Honolulu Senior AdvisorWhat should we know before moving a parent to Oahu for care?
Before moving a parent to Oahu, know that Hawaii's main long-term care setting is the small licensed care home rather than assisted living, that costs are among the highest in the country, and that Med-QUEST requires Hawaii residency, so a parent on another state's Medicaid must reapply in Hawaii.
Oahu has 455 licensed care homes, 1,111 foster family homes, 14 assisted living facilities and 27 certified nursing homes, according to the state and CMS.
How does Medicaid work if a parent moves from another state?
Medicaid does not transfer between states: a parent who moves to Hawaii must establish Hawaii residency and apply to Med-QUEST, which will review income, assets and the 60-month look-back under Hawaii's rules, and then assess level of care.
Coordinate the timing so there is no gap in coverage. Medicare moves with your parent, but a Medicare Advantage plan may need to be changed to one serving Hawaii.
What about a parent moving from a neighbor island?
A parent moving from the Big Island, Maui, Kauai or Molokai to Oahu stays under the same state rules and the same Med-QUEST program, though they may need to change QUEST Integration plans, and Oahu offers far more licensed care homes and nursing homes than the neighbor islands.
Many neighbor island families move a parent to Oahu because a specific setting, such as an expanded ARCH near a hospital, is available there.
How do we prepare for the move itself?
Prepare for the move by securing a place before the flight, bringing a complete medication list and medical records, arranging a new primary care physician, and planning the first week so your parent has familiar belongings and a family visit.
Care homes need a physician's report, tuberculosis clearance and medication orders before admission; arrange these in advance so your parent does not arrive without a place to go.
How long does it take to find a place on Oahu?
Finding a care home on Oahu can take a few days to several weeks depending on the level of care, location and payment source; expanded ARCH nursing-level slots and Med-QUEST foster family home beds are usually the hardest to find quickly.
Start the search before booking flights, and keep a second option in case the first falls through.
At a glance
| On Oahu, families find | On Oahu, families should not expect | |
|---|---|---|
| Settings | Hundreds of small licensed care homes | Many large assisted living buildings |
| Cost | High prices, especially for assisted living | Mainland price levels |
| Medicaid | Med-QUEST through QI health plans | Another state's Medicaid to carry over |
| Medicare | Coverage that moves with your parent | Every Medicare Advantage plan to work in Hawaii |
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.
