Finding health care while having little to no money is difficult for people living on fixed incomes. While Medicaid, a federal-state public insurance program, helps people with fewer resources afford medical care, it may be harder to qualify if your limited income is still too high to qualify for Medicaid. You may need to do what's called a  "Medicaid spend down" to become eligible. 

How can Hawaii's Medically Needy Spenddown Program help me?

Hawaii has a spend-down program called the Medically Needy Spenddown Program, or Med-QUEST.  With this program, you will use or “spend down” the difference of your income and Hawaii's Department of Human Services' income limit on health care expenses. Once you reach the limit, you could qualify for Medicaid. This amount is different for each person. To see if you're eligible, click here to start the Med-QUEST pre-assessement.

What income can I spend down?

Income is money you receive regularly. In addition to your salary or wages, Hawaii's Department of Human Services (DHS) may consider the following as sources of income:

• Social Security retirement payments
• Social Security disability payments like Social Security Disability Insurance (SSDI)
• Veterans benefits
• Pensions
• Interest from bank accounts and certificates of deposit
• Dividends from stocks and bonds

Hawaii DHS will determine the amount of income you’re limited to for Medicaid eligibility. Income limits also depend on if you’re single or married. For married couples, the limits vary even more if one or both spouses need Medicaid.

How do I apply for The Medically Needy  Spenddown Program (or Med-QUEST)?

There are several options available to apply for Medicaid in Hawaii. The Med-QUENT Division accepts applications online, over the phone, by mail, and even by fax.

You can apply online for Medicaid in Hawaii online. To start and submit your online application, you'll need to create a user login.

Create Account

You can also print and fill out the application form and mail it to your local office. If you are 65 years of age or older, blind, or living with a disability, please include the form supplement with your application. 

Below you'll find the link downloads from Hawaii's DHS' Med-QUEST Division:

• Application Form ( English - PDF)
• Application Form Instructions (English PDF) 
• Online Application (Website)

If you have questions or need to speak to someone, call 1-800-316-8005. If you need help in another language, call 1-800-316-8005 and state which language you speak. (TTY: 711 or 1-800-603-1201). 

NCOA also has a HelpLine that you can call to get free support. To get started today, call 1-800-794-6559.

How do Medicare and Medicaid work together?

If you get Medicare, you may also be able to get help from Medicaid. Medicaid pays for some services not covered by Medicare such as eyeglasses, hearing aids, and dental care. It also pays for some Medicare co-payments and deductibles.

Once you "spend down" and qualify for Medicaid, and you enroll in both Medicare and Medicaid, you will be signed up for the Extra Help program through Medicare Part D (prescription drug coverage). This program helps people with limited income and resources pay for medicine.

If you have Medicare and Medicaid, you can get your coverage through a Medicare Advantage Special Needs Plan (SNP). This plan can help you manage the health care services you need. SNPs may also offer more benefits than what you already get from Medicare. In some cases, you may have no monthly premiums and/or you may pay lower co-payments. All SNP plans are different, so check with the plans to see what they cover and if you can enroll.

SNPs are not available in every community. To find out if there is an SNP in your area, please go to www.medicare.gov or call 1-800-633-4227 or 1-877-486-2048 (TTY).