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.
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.