the group’s earning percentage to compare it with their household earnings. Medicaid income requirements are broken down as follows:

  • Infants (younger than 1 year of age) must not have a family income that is more than 196 percent of the FPL.
  • Pregnant women must not have income that is more than 185 percent of the FPL.
  • Children between 1 and 5 years of age must not have a family income that is more than 144 percent of the FPL, while children older than 6 are only eligible with a family income up to 138 percent of the FPL.
  • Adults must not have a household income that is more than 100 percent of the current FPL.

When calculating income for Medicaid requirements, applicants must include the household earnings and not just their individual wages. Correlation between household income and size determines the Medicaid candidate’s FPL percentage threshold. Expectant mothers must claim unborn children in their household size calculations.

Household sizes reflect any dependents listed on tax filings as well as the current spouse of the applicant. Parents must include children younger than 21 years of age living in the same household, regardless if claimed as a dependent on federal taxes. Some domestic partners will need to claim one another to be eligible for Medicaid if they share a child together and claim the partner as a tax dependent.

What are the requirements for Medicaid when it comes to assets such as bank funds? Medicaid applicants cannot have more assets than allowed for the household size. The state limits households of one to $2,000 worth of assets, $3,000 for a household of two and $250 for each additional person.

Asset thresholds do not apply to children younger than 19 years of age or pregnant women for the duration of their pregnancies, plus 60 days. Here are examples that illustrate Medicaid income requirements in Hawaii as they reflect household size:

  • Households of one cannot earn more than $13,670.
  • Households of two cannot earn more than $18,430.
  • Households of three cannot earn more than $23,190.
  • Households of four cannot earn more than $27,950.
  • Households of five cannot earn more than $32,710.
  • Households of six cannot earn more than $37, 470.
  • Households of seven cannot earn more than $42,230.

Learn more about Medicaid requirements by downloading our comprehensive guide.