Kupuna Care Eligibility in Hawaii — What It Covers and How It Differs From Med-QUEST

What Kupuna Care Actually Is

Kupuna Care is a state-funded program — not Medicaid — that provides home and community-based services to older adults who don't qualify for Med-QUEST or who need help while waiting for Medicaid eligibility to process. It's administered through Hawaii's county-level Aging and Disability Resource Centers (ADRCs) and funded by the Hawaii State Legislature.

The program exists to fill a gap: families whose parents earn too much for Medicaid but too little to afford private home care at Hawaii's rates. Private home health aide services in Hawaii can run $30 or more per hour, and nursing home care averages roughly $16,855 per month. Kupuna Care offers a lifeline for the middle-income families who fall between these extremes.

Eligibility Requirements

To qualify for Kupuna Care, your parent must:

• Be age 60 or older
• Be a Hawaii resident
• Need assistance with at least two Activities of Daily Living (ADLs) or two Instrumental Activities of Daily Living (IADLs), a combination of one ADL and one IADL, or have significant cognitive impairment requiring substantial supervision
• Not qualify for Med-QUEST or another comparable government or home- and community-based program

There is no asset test for Kupuna Care. Unlike Med-QUEST, which requires countable assets below $2,000, Kupuna Care does not penalize families for owning a home, having savings, or maintaining retirement accounts. There is an income-based priority system — lower-income applicants receive services first when funding is limited — but income alone doesn't disqualify anyone.

This is a critical distinction. A parent who owns a $900,000 home and has $50,000 in savings would need to spend down dramatically to qualify for Med-QUEST long-term care. They could access Kupuna Care immediately.

What Services Kupuna Care Provides

Kupuna Care covers a range of home and community-based services:

• Personal care — assistance with bathing, dressing, grooming, and toileting
• Homemaker services — meal preparation, light housekeeping, laundry
• Adult day care — supervised daytime programs at community centers
• Transportation — rides to medical appointments and essential errands
• Case management — a care coordinator who assesses needs and connects the family with resources
• Respite care — temporary relief for family caregivers

Services are delivered by contracted providers coordinated through the local ADRC. The scope and hours depend on the assessment and available funding — Kupuna Care is not an entitlement, so service levels can be reduced when legislative appropriations run short.

Kupuna Care vs. Med-QUEST — When to Use Which

The biggest practical difference: Med-QUEST is an entitlement program. If your parent qualifies, they're guaranteed services. Kupuna Care is funded by annual appropriations and can have waitlists when demand exceeds budget.

For families doing long-term planning, Kupuna Care works well as a bridge — providing immediate services while the family prepares a Med-QUEST application, organizes the spend-down, and addresses the 60-month look-back.

The Kupuna Caregivers Program

Separate from Kupuna Care, Hawaii also operates the Kupuna Caregivers Program (KCGP), which provides funding for alternative care services that support employed family caregivers. If you're a working adult child providing care for your parent, KCGP can fund adult day care or in-home services during your work hours — up to certain dollar limits — so you don't have to choose between your job and your parent's safety.

Eligibility requires that the caregiver be employed and the care recipient qualify for community-based long-term care services. Applications go through the same county ADRCs that manage Kupuna Care.

How to Apply

Contact your county's Aging and Disability Resource Center:

• Oahu: Elderly Affairs Division — (808) 768-7700
• Maui County: Maui County Office on Aging — (808) 270-7774
• Hawaii County: Hawaii County Office of Aging — (808) 961-8626
• Kauai County: Kauai Agency on Elderly Affairs — (808) 241-4470

The ADRC conducts an assessment, determines eligibility and priority level, and connects your parent with service providers. Processing times vary — during budget shortfalls, waitlists can extend several months.

If your parent needs legal authority documents established before applying — a power of attorney so you can handle paperwork, a Med-QUEST authorization for future Medicaid applications, or an advance health care directive — the Hawaii Power of Attorney & Guardianship Kit covers all three in one coordinated package.

Frequently Asked Questions

Can my parent receive both Kupuna Care and Med-QUEST services? Generally no — Kupuna Care is designed for people who are not receiving equivalent services through Medicaid. However, during the transition period while a Med-QUEST application is processing, temporary Kupuna Care services may be available.

Is there a cost to the recipient? Cost-sharing may apply based on income and ability to pay. Ask the county ADRC about the amount for the service.

What happens when the Kupuna Care budget runs out? Services may be reduced or waitlisted. This is why families should plan for Med-QUEST eligibility in parallel — it's the entitlement backup when state-funded programs hit their funding ceiling.

See more Hawaii guides →