Hawaii Assisted Living & Home Care: Costs and Financial Assistance

Introduction:

This webpage will help Hawaii residents understand assisted living, home care, and adult day care costs on each island. It also discusses the payment options and financial assistance programs available to help in caring for the elderly, whether in residential care, in the community, or in the home.

The programs available here are comprehensive of what is available from the state of Hawaii, but is not comprehensive of what is available from the rest of the continental United States. To find the program that is most suitable to your needs, it’s important to also search for nationwide assistance. You can easily do so by using our Resource Locator Tool.

Did You Know?  The average cost of assisted living in Honolulu can be up to 70% more expensive than in the rest of the Hawaiian Islands.

Hawaii Elder Care Costs for 2018

Assisted Living / Memory Care

The average assisted living cost in 2018 across the state of Hawaii is $4,195. In Honolulu, the monthly average price is higher and is around $5,070. On the island of Maui, in the area of Kahului, less expensive senior living can be found at approximately $2,695/ month. Memory care (for persons with dementias, such as Alzheimer's disease) can increase the monthly costs by $870 - $1,070. This is due to the increased level of supervision and security that is required for these types of patients.

Home Care

On average, in 2018, home care services cost Hawaiian residents $24.75 / hour, regardless of where in the state one resides. The highest and lowest hourly rates found were $18.75 / hour and $30.75 / hour. As opposed to assisted living, the average hourly cost of home care is less expensive in Honolulu ($24.75 / hour) versus Maui ($27.25 / hour). Home health care is another option, and is ideal for those who are in need of minimal medical assistance. The average cost for the state of Hawaii is just slightly over $1.75 / hour more than for home care.

Adult Day Care

Contrary to home care in Hawaii, which is quite expensive, adult day care is much more affordable. Adult day care services in 2018 cost an average of $72 / day. It can be as low as $61 / day for Kahului, Wailuku, and Lahaina residents, and as high as $88 / day for residents of Honolulu. Notably, for the same number of hours, adult day care costs well less than half of what in-home care costs.

 

Financial Assistance Programs

Medicaid Assistance Programs for the Elderly

Medicaid in Hawaii will pay for nursing home care for low-income elderly and frail individuals, as well as for limited personal care assistance. However, unlike most states, elderly Hawaii residents do not have Medicaid Waiver options, which have enrollment caps. Instead, the state has chosen to service the aging through a single Medicaid managed care program called Med QUEST. However, like Waivers, the program offers residents Medicaid funded care outside of nursing homes. These benefits may include adult day care, home health services, personal emergency response systems, adult foster care, and more. Additional details can be found here.

As of 2018, Hawaii states that in order to qualify for Medicaid as a disabled or elderly person, one must be a resident at least 65 years of age, or under 65 and disabled. The monthly income limit is set at $1,605 for an individual, and the asset limit is $2,000. Certain assets are considered exempt, such as the individual’s home (up to $858,000 in value), household appliances/furnishings, wedding/engagement rings, a primary vehicle, and a burial spot. For married couples, the rules change depending on if there is one Medicaid applicant or two. For instance, if only one spouse is applying for Medicaid, a portion of the applicant’s spouse may be transferred to the non-applicant spouse (the community spouse). Non-applicant spouses are also able to retain a higher level of assets. These rules are in place to prevent spousal impoverishment of community spouses. Medicaid eligibility is complex, especially for married couples. It is recommended that persons unsure of their status consult with a professional in advance of applying.

 

State (Non-Medicaid) Assistance Programs

The state of Hawaii offers five Non-Medicaid assistance programs. These programs provide financial assistance for housing or skilled services, as well as foster care, in order to keep the disabled and elderly residents of Hawaii from having to leave their homes and move to more costly nursing facilities. Click on the programs below to get more information on specific benefits and eligibility guidelines.

1) Kupuna Care (KC) - offers multiple in-home and community based benefits, such as adult day care, personal care, home modifications, meal delivery, and transportation assistance.

2) Chore Services Program - offers in-home assistance to help maintain one's home in a safe, livable condition, as well as provides personal care assistance. Other benefits include preparation of meals, laundry, yard work, and shopping. This program allows for consumer self-direction, meaning individuals are able to choose their own service provider, including some family members. 

3) Adult Foster Care Program - formally referred to as the Community Care Foster Family Home (CCFFH) program, in-home and community based assistance in the homes of foster families is provided. Seniors receive 24-hour supervision and nursing home level of care in this environment.

4) Kupuna Caregivers Program - provides financial assistance for unpaid primary caregivers of an elderly family member. The caregiver must also be employed outside of the home. Funds may be used toward a variety of assistance, such as adult day care, meal delivery, respite care, and aid with Activities of Daily Living (ADLs), like bathing, grooming, eating, and mobility.

5) Community Living Program (CLP) - a new program with limited enrollment, CLP is intended to assist in independent living and prevent nursing home placements. Via a monthly budget, program participants may use the funding on a variety of benefits and services, including companion care, durable medical equipment, home modifications, and personal care assistance.

 

Other Financial Options for Care

Many non-profit and federal options also exist that help pay for care, in addition to the Hawaii specific options that are listed here. Our Resource Locator Tool  is invaluable in finding these programs that pay for, or reduce the burden of the cost of care, including loan options and benefits for veterans. To find the program that best suits your needs, it is strongly recommended you use this search option. 

 

Finding Affordable Care in Hawaii

Given the big jump in pricing between Honolulu and the rest of Hawaii, there is good reason to contact multiple providers to find affordable care. Taking into account the difficulties of moving from island to island, one should consider home care services over assisted living or nursing home care in order to find a plan that may be more affordable. To assist families with the process, our organization includes a free service that pairs an individual’s or family’s specific care needs with senior care providers in their price range and in their constrained geographic area. Click here for help in finding affordable care.