Having a baby in Hawaii

Program

Med-QUEST

Agency

Hawaii Department of Human Services, Med-QUEST Division

Medicaid limit

196% of the poverty level

12-month postpartum coverage since

April 1, 2022

Presumptive eligibility

Not for the pregnancy group, but hospitals can still make presumptive determinations.

Hospitals in every state may make presumptive eligibility determinations.

Hawaii has no paid leave to bond, but Temporary Disability Insurance pays 58% of wages (max $871 a week in 2026) for up to 26 weeks while you recover from pregnancy and childbirth.

Program

Hawaii Temporary Disability Insurance (TDI): employer-provided disability pay for off-the-job illness or injury, including pregnancy and childbirth. Hawaii has no state paid family or bonding leave.

Legal maximum, your own health

26 weeks

Pay

TDI only (statutory plan): 58% of your average weekly wage, rounded up to the next dollar, max $871/week in 2026, for up to 26 weeks while a doctor certifies you can't work, including pregnancy and childbirth recovery. Approved employer plans may pay differently. No paid bonding leave.

Job protection

TDI itself does not protect your job. The Hawaii Family Leave Law (HRS ch. 398) gives up to 4 weeks a year of job-protected family leave, including for the birth of a child, if your employer has 100+ employees in Hawaii and you've worked there 6 consecutive months. That leave is unpaid unless you use accrued leave, and you can use up to 10 days of accrued sick leave for it. Federal FMLA (50+ employees, 12 months/1,250 hours) may also apply.

Who qualifies

To get TDI you must have at least 14 weeks of Hawaii employment in which you were paid for 20+ hours, have earned at least $400 in the 52 weeks before the disability, and be in current employment (or have left work no more than 2 weeks before the disability began). Your disability, including pregnancy, must be certified by a provider. Employers must provide the coverage; some workers (e.g., federal employees, commission-only real estate and insurance agents) are excluded.

Notes

Hawaii is TDI-only: pregnancy and childbirth recovery are covered as a disability, but there is no paid leave to bond with a baby or care for family. TDI is not a state-run fund: employers buy it from an authorized insurer, self-insure, or provide equal or better sick leave under a bargaining agreement. There's no online application. Ask your employer for Form TDI-45 (DLIR says it isn't available online), have your provider certify Part C, and file within 90 days of the disability starting; claims more than 26 weeks late get nothing. Employees can be charged up to half the premium, capped at 0.5% of weekly wages ($7.50/week in 2026). Hawaii's TDI law was enacted in 1969. Some sources say the 7-day wait is shorter if you're hospitalized; DLIR's own pages state only the 7-day rule. DLIR gives no typical pregnancy-recovery length. The 26 weeks is the statutory maximum per benefit year for any covered disability.

The weekly maximum is a ceiling, not a typical benefit. Checked October 2026. Amounts usually change January 1 and July 1, so confirm with the state before you plan.

In Hawaii, the Med-QUEST health plans we checked list lactation counseling as a covered pregnancy benefit.

Notes

Four of the five QUEST Integration plans list lactation or breastfeeding support as a covered pregnancy-related benefit: HMSA and UnitedHealthcare (at least six months), Kaiser Permanente (up to six months, extendable with prior approval, 2023 handbook) and AlohaCare; the 'Ohana Health Plan handbook was not checked. These handbooks do not say which provider types may bill or which codes are used, and no Med-QUEST memo on lactation was found; S9443 is not on the June 2026 FFS fee schedule. Status rests on plan member handbooks, not a state policy document.

Hawaii Medicaid member information

Full-time provider prices before any subsidy, in 2022 dollars. The national median for center infant care was $12,647 a year.