Updated September 17, 2026. Quick answer: In Hawaii, a Medicaid nursing-facility resident’s Personal Needs Allowance is $75.00/Month, the amount of their own income they keep for personal use each month, with the rest going to the facility as the patient-pay amount toward the cost of care. That is well above the $30/month federal floor set in 1988 and never raised since. Hawaii Medicaid State Plan, Attachment 2.6-A, State Plan Amendment Transmittal Number 24-0012 states the figure directly.
Why Hawaii’s figure isn’t the federal floor
Federal Medicaid law requires only a $30-a-month personal needs allowance as a floor; a state is free to set its own, higher figure by statute, regulation, or agency policy. Hawaii has done exactly that, setting $75.00/Month, effective October 1, 2024 (approved by CMS October 28, 2024, State Plan Amendment TN 24-0012).
What the allowance covers, and what it doesn’t
The personal needs allowance pays for the things a facility’s daily rate doesn’t cover: clothing, haircuts, snacks, a phone or television, small personal purchases. It is deducted before the rest of a resident’s income is applied to the facility bill as the patient-pay (or post-eligibility treatment of income, PETI) amount. It is not extra money on top of what Medicaid already pays the facility; it is the one slice of a resident’s own income that Medicaid rules guarantee the resident, not the facility, keeps.
One exception or caveat worth knowing
The couple figure is $150.00/month when both spouses are institutionalized; this page reports the individual figure, $75.00, the case that applies to a single applicant.
| Federal personal needs allowance floor | $30.00/month |
| Hawaii’s personal needs allowance | $75.00/Month |
| How far above the federal floor (calculated by comparing this state’s own figure to the $30.00 federal floor) | 150% higher |
| State citation | Hawaii Medicaid State Plan, Attachment 2.6-A, State Plan Amendment Transmittal Number 24-0012 |
| What it says | “Personal Needs Allowance (PNA) of not less than $75.00 for individuals and $150.00 for Couples for all Institutionalized Persons.” |
| Federal floor citation | 42 CFR § 435.725 (the federal $30.00/month personal needs allowance floor) |
Figures verified against the Hawaii Med-QUEST State Plan Attachment 2.6-A page 4a (TN 24-0012) and SPA Memo 24-12, and 42 U.S.C. § 1396a(q), on September 30, 2026.
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 facility or state caseworker has the final say on any individual case.