Hawaii Medicaid Long Term Care Eligibility for 2025

Hawaii Long Term Care for 2025

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Hawaii’s Medicaid program, known as Med-QUEST, continues to meet federal eligibility requirements while providing robust long-term care services. To qualify for long-term care, an individual must meet both financial and medical criteria. The medical requirement involves demonstrating functional impairment that necessitates an institutional level of care. Eligibility is assessed through Form 1147, which is approved for up to 12 months. At the end of this period, the patient’s condition is re-evaluated, and the form may be renewed as needed.

  • Individuals must require long-term care services for at least 30 consecutive days.
  • All countable assets of a married couple are considered. The community spouse (non-institutionalized spouse) may retain some assets, while the institutionalized spouse’s assets cannot exceed $2,000.
  • Only the income of the person requiring long-term care is used to determine eligibility.
  • For children requiring long-term care, parental income is considered only in the first month of care.

Transfer of Assets Penalty in 2025: Individuals transferring assets for less than fair market value may face a penalty, making them ineligible for Medicaid long-term care during the penalty period. The penalty duration is calculated by dividing the value of transferred assets by the average cost of nursing home care. Hawaii enforces a 60-month look-back period for all asset transfers.

  • The transfer of a home is exempt from penalties under certain conditions, such as transfer to a spouse, minor child, disabled or blind adult child, a caregiving child who lived in the home for at least 24 months before the Medicaid application, or a sibling with an equity interest who lived in the home for at least one year before the applicant’s institutionalization.
Key Financial and Medical Eligibility for 2025:

1. Income Limits: There is no hard income limit for Nursing Home Medicaid, but all income (except $75 for personal needs and certain allowances) must go toward care costs. For Home and Community-Based Services and Regular Medicaid (Aged, Blind, and Disabled), the income limit is $1,443/month for single applicants and $1,958/month for married couples.

2. Asset Limits: The institutionalized person’s assets must not exceed $2,000, while the community spouse may retain up to $157,920 in countable assets.

3. Home Equity Limit: The primary residence is exempt if the equity value is $1,097,000 or less and the applicant or spouse lives in the home. Applicants not living in the home must demonstrate an intent to return for the exemption to apply.

Hawaii Medicaid Programs in 2025:

  • QUEST Integration (QI) Program: Combines medical care with long-term services like adult day care, respite care, and homemaker services to help seniors remain at home or in community care settings.
  • Money Follows the Person (MFP): Facilitates transitioning individuals from institutional care back into the community.
How to Apply for Hawaii Medicaid:

Applications can be submitted online at the Hawaii My Medical Benefits website, by calling Med-QUEST Enrollment Services at 1-800-316-8005, or by visiting a local Med-QUEST office. Applicants should ensure all eligibility requirements are met before applying to avoid delays or denials. Medicaid planning is recommended for those with excess income or assets.

For assistance and additional resources, visit the Hawaii Medicaid website or contact the Med-QUEST office for guidance on completing your application.

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