Hawaii QUEST Integration (QI) Long-Term Services and Supports
QUEST Integration is Hawaii’s Medicaid managed care program. For older adults and people with disabilities who need long-term care, it covers nursing facility care and home and community-based services through the member’s health plan. For the wider picture, see our Hawaii Long-Term Care Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
At a glance
| Item | Details |
|---|---|
| Type of program | Managed long-term services and supports (managed care) |
| Who runs it | Hawaii Department of Human Services, Med-QUEST Division, through QUEST Integration health plans |
| Age | Any age (older adults and people with disabilities for LTSS) |
| Care need | Nursing facility level of care, or at risk |
| Hawaii 2026 income rule (long-term care) | No fixed cap for nursing home care (income goes toward the cost of care) |
| Hawaii 2026 asset limit (single applicant) | $2,000 |
| Waiting list | Some home and community services can have limits |
QUEST Integration LTSS in brief
To sum up, Hawaii Department of Human Services, Med-QUEST Division, through QUEST Integration health plans oversees QUEST Integration LTSS. It serves any age (older adults and people with disabilities for LTSS), and the care requirement is: Nursing facility level of care, or at risk. As for waiting: Some home and community services can have limits. The sections below repeat these points with more detail, and our state guide covers the Hawaii rules that apply to every long-term care program. Other Hawaii programs, and general guides on care at home, are linked at the end of this page for comparison with QUEST Integration LTSS.
What the program is
All Medicaid members in Hawaii are enrolled in QUEST Integration health plans. When a member needs long-term care, the plan’s service coordinator assesses them. Members who meet a nursing facility level of care can choose home and community-based services (at home, in community care foster family homes, expanded adult residential care homes or assisted living) or nursing facility care. Members assessed as at risk of deteriorating to that level can receive some services too.
In a managed long-term services and supports program, the state pays a health plan a monthly amount to arrange all of a member’s long-term care, at home, in assisted living or in a nursing home. Members pick a plan where more than one is available, and that plan’s care coordinator manages the plan of care. The plan must follow the state’s eligibility and coverage rules, and members keep the right to appeal decisions they disagree with. See Managed long-term services and supports.
Who qualifies in 2026
A person generally must meet all of these conditions:
- Is enrolled in Hawaii Medicaid (QUEST Integration)
- Meets a nursing facility level of care, or is at risk (for limited services)
- Qualifies for full Medicaid under Hawaii’s long-term care financial rules (see the money test below)
- Lives in Hawaii and is a U.S. citizen or qualified non-citizen
Financial eligibility. QUEST Integration LTSS requires full Medicaid eligibility under Hawaii’s long-term care financial rules. The income and asset figures in the table above are Hawaii’s 2026 Long-Term Care Medicaid figures from our state guide. The home (up to the equity limit, when the person or a spouse lives there or plans to return), one vehicle, belongings and a small burial fund are generally not counted by Med-QUEST. When one spouse applies for QUEST Integration LTSS and the other stays at home, the spouse at home keeps a protected share of the couple’s assets and may receive part of the applicant’s income. See Spousal impoverishment rules.
How the care assessment works. Med-QUEST’s assessment covers daily activities, from bathing and dressing to toileting and medications, plus memory and safety. A nurse or social worker working with Med-QUEST usually does it in person, wherever the person is living. Have a relative present to describe the hard days, and keep a medication and diagnosis list handy. See Nursing home level of care and Activities of daily living.
What services it can pay for
The plan of care decides which services are used. QUEST Integration LTSS can cover:
- Nursing facility care
- Personal assistance and chore
- Adult day care and adult day health
- Home-delivered meals
- Respite
- Personal emergency response
- Community care foster family home services
- Expanded adult residential care home services
- Assisted living services
- Self-direction of some services
No program pays for everything. QUEST Integration LTSS services are based on assessed need, and a family caregiver who is already helping is usually counted when the plan is written. If needs change, ask for a new assessment.
How to apply
Getting QUEST Integration LTSS means passing a money test and a care test. Step by step:
- Apply for Hawaii Medicaid with Med-QUEST if not already enrolled.
- Request a long-term care assessment from your QUEST Integration plan.
- The plan’s service coordinator completes the assessment.
- Choose the setting and services; the plan arranges them.
For the paperwork, use our documents checklist before applying for QUEST Integration LTSS; Applying for a waiver explains the general process.
Waiting lists
Because QI LTSS is managed care, there is no separate waiver waitlist. Availability of specific settings, such as foster family homes, can vary.
General advice is in Waiver waiting lists.
How it relates to nursing home Medicaid
QI covers nursing homes and community care under one plan. Hawaii’s nursing home income rule has no fixed cap (income goes toward the cost of care), and the asset limit is in our state guide.
Where the nursing home rules still apply. Hawaii’s financial rules for QUEST Integration LTSS track the nursing home rules closely. Gifts and below-value transfers in the five-year look-back can trigger a penalty period for home care as well as nursing home care. Estate recovery also applies: the state can seek repayment from the estate of a person who received long-term care services after age 55. Under QUEST Integration LTSS, income above an allowance may go toward the cost of care each month.
Personal needs allowance. If the person does move to a nursing home, Hawaii’s 2026 personal needs allowance is $75 a month. Most of the rest of their income goes toward the cost of care. Our state guide covers the nursing home rules in detail.
Tips for families
- Start early. If there is a waiting list or a slow assessment, the clock usually starts when you ask, not when the crisis comes.
- Keep a paper trail: copies of forms and notices, plus the names and dates of every call to Med-QUEST.
- Watch the deadlines on notices. A denial or cut can be appealed through a fair hearing, and a timely request can keep services going meanwhile.
- Tell Med-QUEST about changes in money, address or household as they happen.
- Plan for renewals. Medicaid and the care assessment are both renewed, usually once a year. See Renewals.
- Protect a spouse at home. Spousal protections must be claimed; a certified Medicaid planner or legal aid office can explain them for your family.
Common questions
Can Medicaid pay for a foster family home? Yes, QI can pay for care in a community care foster family home. The resident pays room and board.
Do I need a new plan? No. Long-term care is part of your QI plan.
Can family be paid? Self-directed options are available for some services.
Related pages
- Hawaii Long-Term Care Medicaid guide
- Managed long-term services and supports
- Three kinds of Long-Term Care Medicaid
- PACE programs
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.