How to get Medicaid or low-cost care in Hawaii

Med-QUEST is Hawaii's Medicaid program

Medicaid is a health program that the state and the federal government pay for together. Hawaii runs it through the Med-QUEST Division of the Department of Human Services.

The Kaiser Family Foundation lists Hawaii as a state that adopted Medicaid expansion on January 1, 2014. Expansion means that adults can qualify based on income. The Med-QUEST website says Medicaid benefits are open to children and adults, including pregnant people and people who are aged, blind or disabled. HealthCare.gov says the income line in an expansion state works out to 138 percent of the federal poverty level. That level is a yearly dollar amount the government uses to measure poverty.

To see which group fits your family, read about who qualifies for Medicaid in plain words. Med-QUEST can also tell you which group applies to you.

Applying through KOLEA

Med-QUEST asks people to use its secure online application, which it calls KOLEA. The Med-QUEST home page has a button labeled I Need To Apply that leads to a Get Started page. The online system is at medical.mybenefits.hawaii.gov.

If you would rather talk to a person, call the Med-QUEST services center at 1-800-316-8005. That same number works as the free interpreter line, and TTY users can dial 711. For help with disability aids and language services, the Med-QUEST Division lists a separate number, 1-877-628-5076.

Scam texts are a known problem, so check the sender. Med-QUEST says its real text messages come from the number 45421. Be wary of a text from any other number that claims to be Med-QUEST.

Before you start, gather papers such as proof of income and an ID. The guide on how to apply for Medicaid lists what to have ready. The website says you may be able to buy a plan at HealthCare.gov if Med-QUEST finds that you do not qualify.

Changes coming to Hawaii Medicaid on January 1, 2027

A notice titled Changes Coming to Med-QUEST Eligibility for Adults appears on the state's site. It says a new federal law, signed on July 4, 2025, changes the rules for some adults starting January 1, 2027. The changes affect adults ages 19 to 64 who are not blind, disabled or pregnant.

The notice describes two changes for these adults. First, they will renew their eligibility every six months instead of once a year. Second, they must show a certain level of activity each month. That means working or volunteering at least 80 hours, earning at least $580, or being in school at least half time.

The federal agency CMS also lists exemptions, which are reasons you may not have to meet the rule. Parents and caregivers of a child 13 or younger are among them. The rest are listed in our guide to the Medicaid work rule.

To get ready, Med-QUEST suggests a few steps. Set up an online account on the state's mybenefits.hawaii.gov site. Save your pay stubs if you work, or keep other proof that you earn $580 a month if you have no stub. Students can ask their school for an official proof of enrollment.

Job-based coverage in Hawaii works differently

Hawaii has a law called the Prepaid Health Care Act, and the state labor department explains who gets this coverage. You qualify if you work 20 hours or more a week for four weeks in a row. You also need to earn a set monthly wage, which is 86.67 times the state minimum hourly wage. Once you meet both tests, your employer must provide health insurance.

Coverage usually begins on the first of the month after you meet those rules. Ask your employer in writing about the plan if you think you qualify. When the employer says no and you believe that is wrong, the labor department has a page of questions and answers on the law.

People with two jobs must name a main employer on a form called HC-5, according to the labor department. The main employer is the one that pays you the most.

When your income is too high for Medicaid

According to the state Insurance Division, people without job-based coverage can buy a plan through HealthCare.gov during Open Enrollment or after a life event. A life event, such as losing other coverage, opens a Special Enrollment Period. That is a window to sign up outside the usual dates. HealthCare.gov also shows how much help you can get with the monthly cost.

A recent job loss has its own first steps, and they are covered in our guide on losing a job and losing insurance.

Health centers and doctor lookup

Community health centers are federally funded clinics that serve everyone and charge based on income and family size. The Hawaii Primary Care Association has a page that lists the state's federally qualified health centers. You can also search by zip code with the Find a Health Center tool from the Health Resources and Services Administration. Before a first visit, read our list of questions in the guide to community health centers.

Doctors are licensed by the Hawaii Medical Board, which is part of the Department of Commerce and Consumer Affairs. Its page links to a lookup for information on your physician, and the department also offers a Verify a Professional tool that shows license status.

Direct primary care and the ER in Hawaii

A few Hawaii doctors charge a flat monthly fee for primary care and do not bill insurance for those visits. That model has a name, which is direct primary care. You can search our directory of cash-pay doctors, and it helps to ask each office to write down what its fee covers.

In an emergency, call 911 or go to the nearest emergency room. Any Hawaii hospital with an emergency room must check you, by federal law, even if you have no coverage. If a bill comes later, hospital financial assistance may help, and the guide explains how to ask.