Why Alaska and Hawaii Have Higher Medicare Savings Program Income Limits in 2026

Alaska and Hawaii are the only two states where the Medicare Savings Program (MSP) uses different income limits than the rest of the country — not because of a state policy choice, but because the federal government publishes separate, higher poverty guidelines for both states. In 2026, that means QMB, SLMB, and QI income limits run 25% higher in Alaska and 15% higher in Hawaii than the national baseline.

Why Alaska and Hawaii Get Different Limits

Every year, the U.S. Department of Health and Human Services (HHS) publishes the Federal Poverty Guidelines that Medicaid programs use to set income limits, including MSP. Because the cost of living in Alaska and Hawaii is significantly higher than in the contiguous 48 states, HHS publishes two additional poverty guideline tables specifically for those states (HHS Office of the Assistant Secretary for Planning and Evaluation, aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines). Alaska's guideline runs about 25% above the baseline; Hawaii's runs about 15% above it. States build these figures directly into their MSP income limits.

Alaska's 2026 MSP Income Limits

These limits already include Alaska's 25% adjustment and the $20 general income disregard.

• QMB: $1,683/month (individual) or $2,275/month (married couple)
• SLMB: $2,015/month (individual) or $2,725/month (married couple)
• QI: $2,265/month (individual) or $3,064/month (married couple)

Alaska still applies the standard asset test — $9,950 (individual) or $14,910 (couple). The FPL adjustment affects income limits only; it does not change the asset limit.

Hawaii's 2026 MSP Income Limits

These limits already include Hawaii's 15% adjustment and the $20 general income disregard.

• QMB: $1,550/month (individual) or $2,095/month (married couple)
• SLMB: $1,856/month (individual) or $2,509/month (married couple)
• QI: $2,086/month (individual) or $2,821/month (married couple)

Hawaii also keeps the standard asset test — $9,950 (individual) or $14,910 (couple).

How to Apply

In Alaska, apply through the Division of Senior and Disabilities Services (health.alaska.gov/dsds) or call 1-800-770-5650. In Hawaii, apply through Med-QUEST (medquest.hawaii.gov) or call 1-800-316-8005. Both states generally process applications within 45 days, with benefits often retroactive to your application month.

The Bottom Line

If you live in Alaska or Hawaii, don't assume the national income limits you might see quoted elsewhere apply to you — your real limits are higher. Many people in both states self-disqualify based on the wrong numbers and never apply.

Our free eligibility checker automatically applies the correct Alaska or Hawaii income limits — check your eligibility now and see which MSP tier you qualify for.

See the full Alaska Medicare Savings Program page for more detail.

See the full Hawaii Medicare Savings Program page for more detail.

Disclaimer: Income limits are reviewed and updated annually each January after HHS publishes new poverty guidelines. Confirm current figures with your state Medicaid office or a free SHIP counselor before applying.