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  • Dhs 1100b (rev. 12/2020) Page 1 Of 6 Supplemental Form For ...

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State of Hawaii Department of Human Services MedQUEST DivisionApplication Date: Date Sent: Due Date: Supplemental Form for Individuals Applying for Coverage on the basis of Age, Blindness or Disability.

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Who is eligible for Hawaii Quest? Household Size*Maximum Income Level (Per Year)1$16,7702$22,6803$28,5904$34,5004 more rows

In 2023, the Medically Needy Income Limit (MNIL) in HI is $469 / month for an individual and $632 / month for a couple.

In 2023, the asset limit is $2,000 for a single applicant. For married couples, with both spouses as applicants, the asset limit is $3,000. When only one spouse is an applicant, the assets of both the applicant and non-applicant spouse are still limited.

Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Eligibility limits for single adults without dependent children are presented as a percentage of the 2023 FPL for an individual, which is $14,580.

This may include paying for overdue medical bills, prescription drugs, private health insurance, and medical expenses that Medicaid does not cover. In 2023, the Medically Needy Income Limit (MNIL) in HI is $469 / month for an individual and $632 / month for a couple.

It should be noted that Hawaii has higher Federal Poverty Level limits than do the other states, with the exception of Alaska. In dollar terms, for March 2022-February 2023, an applicant cannot have more than $1,303 per month ($15,636 per year) in income.

A non-applicant spouse who already has a monthly income of $3,715.50 or more is not entitled to a MMMNA / Spousal Income Allowance. In 2023, the asset limit is $2,000 for a single applicant. For married couples, with both spouses as applicants, the asset limit is $3,000.

Med-QUEST Division was established in 1994 to administer the State's Medicaid program under title XIX of the Social Security Act. Throughout the years, the Medicaid program has changed from only Fee-For-Services (FFS) to a combination of Managed Care and FFS delivery system.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232