Memory Care in Hawaii
Memory care is a valuable resource for seniors and families in Hawaii. In a state with 1.44 million residents, approximately 20% of the population is aged 65 or older. According to the Alzheimer’s Association, about 29,000 seniors in Hawaii have been diagnosed with the disease, and this number is expected to increase by 30% by 2025. Even with memory care and effective health care services, Alzheimer’s disease is the state’s sixth-leading cause of death.
The median cost of memory care in Hawaii is $6,719. Although this is higher than the national average, it’s lower than many cities, especially those on the West Coast. Older residents benefit from a pleasant year-round climate, with a nearly perfect comfort index of 8.7 out of 10. Seniors who have health concerns can enjoy a high quality of life, thanks to geriatric care specialists and long-term care facilities that are equipped to manage age-related conditions, such as dementia.
Memory care can either be offered on its own in a community designed especially for those with dementia or Alzheimer’s, or, more often, it’s provided as a service in a separate wing of an assisted living facility. Memory care programs are designed specifically for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer’s or dementia.
This guide provides an overview of memory care costs and financial assistance programs in Hawaii. You’ll also find a directory of free and low-cost resources for seniors and their families.
The Cost of Memory Care in Hawaii
Note: No official price estimates are available for memory care services. As memory care typically costs 20-30% more than standard assisted living services, we’ve added 25% to the assisted living cost estimates in Genworth Financial’s 2021 Cost of Care Survey to estimate memory care costs.
In Hawaii, seniors pay an average of $6,719 per month for memory care services, which is $1,094 higher than the national average. This is also higher than many West Coast states, including California at $6,563 and Oregon at $6,306. Memory care prices in Hawaii are $781 lower than in Washington, where seniors pay $7,500, and $1,719 higher than in Arizona, where memory care costs an average of $5,000 per month.
Memory care prices vary significantly, depending on the island or metropolitan area that you’re considering. Prices in Honolulu are on par with the state median of $6,719. On Maui, which includes the cities of Kahului, Lahaina and Wailuku, the median drops to $4,781, representing a 29% savings. Honolulu’s prices are slightly higher than West Coast cities, such as Portland, Oregon, at $6,219 and Los Angeles, California, at $6,563. Rates in Honolulu are also significantly cheaper than cities, such as San Francisco, California, at $7,899 and Seattle, Washington, where seniors pay $8,438. Memory care in Kahului is about $188 cheaper than in Phoenix, Arizona, where the average is $4,969 per month.
Seniors who require memory care or personal assistance can receive these services in a long-term care facility or community-based setting. Adult day health care is the most affordable option, with a cost of $1,625 per month. Assisted living costs $5,375 per month, about 20% less than memory care. In-home care averages $5,720 for both homemaker and home health aide services. While this is a substantial expense, it’s significantly lower than nursing home services, which cost $12,501 per month for a semiprivate room and $14,113 for private accommodations.
Does Medicaid Cover Memory Care in Hawaii?
Note: For the purposes of this guide, when we say “Memory Care” we are referring to memory care provided in a “social setting,” such as an Assisted Living Facility. This is the most common way to receive Memory Care and is the best fit for all but the frailest seniors. Sometimes the actual service of memory care can be provided in a Nursing Home (“medical setting”), so the financial assistance options will be very different. To learn more about the financial assistance options available for memory care provided in a nursing home, read our guide to Nursing Home Care in Hawaii.
Hawaii provides robust coverage for residential care, medical services and related supports through Med-QUEST. The state follows a managed care model, which means eligible individuals can sign up for an approved plan administered by one of several commercial health insurance providers. All standard benefits are included at no cost. Once enrolled, beneficiaries can change plans during their annual enrollment period.
What Memory Care Services Are Covered by Medicaid in Hawaii?
Med-QUEST covers a wide range of medical and long-term care services, including primary and acute care, prescription medications, behavioral care and long-term services and supports, such as those provided in assisted living. Here are some of the most relevant services for seniors who require memory care:
- Adult day health care
- Assisted living services
- Basic or advanced personal assistance
- Non-medical transportation
- Respite care for family caregivers
- Emergency response systems
- Medical equipment and supplies
- Home-delivered meals
- Housekeeping
- Home maintenance
- Skilled nursing
How to Know if You’re Eligible for Medicaid in Hawaii
Medicaid eligibility is based on a variety of medical and financial criteria, as well as your age and health. Individuals who require a nursing home level of care but prefer to live in a residential setting, including their own home or a memory care unit, can have up to $1,235 in individual monthly income. Assets are typically capped at $2,000, excluding a home, vehicle and other essentials. If you have significant medical bills, this can help to reduce your qualifying income. Your spouse may also be entitled to a monthly personal needs allowance. Learn more about these limits below.
2022 Medicaid Income Limits for Seniors in Hawaii
Income Limits*
Asset Limits
Single Applicant
$14,820
$2,000
Two-Person Household
(One Spouse Applying)
$14,820 for applicant
$2,000 for applicant
$137,400 for non-applicant
Two-Person Household
(Both Spouses Applying)
$29,640
$2,000
*Per year
In addition to meeting these financial requirements, individuals must be:
- Aged 65 or older or have a disability
- A permanent Hawaii resident
- Certified as needing a nursing home level of care
How to Apply for Medicaid in Hawaii
There are three ways to apply for Med-QUEST managed care. Choose the one that’s most convenient for you. To apply for Med-QUEST, you can:
- Call the Med-QUEST helpline at (877) 628-5076
- Complete a paper application, and mail it to your local Med-QUEST Division Eligibility Office
- Apply online at MyBenefits.Hawaii.gov for faster service
Information You Will Need
- Name
- Date of birth
- Home address
- Social Security number
- Proof of citizenship or immigration
- Household information
- All sources of income
- Tax filing status
- Insurance details
How to Get Help Applying for Medicaid
If you need help applying for Medicaid or want to check your eligibility, contact one of the following organizations for assistance. Application counselors can help you gather documentation whether you’re applying for yourself or a family member. You also have a right to appeal adverse decisions regarding your application or benefits.
Program
Contact
Services Provided
(808) 524–3370 (Oahu)
(800) 316-8005 (Other Islands)
For general inquiries, call the Med-QUEST Customer Services Call Center. Agents can check on your application status, update your personal information, help you enroll in a managed care plan or order a replacement copy of your Medicaid ID card.
(800) 316-8005
Once you're approved from Med-QUEST, the next step is to enroll in an approved health plan. If you have questions about your eligibility or how to sign up with a provider, contact the state's Enrollment Services Section for assistance.
Varies By Location
The Department of Human Services maintains a directory of approved Application Counselors located on Oahu, Hawaii, Kauai and Maui. Counselors are employed by local health centers, legal aid societies and other community service organizations.
(877) 628-5076
If you disagree with a notice or decision, you can contact your local Med-QUEST office for more information. You have a right to file an appeal and request a hearing within 90 days of the date shown on the notice.
(888) 488-7988
(808) 746-3324 (Oahu)
If you're having trouble with your coverage or the services provided, the first step is to contact your health plan. If you still can't reach an agreement, contact the QUEST Integration Ombudsman in your county.
Does Medicare Cover Memory Care in Hawaii?
The short answer is that no, Medicare does not cover the cost of memory care in Hawaii. As was mentioned above, this doesn’t apply to Memory Care received in a Nursing Home. Since it is the most common to receive memory care in a “social setting” (such as an assisted living facility), Medicare won’t be a viable financial assistance option for most seniors who need Memory Care. However, Medicare will still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.
For more information about when Medicare can be used to pay for Memory Care in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Hawaii.
Other Financial Assistance Options for Memory Care in Hawaii
Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Memory Care affordable.
How to Apply
How It Works
Aid and Attendance
Learn more and apply online at va.gov.
Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Memory Care.
Reverse Mortgages
Learn more about your options and how to apply at ftc.gov
If you own a home, you may be able to use a reverse mortgage to help pay for Memory Care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
Long-Term Care (LTC) Insurance
Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.
Seniors who already have long-term care insurance may be able to use it to pay for Memory Care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Memory Care will not typically be eligible to sign up for a LTC insurance policy.
Free and Low-Cost Resources for Seniors in Hawaii
Seniors and families in Hawaii can find a number of free and low-cost memory care resources through government agencies and non-profit groups. The following resources provide information about long-term care, support groups, training programs and caregiver relief, among other services.
Resource
Contact
Services Provided
(800) 272-3900
The Aloha Chapter of the Alzheimer’s Association advocates for seniors and families across the Hawaiian Islands and other outlying areas. It provides information about diagnostic tools and memory loss screenings for those who are concerned about dementia. Educational materials and support groups, including the ALZconnected online community, help families understand the disease and find healthy ways to cope.
(808) 586-4400
Hawaii has four Area Agencies on Aging based in Honolulu, Hawaii County, Maui County and Kauai. These agencies connect residents aged 60 and older to home- and community-based services and federal programs sponsored by the Older Americans Act. Staff can help with in-home assistance, memory care placement, meal deliveries, legal advice and respite care.
(808) 586-0100
The Executive Office on Aging administers state and federal benefits that support older adults and family caregivers. The Healthy Aging Partnership offers evidence-based programs to help older residents increase their health and manage chronic diseases. Hawaii SHIP provides free health insurance counseling for Medicare and related supplements, and Senior Medicare Patrol helps beneficiaries identify and correct billing errors.
(888) 229-2231
Sponsored by the Executive Office on Aging, The Long-Term Care Ombudsman Program engages in outreach and provides confidential consultations to help seniors and families learn more about long-term care, how to choose a facility and ways to pay for care. Staff and volunteer advocates answer questions, investigate complaints and work to ensure residents’ well-being.
(808) 956-5001
The Alzheimer’s Disease Initiative is a federally funded program sponsored by the University of Hawaii Center on Aging. It’s dedicated to training health care professionals and building dementia-friendly communities. Care navigators offer memory care road maps and cognitive health assessments to help patients and families assess their needs and understand their options.
(800) 499-4302
The Legal Aid Society of Hawaii helps low-income residents with civil legal issues, such as estate planning, government benefits, long-term care and guardianship petitions. Residents can take advantage of self-help guides or consult an attorney at their local legal aid office. The organization has offices across the state, including locations on Lanai and Molokai.
Dementia Friends Hawaii is part of a nationwide initiative dedicated to changing the way people think and act when it comes to dementia. One-hour information sessions offered at senior centers and other community-based organizations educate the public about the disease and ways to enhance seniors’ quality of life.
COVID-19 Rules for Memory Care in Hawaii
The following information is based on research done on several government websites, including health.hawaii.gov/coronavirusdisease2019. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/7/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.
Visitation Policies
Are loved ones allowed to visit to provide emotional support?
Are relatives allowed to visit for end-of-life care?
Are residents required to quarantine after visiting with a loved one?
Are visitors required to wear PPE (including masks) in order to visit residents?
Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?
Are visitors checked for elevated temperatures?
Are visitors required to answer questions about health, travel, and potential virus contact?
Outings & Social Activities
Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?
Are residents who leave required to quarantine when they return?
Are senior living communities required to cancel all group outings?
Are residents allowed to eat meals together in a common area?
Are residents allowed to gather in common areas for group activites?
COVID-19 Safety Measures for Staff and Residents
Are staff members regularly required to do a temperature check?
Are staff members regularly tested for COVID-19?
Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?
Are residents regularly screened for COVID-19 symptoms?
Are residents regularly checked for elevated temperatures?
Are residents regularly tested for COVID-19?
Memory Care Laws and Regulations in Hawaii
Hawaii residential care facilities that offer memory care services are licensed, inspected and regulated by Hawaii’s Department of Health, Office of Health Care Assurance. The OHCA does not have specific memory care licensing requirements, although the requirements for assisted living facilities, adult residential care homes and expanded adult residential care homes cover facilities that offer memory care services.
Scope of Care
Assisted living facilities must provide residents with ongoing health monitoring, medication management, 24/7 supervision and nonmedical care. These facilities may not admit or retain anyone who presents a danger to themselves or others due to aggressive behavior, or those who require around-the-clock skilled nursing care.
Care Plan Requirements
All residential facilities must conduct a comprehensive assessment of each resident upon admission, and use this assessment to prepare a personalized care plan that accurately reflects the needs and preferences of the resident. This plan must be reviewed and updated on a regular basis.
Medication Management Requirements
Assistance with the self-administration of medications can be provided at the direction of a registered nurse. All resident medications must be stored under lock and key, and prescriptions must be reviewed by a registered nurse or licensed physician at least once every 90 days. Prescription medications that require injection can only be administered by a registered nurse.
Staff Screening Requirements
Direct care staff and adult volunteers must complete a comprehensive background check through the Hawaii Background Check System (HI BCD). Those with prior convictions or confirmation of abuse are prohibited from working with vulnerable persons, including residents in long-term care facilities.
Staff Training Requirements
Staff must be trained in first aid and CPR, and complete comprehensive orientation prior to commencing work as a caregiver. Staff are also required to take at least six hours of in-service training each year on topics related to senior care and dementia.
Medicaid Coverage
The QUEST Integration program covers memory care costs for eligible beneficiaries who require placement in a residential memory care program, although beneficiaries are responsible for the room and board portion of their care costs.
Reporting Abuse
Anyone who has concerns about the quality of care provided in a long-term care facility should file a report with the Long-Term Care Ombudsman by calling 808-586-7268. Situations that pose an immediate threat to the health and safety of any vulnerable person, including those living in a memory care community, should be reported to the nearest law enforcement agency.
Frequently Asked Questions
How Much Does Memory Care Cost in Hawaii?
The average monthly cost of residential memory care in Hawaii is $5,469, although actual costs may vary between individual service providers.
Does Hawaii Medicaid Pay for Memory Care?
Yes. Hawaii residents who meet the financial criteria for Medicaid coverage and require the level of care normally provided in a skilled nursing facility may be eligible for enrollment in QUEST Integration, a Medicaid home and community-based waiver program that funds memory care services.
What Security Features Are Present in Memory Care Facilities?
60% of people with dementia wander. When combined with memory loss wandering can be exceptionally dangerous, so memory care facilities have a number of anti-wandering security features in place. These features often include security cameras, enclosed outdoor spaces and exterior doors equipped with delayed-egress devices. Some facilities also use a wireless, wearable resident tracking system that uses GPS and Wi-Fi transponders to provide caregivers with real-time updates on the location of each resident.
What Are Activities of Daily Living?
Activities of daily living are basic self-care tasks, such as ambulating, eating, getting dressed and grooming, which are often referred to as ADLs. People who live with memory loss often require assistance with one or more of these activities.
How Many Memory Care Facilities Are in Hawaii?
Hawaii has 20 memory care facilities for seniors who are in need of Alzheimer’s or dementia care and services. The island location and small size of the state mean it has fewer facilities, but seniors and any residents who need this type of care will find some options. Read More
What Types of Services Does Memory Care Provide?
Memory care facilities provide residents with semiprivate or private accommodation, three daily meals plus snacks, and around-the-clock supervision and support. These facilities also provide some assistance with activities of daily living, and recreational and social activities designed to help slow the progression of Alzheimer’s disease. Some memory care communities offer support groups to help family caregivers connect with each other, learn coping strategies and gain insights into their loved one’s dementia.