Honolulu Senior AdvisorWhat kinds of in-home care are there on Oahu?
In-home care on Oahu falls into three kinds: non-medical home care (help with bathing, meals, housekeeping and companionship), Medicare-covered home health (intermittent skilled nursing and therapy for homebound patients), and publicly funded in-home services through the Elderly Affairs Division and Med-QUEST.
CareScout's 2025 Hawaii median for non-medical home care is $93,808 a year for 44 hours a week, about $41 an hour. Hawaii's home care costs fell 2% from 2024 while the national median rose.
Who pays for in-home care?
Non-medical home care is paid privately, by long-term care insurance or VA pension, or by Med-QUEST long-term care for members at the needed level of care; Medicare pays only for skilled home health, not for ongoing personal care.
EAD services such as personal care, homemaker help and home-delivered meals are free or low cost but have limited funding. Call (808) 768-7700.
How do we choose a home care provider?
Choose a home care provider by asking about caregiver screening and training, supervision, minimum shift lengths, what happens when a caregiver calls in sick, and whether they are licensed or contracted with Med-QUEST health plans if that matters for payment.
Hawaii licenses home health agencies through OHCA's Medicare Section; companion and homemaker agencies are not licensed the same way, so ask each one about its insurance, background checks and supervision.
How many hours of home care does a kupuna usually need?
Most families start with 10 to 20 paid hours a week, focused on bathing, meals, medications and rides, and add hours as needs grow; at Hawaii's median of about $41 an hour, 20 hours a week costs roughly $3,550 a month.
When the paid hours pass 50 or 60 a week, or overnight help is needed, a care home's single monthly rate usually costs less. See the home care math.
What can't home care do?
Non-medical home care cannot provide skilled nursing, cannot cover the hours when no aide is scheduled, and depends on the agency's staffing, so missed shifts and changing aides are common problems.
Medicare home health adds skilled visits for homebound patients but not ongoing personal care. Families combining home care with family help should have a backup plan for the day an aide does not arrive.
At a glance
| In-home care offers | In-home care does not offer | |
|---|---|---|
| Place | Care in the kupuna's own home | 24-hour supervision without paying for every hour |
| Flexibility | As few or as many hours as needed | Guaranteed same aide every shift |
| Medicare | Skilled home health for homebound patients | Ongoing personal care |
| Cost | About $41/hour median (2025) | A cap on monthly cost |
Sources include Hawaii Administrative Rules chapters 11-100.1, 11-90 and 11-800, HRS 321-481 and 321-1.8, Office of Health Care Assurance rosters and pages, the 2026 HHS poverty guidelines, CMS, CareScout and VA rate tables as cited above; see our editorial standards.
