Home Care in Hawaii

Genworth’s 2021 Cost of Care Survey shows that the average in-home care and home health care rate in Hawaii is $5,720 per month. In-home care includes non-medical assistance with personal care, light housework and companionship, and home health care involves medical and rehabilitation services delivered by a licensed medical professional.

With an average monthly rate of $5,720, home care costs in Hawaii match the rates in Alaska and are higher than the national average, $4,957. By comparison, rates in California ($6,101) are higher, and seniors in Nevada ($5,148) and Arizona ($5,339) pay less for home care than Hawaiian seniors do.

In terms of home health care costs, Hawaii’s monthly average of $5,720 also matches the average rate in Alaska and is $572 above the national average of $5,148. In California, the same type of care costs around $6,101 per month. This care type costs $5,148 in Nevada and $5,434 in Arizona.

Hawaii’s senior care costs start at an average of $1,625 per month for adult day health care services. Assisted living care runs about $5,375 per month, and the average in-home and home health care rate is $5,720. Nursing home care, which includes around-the-clock medical care in a specialized residential facility, is by far the costliest option, with an average cost of $12,501 per month.

Home care services are covered through Med-QUEST, which is Hawaii’s integrated elderly, blind and disabled Medicaid program.

Med-QUEST Programs in Hawaii

Eligible seniors can use Med-QUEST benefits to access a range of community-based services designed to help older adults remain safe and independent and avoid placement in an institutional setting such as a nursing home.

Med-QUEST covers services such as:

• Home care
• Personal care
• Respite care
• Adult day care
• Chore services
• Home health care
• Meal delivery
• Non-medical transportation
• Skilled intermittent nursing care
• Wearable medical alert systems
• Durable and disposable medical equipment

To receive Med-QUEST home care services, you need to be a Medicaid beneficiary. You also need to undergo an assessment to determine if home care services will meet your specific care needs.

Medicaid eligibility is based on your income, your countable assets and your citizenship status. To qualify for regular Medicaid, you can earn up to $1,303 per month, or $15,636 per year, if you live alone. If you live with a spouse or common-law partner and you’re both applying for Medicaid, your combined annual income can be no greater than $21,060 per year.

In terms of countable assets, which includes cash, bonds and all real estate except your principal residence, you can have up to $2,000 per person.

There are three ways to apply for Medicaid in Hawaii.

You can either:

• Download the Med-QUEST application form from the Department of Human Services Website, and mail it to your nearest Med-QUEST office
• Complete an online application at www.mybenefits.hawaii.gov
• Dial the Hawaii Connector Call Center at (877) 628-5076 to complete your application over the phone, which takes about 40 minutes

To locate a Med-QUEST office that accepts mailed-in Medicaid applications, phone the Hawaii Connection Call Center.

What Information You Will Need

Medicaid enrollment is contingent on financial need, citizenship status and place of residence. To verify your eligibility for Hawaii MedQuest benefits, you’ll be asked to demonstrate the following:

• That you’re either a U.S. citizen or a permanent resident or you hold a naturalization certificate or refugee travel document
• That you have a valid Social Security number
• Your date of birth, verified through an approved piece of government-issued ID
• That you meet current income limits, as shown on your latest federal income tax form
• The total value of all your countable assets, including any cash, stocks, bonds or other investments that you own
• How much life and burial insurance you have

In Hawaii, new residents can apply for Medicaid as soon as they arrive, as long as they plan to make Hawaii their permanent home.

How to Get Help Applying for Medicaid

If you need assistance with your Medicaid application, you can contact one of the following programs for help.

Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.

Below is an overview of some of the services typically covered by Medicare for those who are eligible:

• Physical Therapy: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), and to treat ongoing conditions such as arthritis. Additionally, physical therapy is often provided in the home to help seniors recover from surgeries and procedures, such as a knee or hip replacement.
• Nursing Care: Licensed nurses can provide a number of medical services (such as wound care, changing feeding tubes, etc.) for those who need medical care, but don’t need to stay in a hospital full-time.
• Occupational Therapy: Occupational therapy is designed to help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, etc., and providers can travel to your home if needed.
• Speech Therapy: Seniors can lose the ability to adequately communicate for many reasons, and speech therapists are there to help seniors regain the ability to communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets and teaching special techniques to swallow safely.

As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.

Read our guide to Medicare and Home Care Coverage for more information.

While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.

Hawaiian seniors who want to age in place in their own homes can access support through the state’s many free and low-cost resources geared toward seniors.

In accordance with COVID-19 vaccination mandates issued by the Centers for Medicare & Medicaid Services, all home health care workers in Hawaii who deliver Medicaid and/or Medicare-funded services must be fully vaccinated against COVID-19.

The CMS COVID-19 mandate states that all Hawaii health care workers to whom the mandate applies to must have at least one dose of an approved, single-shot vaccine or two doses of a two-dose vaccine, by February 2022.

Some limited exemptions do apply to the CMS vaccination rule, but these exemptions are quite rare. Exemptions are available for health care workers who cannot complete their full course of COVID-19 vaccination because they had a severe allergic reaction to their first dose and those who need to delay vaccination due to recent COVID-19 infection.

Hawaii’s home care providers are regulated under Chapter 11-700 of Hawaii’s Administrative Rules. The state’s Department of Health, Office of Health Care Assurance licenses and inspects home care agencies in Hawaii. You can verify the license status of home care agencies in Hawaii online through the government Home Care Agency Licensing website.

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.

Download PDF Here

Learn More About Home Care in Hawaii’s Top Cities

• Honolulu