Updated September 3, 2026. Quick answer: partially, through QUEST Integration (Section 1115 demonstration), HCBS benefit package: Hawaii folded its former standalone 1915(c) waivers into managed care effective February 1, 2009: coverage is real but narrower than a full assisted living placement. Medicaid does not pay the facility’s room and board either way.
What Hawaii covers
| Waiver / state plan option | QUEST Integration (Section 1115 demonstration), HCBS benefit package: Hawaii folded its former standalone 1915(c) waivers into managed care effective February 1, 2009 |
|---|---|
| Covers an assisted living setting? | Partial: Med-QUEST’s 2025 LTSS Choice Form (memo QI-2502) lists “(Community Care Family Foster Home (CCFFH), Expanded Adult Residential Care Home (EARCH), Assisted Living Facility (ALF))” as residential setting choices and lists Assisted Living Facility as a home and community-based service choice. It does not say what the health plan pays for inside an assisted living facility. |
| Room and board | Never covered by Medicaid, in Hawaii or any state; see below. |
The room-and-board split
Federal law is the floor every state builds on: “The Secretary may by waiver provide that a State plan approved under this subchapter may include as “medical assistance” under such plan payment for part or all of the cost of home or community-based services (other than room and board) approved by the Secretary” (42 U.S.C. §1396n(c)(1), Social Security Act §1915(c)). The words in parentheses do the work: whatever a state’s waiver pays for inside an assisted living community, it is not the rent, the meals, or the room itself. That portion stays the resident’s own to fund, out of income, savings, or a family contribution; the waiver only ever reaches the care and service layer on top of it. We did not find Hawaii’s own materials restating this point in the sources read this session; the federal rule above still governs.
The waitlist
Not published by the state in the materials reviewed this session.
What you get to keep: the personal needs allowance
Not published in the materials reviewed this session. This is the amount of a waiver participant’s own income the state lets them keep for personal spending after the rest goes toward the cost of their care; it varies by state because each state sets its own figure inside the federal floor.
What this doesn’t answer
Direct fetches of medquest.hawaii.gov succeeded on September 30, 2026 and were used to re-check this page. The QUEST Integration page confirms that QUEST Integration provides home and community-based long-term services and supports under the Section 1115 demonstration, and the 2025 LTSS Choice Form (QI-2502) lists Assisted Living Facility as a residential setting and service choice. The February 1, 2009 date for folding standalone waivers into managed care, the exact scope of what is paid inside an assisted living facility, and waitlist status were not confirmed from those pages.
Figures verified against Hawaii Med-QUEST (QUEST Integration page and 2025 LTSS Choice Form QI-2502) and 42 U.S.C. §1396n(c)(1) (law.cornell.edu) on September 30, 2026; the February 1, 2009 managed care date, the scope of assisted living payment and waitlist status were not re-checked.
Sources
Read September 3, 2026.
Same question, other states: Idaho · Illinois.
Related: what assisted living actually costs · assisted living vs. staying home vs. a CCRC · why home care has a waitlist and a nursing home doesn’t.
General information drawn from each state’s own Medicaid agency and federal statute, not legal, tax or financial advice. Medicaid is administered state by state; waiver names, coverage decisions, waitlists and allowance amounts change by state budget and legislative action. This page cannot see your own state’s current caseload. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.
Related: Hawaii’s Medicaid Personal Needs Allowance, the amount a nursing-facility resident keeps from their own income each month.
Related: Hawaii’s Medicaid home equity limit.