Updated September 5, 2026. Quick answer: Hawaii sets no income ceiling at all for an aged, blind, or disabled applicant, including someone applying for nursing-facility Medicaid. Its own administrative rule states countable income is “unlimited” before spend-down; eligibility instead runs through the state’s medically needy spend-down process against allowable medical expenses.
What the rule actually says
Hawaii Administrative Rules §17-1730.1-11 sets the maximum allowable countable income before spend-down for a child or pregnant woman at 300% of the federal poverty level, but for an aged, blind, or disabled individual (the category that covers nursing-facility applicants), the rule states no maximum shall be considered at all.
What this means in practice
A high-income applicant in Hawaii is not disqualified by income alone. Eligibility instead runs through the medically needy spend-down process: countable income above a low protected amount is applied against incurred medical and nursing-facility expenses until the applicant’s remaining income falls within the medically needy standard, at which point Medicaid coverage begins for the rest of that period.
| Citation | Hawaii Administrative Rules §17-1730.1-11 (Medically Needy Spenddown) |
| What it says | “§17-1730.1-11 Income requirements. (a) The maximum allowable countable income, prior to spenddown, determined under the provisions of chapter 17-1724.1 for eligibility under this chapter is: (1) Three hundred percent of the Federal Poverty Level for a child, or pregnant woman; or (2) For an aged, blind, or disabled individual, no maximum shall be considered. Unlimited for an aged, blind, or disabled individual.” |
This page covers the income eligibility figure itself. How a state handles income above that figure (a Qualified Income Trust, a medically needy spend-down, or something else) is covered on Hawaii’s excess income mechanism page.
Figures verified against Hawaii Administrative Rules §17-1730.1-11 (Department of Human Services copy, effective 09/30/13) on September 30, 2026; whether the rule has been amended since, and how nursing-facility applicants are routed under it, were not re-checked.
Every citation on this page was read directly from the state’s own Medicaid agency, administrative code, or official eligibility manual this session. General information, not legal or financial advice; a figure this specific can change with a budget cycle or a rule amendment, and a county or state caseworker has the final say on any individual application.
Related: use the Medicaid spend-down calculator to estimate how much you would need to spend down to qualify for long-term-care Medicaid in your state.