How to Get a Hawaii Medical Cannabis Card: Eligibility, Costs and Application Steps
Hawaii’s medical cannabis program, established in 2000, remains the state’s legal pathway for patients who need cannabis for a qualifying medical condition. To participate, patients must receive a certification from an eligible Hawaii physician or advanced practice registered nurse, register with the state Department of Health, and obtain a 329 medical cannabis card before purchasing or using cannabis under the program.
The program continues to serve tens of thousands of residents. The Hawaii Department of Health reported 29,226 valid in-state patients as of July 31, 2026.
Who qualifies for a Hawaii medical cannabis card?
Patients may qualify if they have a condition recognized under Hawaii law, including:
- Amyotrophic lateral sclerosis (ALS)
- Cancer
- Glaucoma
- Lupus
- Epilepsy
- Multiple sclerosis
- Rheumatoid arthritis
- HIV or AIDS
- Post-traumatic stress disorder (PTSD)
Patients may also qualify when a medical condition—or its treatment—causes cachexia or wasting syndrome, severe pain, severe nausea, seizures, or severe and persistent muscle spasms. Hawaii’s current qualifying-condition guidance also allows a primary treating physician or APRN to certify a patient for another medical condition when the provider determines that cannabis’s potential benefits are likely to outweigh its health risks. Hospice providers may certify patients receiving hospice care.
A certification requires a bona fide provider-patient relationship. In practical terms, the physician or APRN must have ongoing responsibility for assessing and treating the condition for which cannabis is being recommended. A certification is not the same as a prescription, and a provider’s approval does not authorize medical cannabis use until the Department of Health issues the patient’s 329 registration card.
How to apply
- See an eligible medical provider. The certifying physician must hold a Hawaii medical license and controlled-substance license. An APRN must be licensed in Hawaii and have prescriptive authority.
- Create an online registry account. Patients use the Hawaii Medical Cannabis Registry portal to begin an application.
- Upload identification and required forms. Applicants generally need a valid driver’s license, state identification card, or passport. Caregiver and grow-site forms may also be required.
- Pay the state registration fee. The fee is $38.50 for a one-year registration. Eligible renewal patients may pay $77 for a two-year registration.
- Submit the application to the certifying provider. The provider completes the certification and submits the application to the Department of Health.
- Wait for approval and download the card. The Department says applications are typically processed within three to five business days when complete. Patients must have the 329 card before using medical cannabis legally under the program.
The state fee is separate from the provider’s certification charge. Under Hawaii’s current fee cap, a medical provider may charge no more than three times the Department of Health registration fee for the certification process—up to $105 for a one-year certification or $210 for a two-year certification. Providers must disclose certification and any separate medical-service fees before the evaluation. The Department of Health’s fee guidance explains the current limits.
Caregivers and home cultivation
A primary caregiver must generally be at least 18 years old and may be designated to manage a patient’s medical cannabis. Hawaii law generally limits a patient to one primary caregiver at a time, with special rules for parents, guardians, or people with legal custody of minors or adults who lack legal capacity.
A patient or registered caregiver may cultivate cannabis for the patient if the grow site is identified on the valid 329 card. Hawaii defines an adequate supply as no more than four ounces of usable cannabis and 10 plants, whether mature or immature, jointly possessed by the patient and primary caregiver. Cannabis may be grown only at an approved location, such as the patient’s or caregiver’s residence or another site owned or controlled by one of them. The state’s cultivation rules provide additional requirements.
Buying medical cannabis in Hawaii
Hawaii licenses medical cannabis dispensaries on Hawaii Island, Maui, Oahu, and Kauai. Patients must present a valid 329 card and government-issued identification when purchasing cannabis. The Department of Health maintains a directory of licensed dispensaries and their websites.
Medical cannabis cannot be used or possessed in public places, including public parks, beaches, schools, public transportation, and moving vehicles. Driving under the influence of cannabis is illegal. Patients and caregivers should also remember that cannabis remains illegal under federal law, including on federal property and when transported through airports or across state lines.
Visitors with medical cannabis cards
Visitors from another U.S. state or territory may apply for a temporary Hawaii medical cannabis registration. Hawaii accepts valid medical cannabis cards issued by another state or territory—not cards issued only by private certification services. An approved out-of-state registration is valid for up to 60 days and may be renewed once during the calendar year for an additional period of up to 60 days. The application fee is $49.50.
Out-of-state applicants must provide a valid home-state identification document, a valid medical cannabis card issued by that state or territory, and documentation showing a qualifying condition recognized by Hawaii. Visitors should apply before traveling because they cannot rely on their home-state card alone to enter a Hawaii dispensary. Hawaii also advises travelers not to bring cannabis through airports or other federal jurisdictions.
Hawaii’s medical cannabis system has expanded since the state first authorized medical use in 2000, but access remains regulated through the 329 registry. Anyone considering an application should confirm the current fees, forms, processing requirements, and travel rules directly with the Department of Health before submitting documents or making travel plans.
