Medicaid in Hawaii: what you may be able to apply for
What it is
Public health insurance for low-income people, jointly funded by the federal and state governments. It covers doctor visits, hospital care, prescriptions, pregnancy, and children's care. States run it under federal rules, and each state has its own name and details (California calls it Medi-Cal).
Med-QUEST (QUEST Integration) — Hawaii's Medicaid program, run by the Med-QUEST Division of the state Department of Human Services.
Final eligibility is decided by the agency
Policies can change — always check the latest official information.
🔎 Will this affect your green card?
Regular Medicaid does NOT count in the public charge test — receiving it does not affect your green card or immigration application. First, a sentence that may make this whole section irrelevant to you: many people are outside this assessment altogether. The exemption categories Congress created by statute remain in force — DHS said so in the July 20, 2026 rule: what it removed was the list, while "USCIS will provide training and guidance to its officers, including information about which aliens are statutorily exempt from the public charge ground of inadmissibility". ✅ Each of the following rests on its own statute and does not disappear with that list: refugees (8 U.S.C. §1157(c)(3): paragraph (4) of §1182(a) "shall not be applicable"); refugees and asylees adjusting status (§1159(c), same wording); Special Immigrant Juveniles (§1255(h)(2)(A): paragraph (4) "shall not apply"); and VAWA self-petitioners, U nonimmigrant applicants or holders, and battered spouses and children under §1641(c) (§1182(a)(4)(E): "shall not apply"). Battered spouses and children have a second layer of statutory protection: the law forbids considering any public benefits for them (INA §212(s)). If you hold a T visa: the law allows immigration authorities to waive the public charge ground (§1255(l)(2), "may waive") — but that waiver is discretionary; it does not apply automatically as the categories above do. ✅ This does not mean you cannot get a waiver; it means it has to be requested and explained case by case. Have a lawyer help you prepare it. For the full list, and whether you are in it, have a lawyer check. ✅ For what you received before September 18, 2026, the rule considers only two things: (a) public cash assistance for income maintenance (SSI, TANF cash, and state, tribal, territorial or local general-assistance cash) and (b) long-term institutionalization at government expense. Anything outside those two is not counted — that is written into the rule itself and has not changed. But if you did receive (a) or (b) before that date, those are considered; have an attorney look at your specific situation. (This is in the rule itself: it applies only going forward — DHS "will only consider the receipt of public cash assistance for income maintenance and long-term institutionalization at government expense before the effective date".) And if this assessment does apply to you — from September 18, 2026 onwards, things change — means-tested public benefits received on or after that day - that is, the public benefits that look at your income or assets when you apply - and for example SNAP, Medicaid, CHIP and WIC, but not limited to these, because the rule names a whole category rather than a list, and not limited to federal programs either - state, territorial, Tribal and local ones count too (verbatim: "Federal, State, territorial, Tribal, and local programs that provide means-tested public benefits"); if you are not sure whether the one you receive counts, ask a licensed immigration attorney - may be weighed as one of the factors (the rule "will consider the receipt of any means tested public benefits on or after that date"). ✅ It is one factor among many, not an automatic denial. The rule requires each case to be weighed on all of its circumstances. How much weight any one of them carries has not been published — USCIS has not issued its operating guidance. We have not verified it; that is not the same as saying it has changed. If you are applying for a visa abroad, or entering at a port of entry: the above describes USCIS (applications filed inside the United States). The rule itself notes that CBP at a port of entry may consider different information; how consulates abroad apply it, we have not verified. See details →
Who may qualify
Income limit
- Adults under 65 who are not receiving SSI or Medicare≤ 138% FPL
Source:State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-07
Official excerpt
“Adults under the age of 65 (not receiving Supplemental Security Income or Medicare)– up to 138% of the FPL”
FAQ
View the official document → (Opens in a new tab) - Children — up to 313% FPL, among the highest lines in the country≤ 313% FPL
Source:State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-07
- Pregnant women≤ 196% FPL
Source:State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-07
Official excerpt
“Pregnant Women – up to 196% of the FPL”
FAQ
View the official document → (Opens in a new tab) - Parents and caretaker relatives — note this line is lower than the adult expansion line≤ 105% FPLDo not let the 105% line put you off: adults 19-64 also have the 138% expansion line, and the two run in parallel.
Source:State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-07
Official excerpt
“Parent/Caretaker relatives – up to 105% of the FPL”
FAQ
View the official document → (Opens in a new tab) - People who are 65 and over, or blind or disabled≤ 100% FPLThis track also has an asset test: $2,000 for a one-person household, $3,000 for a household of two. And being over 100% FPL is not the end of it — the same official passage says that someone over that line but within the asset limits may qualify through the Medically Needy spend-down route.
Source:State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-07
Official excerpt
“People who are 65 and over, or blind or disabled, may have eligibility determined using the following income and asset thresholds: Income up to 100% of the FPL and up to $2,000 in assets for a single person household or up to $3,000 for a household of two; or If income is greater than 100% of the FPL and assets up $2,000 for a single person household or up to $3,000 for a household of two, may be eligible for medical assistance under the Medically Needy Spend”
FAQ
View the official document → (Opens in a new tab)
Immigration-status rules in this state
If you are a citizen of one of the COFA nations — the Federated States of Micronesia, the Republic of the Marshall Islands, or the Republic of Palau — read this first, because the question the mainland states put to immigrants ("are you a qualified alien?") does not arise here. The federal statute names you directly. 8 U.S.C. § 1612(b)(2)(G), "Exception for citizens of freely associated states," reads: "With respect to eligibility for benefits for any designated Federal program, paragraph (1) shall not apply to any individual who lawfully resides in 1 of the 50 States or the District of Columbia in accordance with the Compacts of Free Association …" — and § 1612(b)(3) defines "designated Federal program" as TANF, the social services block grant, and Medicaid. Note the wording: the statute reaches "any individual who lawfully resides … in accordance with the Compacts." It does not run through the "qualified alien" test at all. So on this program, the question "do I fall into a qualified-immigrant category?" is one COFA citizens do not need to ask — and it is why no mainland state's immigration-eligibility account should be copied onto this page. Hawaii's own words line up with that. Med-QUEST: "Effective 12/27/2020, Hawaii residents who are citizens of one of the COFA Nations will have access to Medicaid coverage." The same notice recalls what came before: "While Hawai'i has continued to provide coverage to eligible children and pregnant women and has used State-only funds to cover those who are 65 and over, blind, or disabled, this new law restores federal funding and support of Medicaid for all COFA citizens who reside in the U.S." In other words, before the federal restoration Hawaii carried part of this on its own state funds. One thing we are not answering for you: the provision above settles the § 1612 question. How the five-year bar at 8 U.S.C. § 1613 applies to COFA citizens is something we have not yet read word for word, so this page makes no claim about it — if that point matters to you, ask Med-QUEST directly. For people without lawful status, none of the above applies. We did not find broad state-funded coverage for undocumented adults in Hawaii; what exists is emergency Medicaid, whose definition and limits are set federally (see the federal section on this program's page). One narrow door is worth naming: Hawaii runs a state-funded breast and cervical cancer medical assistance program whose own rule describes it as covering "an individual who meets the requirements under the Breast and Cervical Cancer Program except for citizenship status." It is narrow, but it is a real door.
How to apply
What you'll need
Before converting any of the percentages above into dollars, note something specific to Hawaii: the federal poverty guideline is issued separately for Hawaii and is higher than for the 48 contiguous states. So any dollar threshold calculated from mainland figures is wrong here — and wrong in the direction that makes people who do qualify believe they are over the line. We give no dollar figures in this cell; use the income standard chart Med-QUEST publishes for the current year. How to apply: online at mybenefits.hawaii.gov (Med-QUEST's KOLEA system), or in person with a Med-QUEST Community Partner, a route the agency itself lists in its COFA notice. Language: Med-QUEST's COFA notice is itself published in COFA languages including Marshallese and Kosraean, not only English. Phone: the notice gives 808-524-3370 (Oʻahu) and 1-800-316-8005 (Neighbor Islands). ⚠️ A different language version on the same page shows numbers that do not match these — if one does not connect, try the other, or take the current number from the Med-QUEST home page.
Timeline
Something with a date already on it, and it will affect a lot of people — read it now. From Med-QUEST's own page: · When: "Starting on January 1, 2027"; · Why: "Congress passed a Bill (HR1) that President Trump signed into law on 7/4/25 that is requiring Medicaid programs to change eligibility rules for some adults."; · Who: "These changes only impact adults between 19-64 who are not Blind, Disabled or Pregnant." · What changes: (1) "eligibility renewals will happen every six months instead of once per year"; (2) to keep coverage, this group of adults will need to show that they are working or volunteering at least 80 hours per month, or earning at least $580 per month, or enrolled at least half-time in an educational program. · The agency adds: "More details will be available by July 2026." Med-QUEST also sets out what you can do now, and it is worth doing: (1) set up your online account (Med-QUEST and mybenefits.hawaii.gov) — in the agency's words, this is "the BEST way to ensure Med-QUEST has the information it needs to help you stay enrolled"; (2) if you have no payslip but do have proof of $580 a month, keep that evidence; (3) if you are enrolled at least half-time, ask your school for official proof of enrolment. All three can be done before January 1, 2027 — and they are exactly what you will be asked for then. Why this cell carries no structured "work requirement" module: that module requires one parameter — how many days you have to respond after a notice — and Hawaii has not published that number yet. Our rule is that an unverified field is omitted whole rather than filled with "usually about X days." Check the official page again after mid-2026 (the agency says details arrive in July 2026).
Go to the official application → (Opens in a new tab)Hawaii Med-QUEST official site (apply at mybenefits.hawaii.gov)
The state has not published a deadline for responding. Not published does not mean there is no deadline — once a renewal notice arrives, the window to respond may be short. ✅ What you can do now: make sure the agency has your current address and phone number (a notice that never reaches you is one of the most common ways people lose benefits), and contact them on the day the notice arrives to confirm the deadline.
How to respond
The agency itself lists three things you can do now, and all three can be done before January 1, 2027: (1) set up your online account (your Med-QUEST account and mybenefits.hawaii.gov) — in the agency's words this is "the BEST way to ensure Med-QUEST has the information it needs to help you stay enrolled"; (2) if you have no payslip but do have proof of $580 a month, keep that evidence; (3) if you are enrolled at least half-time, ask your school for official proof of enrolment. These three are exactly what you will be asked for — doing them now is far easier than hunting for them after a notice arrives.
Source:State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-07
Official excerpt
“Set up online access to your existing Med-QUEST account and mybenefits.hawaii.gov … It is fast and easy and is the BEST way to ensure Med-QUEST has the information it needs to help you stay enrolled. · If you don't have a paystub, but have proof of $580 income per month, save that evidence of income. · If you are enrolled in an educational program at least half time, ask your school for an official proof of enrollment.”
"Changes coming to Med-QUEST Eligibility for Adults!" — Hawaii Med-QUEST。逐字:When = "Starting on January 1, 2027";Why = "Congress passed a Bill (HR1) that President Trump signed into law on 7/4/25 that is requiring Medicaid programs to change eligibility rules for some adults.";Who = "These changes only impact adults between 19-64 who are not Blind, Disabled or Pregnant.";"eligibility renewals will happen every six months instead of once per year";"this adult group will need to demonstrate that they are either working or volunteering at least 80 hours per month or earning a minimum of $580 per month or are enrolled at least half-time in an educational program.";"More details will be available by July 2026.";准备三条含 "It is fast and easy and is the BEST way to ensure Med-QUEST has the information it needs to help you stay enrolled." 🔴 页面未给出「收到通知后须在几天内回复」 ⇒ workRequirement 模块本轮不出(见 source 说明 ④)。
View the official document → (Opens in a new tab)What this is
In the agency's words: "To keep Med-QUEST coverage, this adult group will need to demonstrate that they are either working or volunteering at least 80 hours per month or earning a minimum of $580 per month or are enrolled at least half-time in an educational program." So this is the condition for keeping the coverage you have. One more point matters just as much: the agency states that for this group "eligibility renewals will happen every six months instead of once per year" — meaning the number of times you have to respond doubles.
In effect since: 2027-01-01
This is not something Hawaii decided on its own. The agency's words: "Congress passed a Bill (HR1) that President Trump signed into law on 7/4/25 that is requiring Medicaid programs to change eligibility rules for some adults." Similar changes will appear state by state, with different timing and details in each. The agency adds: "More details will be available by July 2026" — check your state's official page then.
Federal background
Source:State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-07
Official excerpt
“To keep Med-QUEST coverage, this adult group will need to demonstrate that they are either working or volunteering at least 80 hours per month or earning a minimum of $580 per month or are enrolled at least half-time in an educational program. … For individuals described above, eligibility renewals will happen every six months instead of once per year”
"Changes coming to Med-QUEST Eligibility for Adults!" — Hawaii Med-QUEST。逐字:When = "Starting on January 1, 2027";Why = "Congress passed a Bill (HR1) that President Trump signed into law on 7/4/25 that is requiring Medicaid programs to change eligibility rules for some adults.";Who = "These changes only impact adults between 19-64 who are not Blind, Disabled or Pregnant.";"eligibility renewals will happen every six months instead of once per year";"this adult group will need to demonstrate that they are either working or volunteering at least 80 hours per month or earning a minimum of $580 per month or are enrolled at least half-time in an educational program.";"More details will be available by July 2026.";准备三条含 "It is fast and easy and is the BEST way to ensure Med-QUEST has the information it needs to help you stay enrolled." 🔴 页面未给出「收到通知后须在几天内回复」 ⇒ workRequirement 模块本轮不出(见 source 说明 ④)。
View the official document → (Opens in a new tab)Hours threshold and qualifying activities
80 hours per month (work or volunteering) — or at least $580 per month in earnings, or at least half-time enrolment in an educational program
It is not only paid work that counts — the agency gives three parallel routes, and meeting any one of them is enough: (1) working or volunteering at least 80 hours a month; or (2) earning at least $580 a month; or (3) being enrolled at least half-time in an educational program. So volunteering counts, studying counts, and earnings alone can count — do not rule yourself out because you do not have a full-time job.
Paid work is not the only thing that counts. Going to school, job training, community service, and looking for work may also count — check which activities qualify before assuming your situation doesn't.
Source:State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-07
Official excerpt
“this adult group will need to demonstrate that they are either working or volunteering at least 80 hours per month or earning a minimum of $580 per month or are enrolled at least half-time in an educational program.”
"Changes coming to Med-QUEST Eligibility for Adults!" — Hawaii Med-QUEST。逐字:When = "Starting on January 1, 2027";Why = "Congress passed a Bill (HR1) that President Trump signed into law on 7/4/25 that is requiring Medicaid programs to change eligibility rules for some adults.";Who = "These changes only impact adults between 19-64 who are not Blind, Disabled or Pregnant.";"eligibility renewals will happen every six months instead of once per year";"this adult group will need to demonstrate that they are either working or volunteering at least 80 hours per month or earning a minimum of $580 per month or are enrolled at least half-time in an educational program.";"More details will be available by July 2026.";准备三条含 "It is fast and easy and is the BEST way to ensure Med-QUEST has the information it needs to help you stay enrolled." 🔴 页面未给出「收到通知后须在几天内回复」 ⇒ workRequirement 模块本轮不出(见 source 说明 ④)。
View the official document → (Opens in a new tab)Situations that may be exempt
The situations below may qualify for an exemption. Whether one applies to you is decided by Hawaii Medicaid.
The agency draws the scope in so many words: "These changes only impact adults between 19-64 who are not Blind, Disabled or Pregnant." So people under 19 and over 65, and people who are blind, disabled or pregnant, are outside this change. Whether you fall into one of those is for the agency to determine against its own standards — we do not decide it for you, but if you believe you do, say so when you are asked for proof of hours.
Source:State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-07
Official excerpt
“These changes only impact adults between 19-64 who are not Blind, Disabled or Pregnant.”
"Changes coming to Med-QUEST Eligibility for Adults!" — Hawaii Med-QUEST。逐字:When = "Starting on January 1, 2027";Why = "Congress passed a Bill (HR1) that President Trump signed into law on 7/4/25 that is requiring Medicaid programs to change eligibility rules for some adults.";Who = "These changes only impact adults between 19-64 who are not Blind, Disabled or Pregnant.";"eligibility renewals will happen every six months instead of once per year";"this adult group will need to demonstrate that they are either working or volunteering at least 80 hours per month or earning a minimum of $580 per month or are enrolled at least half-time in an educational program.";"More details will be available by July 2026.";准备三条含 "It is fast and easy and is the BEST way to ensure Med-QUEST has the information it needs to help you stay enrolled." 🔴 页面未给出「收到通知后须在几天内回复」 ⇒ workRequirement 模块本轮不出(见 source 说明 ④)。
View the official document → (Opens in a new tab)
Exemptions are often broader than people assume. If you are not sure, check — do not assume you don't qualify.
Work requirements and public charge are two different things. Getting or losing Medicaid does not, because of this rule, affect your green card application.
Many immigrant families worry that responding to a government letter could cause problems. But this kind of notice is a check on the coverage you already have, and the outcome of not responding is clear: you may lose that coverage. If you're unsure what the letter is, or worried about your situation, don't simply leave it unanswered — you can contact the Hawaii Medicaid office, a free or low-cost legal aid organization, or a community organization to help you read it; for questions about immigration status, consult a licensed immigration attorney.
Will it affect your green card? (Public charge)
✅ Regular Medicaid does NOT count in the public charge test — receiving it does not affect your green card or immigration application. First, a sentence that may make this whole section irrelevant to you: many people are outside this assessment altogether. The exemption categories Congress created by statute remain in force — DHS said so in the July 20, 2026 rule: what it removed was the list, while "USCIS will provide training and guidance to its officers, including information about which aliens are statutorily exempt from the public charge ground of inadmissibility". ✅ Each of the following rests on its own statute and does not disappear with that list: refugees (8 U.S.C. §1157(c)(3): paragraph (4) of §1182(a) "shall not be applicable"); refugees and asylees adjusting status (§1159(c), same wording); Special Immigrant Juveniles (§1255(h)(2)(A): paragraph (4) "shall not apply"); and VAWA self-petitioners, U nonimmigrant applicants or holders, and battered spouses and children under §1641(c) (§1182(a)(4)(E): "shall not apply"). Battered spouses and children have a second layer of statutory protection: the law forbids considering any public benefits for them (INA §212(s)). If you hold a T visa: the law allows immigration authorities to waive the public charge ground (§1255(l)(2), "may waive") — but that waiver is discretionary; it does not apply automatically as the categories above do. ✅ This does not mean you cannot get a waiver; it means it has to be requested and explained case by case. Have a lawyer help you prepare it. For the full list, and whether you are in it, have a lawyer check. ✅ For what you received before September 18, 2026, the rule considers only two things: (a) public cash assistance for income maintenance (SSI, TANF cash, and state, tribal, territorial or local general-assistance cash) and (b) long-term institutionalization at government expense. Anything outside those two is not counted — that is written into the rule itself and has not changed. But if you did receive (a) or (b) before that date, those are considered; have an attorney look at your specific situation. (This is in the rule itself: it applies only going forward — DHS "will only consider the receipt of public cash assistance for income maintenance and long-term institutionalization at government expense before the effective date".) And if this assessment does apply to you — from September 18, 2026 onwards, things change — means-tested public benefits received on or after that day - that is, the public benefits that look at your income or assets when you apply - and for example SNAP, Medicaid, CHIP and WIC, but not limited to these, because the rule names a whole category rather than a list, and not limited to federal programs either - state, territorial, Tribal and local ones count too (verbatim: "Federal, State, territorial, Tribal, and local programs that provide means-tested public benefits"); if you are not sure whether the one you receive counts, ask a licensed immigration attorney - may be weighed as one of the factors (the rule "will consider the receipt of any means tested public benefits on or after that date"). ✅ It is one factor among many, not an automatic denial. The rule requires each case to be weighed on all of its circumstances. How much weight any one of them carries has not been published — USCIS has not issued its operating guidance. We have not verified it; that is not the same as saying it has changed. If you are applying for a visa abroad, or entering at a port of entry: the above describes USCIS (applications filed inside the United States). The rule itself notes that CBP at a port of entry may consider different information; how consulates abroad apply it, we have not verified.
⚠️ The one exception: Medicaid that pays for long-term institutional care (a long-term stay in a nursing facility or mental-health institution at government expense) DOES count. Everyday doctor visits, hospital care, prescriptions, and home- and community-based care are not this exception.
➕ Because the current rule excludes all non-institutional Medicaid, Medicaid for children, pregnancy, and emergencies also does not count. In mixed-status families, eligible citizen or qualified children can safely get the care they qualify for.
The statute itself names the moments at which this is assessed. INA § 212(a)(4)(A) (8 U.S.C. § 1182(a)(4)(A)) reads that an alien is inadmissible who, "in the opinion of the consular officer at the time of application for a visa, or in the opinion of the Attorney General at the time of application for admission or adjustment of status, is likely at any time to become a public charge." ⇒ Three occasions are named: applying for a visa, applying for admission, and applying for adjustment of status. Two things are commonly read too narrowly, and both errors point the same way — toward "this does not concern me": the statute says "a visa" and does not limit that to immigrant visas; and "application for admission" is its own separate occasion. We do not tell you whether your own situation is one of these — that depends on your case; consult a licensed immigration attorney.
The exemptions are not "a few categories" — the regulation lists twenty-nine of them. 8 CFR 212.23(a) opens: "The public charge ground of inadmissibility under section 212(a)(4) of the Act does not apply … to the following categories of aliens," and then runs (1) through (29). Among those most relevant to readers of this site: refugees (1); asylees (2); Cuban and Haitian entrants (5); Cuban Adjustment Act applicants (6); NACARA (7); Special Immigrant Juveniles (10); Temporary Protected Status (12); T nonimmigrants (17) and (18); U nonimmigrants (19); VAWA self-petitioners (20); battered spouses and children who are qualified aliens under PRWORA § 431(c) (21); Afghan and Iraqi interpreters (4); nationals of Vietnam, Cambodia and Laos (25). Category (29) has to be read along with the rest, and it is the one most easily missed: "Any other categories of aliens exempt under any other law from the public charge ground of inadmissibility provisions under section 212(a)(4) of the Act." ⇒ "I am not in the categories listed above" does not mean "I am not exempt." The full list of 29 is at 8 CFR 212.23(a). That regulation is scheduled for removal on September 18, 2026 (91 FR 45477); on that date this whole block closes rather than continuing to show old text — but the statutory exemptions themselves come from their own laws and do not disappear with it. Whether your case falls within one is a question for a licensed immigration attorney. These exemptions do not disappear with that list: in the rescission rule of July 20, 2026 DHS says so itself — "Although DHS is removing the regulation listing exemptions, the statutory exemptions created by Congress for certain Cuban and Haitian applicants for adjustment of status continue to exist." Note the scope of that sentence: it is DHS responding to a comment about Cuban and Haitian applicants, and it covers only those two groups. Each of the 29 categories rests on its own statute, which the regulation merely collected in one place - and that is why the list does not vanish with the regulation.
Renewing a green card and naturalizing are generally not occasions for a public charge assessment. For a green-card holder returning from a trip abroad, the statute writes out an exhaustive list of when they are treated as seeking admission at all. 8 U.S.C. § 1101(a)(13)(C): a lawful permanent resident "shall not be regarded as seeking an admission … unless the alien—" falls within one of six situations: (i) has abandoned or relinquished that status; (ii) has been absent for a continuous period in excess of 180 days; (iii) has engaged in illegal activity after departing; (iv) departed while under legal process seeking removal, including removal or extradition proceedings; (v) has committed an offense identified in 8 U.S.C. § 1182(a)(2), unless relief has since been granted under § 1182(h) or § 1229b(a); or (vi) is attempting to enter at a time or place other than as designated by immigration officers, or has not been admitted after inspection and authorization by an immigration officer. Those six are the whole of what the statute gives — the widely quoted "180 days" is only item (ii), not the only one. Whether your own situation falls within any of them is a question for a licensed immigration attorney; this site does not judge individual cases.
This is information only, not immigration, legal, or tax advice. Public charge and your personal status are complex — consult a licensed immigration attorney. We never tell you whether you "will" or "won't" be affected.
USCIS Policy Manual, Volume 8, Part G, Chapter 7 (benefits considered) and Chapter 3 (who it applies to) — 8 USCIS-PM G.7 / G.3; regulation 8 CFR 212.21–212.23; 2022 final rule 87 FR 55472. · 2022-12-23
Source:U.S. Citizenship and Immigration Services (uscis.gov) · checked 2026-07-16
Official excerpt
“Long-term institutionalization at government expense is the only category of Medicaid-funded services (limited to institutional services provided under section 1905(a) of the Social Security Act) considered in a public charge inadmissibility determination.”
Chapter 7 - Consideration of Current and/or Past Receipt of Public Cash Assistance for Income Maintenance or Long-term Institutionalization at Government Expense | USCIS · 8 USCIS-PM G.7
View the official document → (Opens in a new tab)Frequently asked questions
What is Medicaid?
Public health insurance for low-income people, jointly funded by the federal and state governments. It covers doctor visits, hospital care, prescriptions, pregnancy, and children's care. States run it under federal rules, and each state has its own name and details (California calls it Medi-Cal).
Who can apply for Medicaid in Hawaii?
Generally, Adults under 65 who are not receiving SSI or Medicare: ≤ 138% FPL; Children — up to 313% FPL, among the highest lines in the country: ≤ 313% FPL; Pregnant women: ≤ 196% FPL; Parents and caretaker relatives — note this line is lower than the adult expansion line: ≤ 105% FPL; People who are 65 and over, or blind or disabled: ≤ 100% FPL. The agency makes the final determination.
Can non-citizens or people without immigration status get Medicaid?
If you are a citizen of one of the COFA nations — the Federated States of Micronesia, the Republic of the Marshall Islands, or the Republic of Palau — read this first, because the question the mainland states put to immigrants ("are you a qualified alien?") does not arise here. The federal statute names you directly. 8 U.S.C. § 1612(b)(2)(G), "Exception for citizens of freely associated states," reads: "With respect to eligibility for benefits for any designated Federal program, paragraph (1) shall not apply to any individual who lawfully resides in 1 of the 50 States or the District of Columbia in accordance with the Compacts of Free Association …" — and § 1612(b)(3) defines "designated Federal program" as TANF, the social services block grant, and Medicaid. Note the wording: the statute reaches "any individual who lawfully resides … in accordance with the Compacts." It does not run through the "qualified alien" test at all. So on this program, the question "do I fall into a qualified-immigrant category?" is one COFA citizens do not need to ask — and it is why no mainland state's immigration-eligibility account should be copied onto this page. Hawaii's own words line up with that. Med-QUEST: "Effective 12/27/2020, Hawaii residents who are citizens of one of the COFA Nations will have access to Medicaid coverage." The same notice recalls what came before: "While Hawai'i has continued to provide coverage to eligible children and pregnant women and has used State-only funds to cover those who are 65 and over, blind, or disabled, this new law restores federal funding and support of Medicaid for all COFA citizens who reside in the U.S." In other words, before the federal restoration Hawaii carried part of this on its own state funds. One thing we are not answering for you: the provision above settles the § 1612 question. How the five-year bar at 8 U.S.C. § 1613 applies to COFA citizens is something we have not yet read word for word, so this page makes no claim about it — if that point matters to you, ask Med-QUEST directly. For people without lawful status, none of the above applies. We did not find broad state-funded coverage for undocumented adults in Hawaii; what exists is emergency Medicaid, whose definition and limits are set federally (see the federal section on this program's page). One narrow door is worth naming: Hawaii runs a state-funded breast and cervical cancer medical assistance program whose own rule describes it as covering "an individual who meets the requirements under the Breast and Cervical Cancer Program except for citizenship status." It is narrow, but it is a real door. Federal Medicaid generally requires a "qualified" immigration status, and most people must wait five years after getting that status (the "five-year bar") before applying. Refugees, asylees, and certain others are exempt from the five-year wait; emergency Medicaid is available regardless of status. Some states (such as California) use state funds to cover more people — see your state's details. The 2025 federal law OBBBA (H.R.1, Public Law 119-21, enacted July 4, 2025) significantly narrows eligibility: effective Oct 1, 2026 (Section 71109), federal Medicaid/CHIP funding is limited to four groups — U.S. citizens/nationals, lawful permanent residents (LPRs), Cuban/Haitian entrants, and COFA migrants (Micronesia/Marshall Islands/Palau). Refugees, asylees, trafficking victims, parolees, and other "qualified aliens" who are not yet LPRs lose federal eligibility (refugees/asylees can generally regain it after becoming LPRs). Emergency Medicaid remains available regardless of status (though Section 71110 lowers its federal match to the regular FMAP effective Oct 1, 2026 — this does not change its availability); the state options for lawfully-residing children and pregnant women are preserved. Section 71119 adds community-engagement (work) requirements for ACA-expansion adults (19-64) effective Dec 31, 2026 (or sooner at state option) — at least 80 hours/month, with exemptions for pregnant/postpartum people, the medically frail, caretakers of a child under 14, and others. This is a changing area — check the latest official guidance. The agency makes the final determination.
Does getting Medicaid affect my green card?
Regular Medicaid does NOT count in the public charge test — receiving it does not affect your green card or immigration application. First, a sentence that may make this whole section irrelevant to you: many people are outside this assessment altogether. The exemption categories Congress created by statute remain in force — DHS said so in the July 20, 2026 rule: what it removed was the list, while "USCIS will provide training and guidance to its officers, including information about which aliens are statutorily exempt from the public charge ground of inadmissibility". ✅ Each of the following rests on its own statute and does not disappear with that list: refugees (8 U.S.C. §1157(c)(3): paragraph (4) of §1182(a) "shall not be applicable"); refugees and asylees adjusting status (§1159(c), same wording); Special Immigrant Juveniles (§1255(h)(2)(A): paragraph (4) "shall not apply"); and VAWA self-petitioners, U nonimmigrant applicants or holders, and battered spouses and children under §1641(c) (§1182(a)(4)(E): "shall not apply"). Battered spouses and children have a second layer of statutory protection: the law forbids considering any public benefits for them (INA §212(s)). If you hold a T visa: the law allows immigration authorities to waive the public charge ground (§1255(l)(2), "may waive") — but that waiver is discretionary; it does not apply automatically as the categories above do. ✅ This does not mean you cannot get a waiver; it means it has to be requested and explained case by case. Have a lawyer help you prepare it. For the full list, and whether you are in it, have a lawyer check. ✅ For what you received before September 18, 2026, the rule considers only two things: (a) public cash assistance for income maintenance (SSI, TANF cash, and state, tribal, territorial or local general-assistance cash) and (b) long-term institutionalization at government expense. Anything outside those two is not counted — that is written into the rule itself and has not changed. But if you did receive (a) or (b) before that date, those are considered; have an attorney look at your specific situation. (This is in the rule itself: it applies only going forward — DHS "will only consider the receipt of public cash assistance for income maintenance and long-term institutionalization at government expense before the effective date".) And if this assessment does apply to you — from September 18, 2026 onwards, things change — means-tested public benefits received on or after that day - that is, the public benefits that look at your income or assets when you apply - and for example SNAP, Medicaid, CHIP and WIC, but not limited to these, because the rule names a whole category rather than a list, and not limited to federal programs either - state, territorial, Tribal and local ones count too (verbatim: "Federal, State, territorial, Tribal, and local programs that provide means-tested public benefits"); if you are not sure whether the one you receive counts, ask a licensed immigration attorney - may be weighed as one of the factors (the rule "will consider the receipt of any means tested public benefits on or after that date"). ✅ It is one factor among many, not an automatic denial. The rule requires each case to be weighed on all of its circumstances. How much weight any one of them carries has not been published — USCIS has not issued its operating guidance. We have not verified it; that is not the same as saying it has changed. If you are applying for a visa abroad, or entering at a port of entry: the above describes USCIS (applications filed inside the United States). The rule itself notes that CBP at a port of entry may consider different information; how consulates abroad apply it, we have not verified. The one exception: Medicaid that pays for long-term institutional care (a long-term stay in a nursing facility or mental-health institution at government expense) DOES count. Everyday doctor visits, hospital care, prescriptions, and home- and community-based care are not this exception. The exemptions are not "a few categories" — the regulation lists twenty-nine of them. 8 CFR 212.23(a) opens: "The public charge ground of inadmissibility under section 212(a)(4) of the Act does not apply … to the following categories of aliens," and then runs (1) through (29). Among those most relevant to readers of this site: refugees (1); asylees (2); Cuban and Haitian entrants (5); Cuban Adjustment Act applicants (6); NACARA (7); Special Immigrant Juveniles (10); Temporary Protected Status (12); T nonimmigrants (17) and (18); U nonimmigrants (19); VAWA self-petitioners (20); battered spouses and children who are qualified aliens under PRWORA § 431(c) (21); Afghan and Iraqi interpreters (4); nationals of Vietnam, Cambodia and Laos (25). Category (29) has to be read along with the rest, and it is the one most easily missed: "Any other categories of aliens exempt under any other law from the public charge ground of inadmissibility provisions under section 212(a)(4) of the Act." ⇒ "I am not in the categories listed above" does not mean "I am not exempt." The full list of 29 is at 8 CFR 212.23(a). That regulation is scheduled for removal on September 18, 2026 (91 FR 45477); on that date this whole block closes rather than continuing to show old text — but the statutory exemptions themselves come from their own laws and do not disappear with it. Whether your case falls within one is a question for a licensed immigration attorney. These exemptions do not disappear with that list: in the rescission rule of July 20, 2026 DHS says so itself — "Although DHS is removing the regulation listing exemptions, the statutory exemptions created by Congress for certain Cuban and Haitian applicants for adjustment of status continue to exist." Note the scope of that sentence: it is DHS responding to a comment about Cuban and Haitian applicants, and it covers only those two groups. Each of the 29 categories rests on its own statute, which the regulation merely collected in one place - and that is why the list does not vanish with the regulation. This is information only, not immigration, legal, or tax advice. Public charge and your personal status are complex — consult a licensed immigration attorney. We never tell you whether you "will" or "won't" be affected.
How do I apply for Medicaid in Hawaii?
Before converting any of the percentages above into dollars, note something specific to Hawaii: the federal poverty guideline is issued separately for Hawaii and is higher than for the 48 contiguous states. So any dollar threshold calculated from mainland figures is wrong here — and wrong in the direction that makes people who do qualify believe they are over the line. We give no dollar figures in this cell; use the income standard chart Med-QUEST publishes for the current year. How to apply: online at mybenefits.hawaii.gov (Med-QUEST's KOLEA system), or in person with a Med-QUEST Community Partner, a route the agency itself lists in its COFA notice. Language: Med-QUEST's COFA notice is itself published in COFA languages including Marshallese and Kosraean, not only English. Phone: the notice gives 808-524-3370 (Oʻahu) and 1-800-316-8005 (Neighbor Islands). ⚠️ A different language version on the same page shows numbers that do not match these — if one does not connect, try the other, or take the current number from the Med-QUEST home page. Something with a date already on it, and it will affect a lot of people — read it now. From Med-QUEST's own page: · When: "Starting on January 1, 2027"; · Why: "Congress passed a Bill (HR1) that President Trump signed into law on 7/4/25 that is requiring Medicaid programs to change eligibility rules for some adults."; · Who: "These changes only impact adults between 19-64 who are not Blind, Disabled or Pregnant." · What changes: (1) "eligibility renewals will happen every six months instead of once per year"; (2) to keep coverage, this group of adults will need to show that they are working or volunteering at least 80 hours per month, or earning at least $580 per month, or enrolled at least half-time in an educational program. · The agency adds: "More details will be available by July 2026." Med-QUEST also sets out what you can do now, and it is worth doing: (1) set up your online account (Med-QUEST and mybenefits.hawaii.gov) — in the agency's words, this is "the BEST way to ensure Med-QUEST has the information it needs to help you stay enrolled"; (2) if you have no payslip but do have proof of $580 a month, keep that evidence; (3) if you are enrolled at least half-time, ask your school for official proof of enrolment. All three can be done before January 1, 2027 — and they are exactly what you will be asked for then. Why this cell carries no structured "work requirement" module: that module requires one parameter — how many days you have to respond after a notice — and Hawaii has not published that number yet. Our rule is that an unverified field is omitted whole rather than filled with "usually about X days." Check the official page again after mid-2026 (the agency says details arrive in July 2026). Policies can change — always check the latest official information. https://medquest.hawaii.gov/
Official sources
- 8 U.S. Code § 1612 - Limited eligibility of qualified aliens for certain Federal programs | U.S. Code | US Law | LII / Legal Information Institute (Opens in a new tab)
Cornell Law School — Legal Information Institute (LII) · checked 2026-08-24 · This document states no effective date
- "Congress has restored Medicaid eligibility for citizens from one of the Compact of Free Association (COFA) Nations residing in the United States." — Hawaii Med-QUEST。逐字:"Effective 12/27/2020, Hawaii residents who are citizens of one of the COFA Nations will have access to Medicaid coverage." · "While Hawai'i has continued to provide coverage to eligible children and pregnant women and has used State-only funds to cover those who are 65 and over, blind, or disabled, this new law restores federal funding and support of Medicaid for all COFA citizens who reside in the U.S." 🌟 该页同时以马绍尔语、科斯雷语等 COFA 语言发布。🔴 页内不同语言版本给出的电话号码互不一致(马绍尔语版 808-524-3370 / 1-800-316-8005;科斯雷语版作 808-525-3370 / 1-800-3005),已在正文如实提示。 (Opens in a new tab)
State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-07 · This document states no effective date
- FAQ (Opens in a new tab)
State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-23 · This document states no effective date
- "Changes coming to Med-QUEST Eligibility for Adults!" — Hawaii Med-QUEST。逐字:When = "Starting on January 1, 2027";Why = "Congress passed a Bill (HR1) that President Trump signed into law on 7/4/25 that is requiring Medicaid programs to change eligibility rules for some adults.";Who = "These changes only impact adults between 19-64 who are not Blind, Disabled or Pregnant.";"eligibility renewals will happen every six months instead of once per year";"this adult group will need to demonstrate that they are either working or volunteering at least 80 hours per month or earning a minimum of $580 per month or are enrolled at least half-time in an educational program.";"More details will be available by July 2026.";准备三条含 "It is fast and easy and is the BEST way to ensure Med-QUEST has the information it needs to help you stay enrolled." 🔴 页面未给出「收到通知后须在几天内回复」 ⇒ workRequirement 模块本轮不出(见 source 说明 ④)。 (Opens in a new tab)
State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-07 · This document states no effective date
- "Medicaid Programs" — Hawaii Med-QUEST(逐项目一句话说明)。🌟 本行引用的一条逐字:"Establishes a State funded medical assistance program for an individual who meets the requirements under the Breast and Cervical Cancer Program except for citizenship status and the eligibility requirements of this chapter." 另含 Medically Needy、Refugee Medical Assistance、Medicare Savings Programs 等条目。🔴 页面未标注自身生效日 → null。 (Opens in a new tab)
State of Hawaii, Department of Human Services — Med-QUEST Division · checked 2026-08-07 · This document states no effective date
Last checked: 2026-08-07
Policies can change — always check the latest official information.
This site is informational only and is not immigration, legal, or tax advice. For public charge and your personal status questions, consult a licensed immigration attorney.