Honolulu Senior AdvisorDoes Medicare pay for a care home or assisted living on Oahu?
No. Medicare does not pay for custodial care, which includes room, board and help with daily activities in an adult residential care home, foster family home or assisted living facility; it pays for medical care, short skilled nursing stays after a hospital stay, home health, hospice and medical equipment.
Families are often told a parent “has Medicare, so care is covered”. It is covered only while the need is skilled and short-term. Once a resident needs ongoing help with bathing, dressing and supervision, the payer is the family, long-term care insurance, VA or Med-QUEST.
What does Medicare pay for after a hospital stay?
After a qualifying inpatient hospital stay of at least three days, Original Medicare can pay for up to 100 days of skilled nursing facility care per benefit period when daily skilled care is needed, covering days 1 to 20 in full and days 21 to 100 with a daily coinsurance.
Observation days do not count toward the three-day stay, so ask the hospital whether your parent is formally admitted. Medicare Advantage plans, popular on Oahu, often waive the three-day rule but require prior authorization and use network facilities. Coverage stops when skilled care is no longer needed, even before day 100.
Does Medicare cover home health and hospice?
Yes: Medicare covers intermittent skilled home health care for homebound beneficiaries under a doctor's plan of care, and hospice care for people with a terminal prognosis of six months or less, including care delivered in a care home or foster family home.
Home health does not include round-the-clock help or homemaker-only services. Hospice covers the care team, medications for comfort and equipment, but not the care home's room and board.
Where can Oahu families get free Medicare counseling?
Hawaii SHIP, the State Health Insurance Assistance Program at the Executive Office on Aging, gives free, unbiased Medicare counseling; call (808) 586-7299 on Oahu or 1-888-875-9229 toll-free.
SHIP counselors can compare Medicare Advantage and Medigap options, explain Part D, and check eligibility for the Medicare Savings Programs that help with premiums. Senior Medicare Patrol Hawaii, at (808) 586-7281, helps if a Medicare statement shows services that were never received.
At a glance
| Medicare pays for | Medicare does not pay for | |
|---|---|---|
| After the hospital | Short skilled nursing stays when daily skilled care is needed | Long-term nursing home custodial care |
| At home | Intermittent skilled home health for homebound patients | Daily personal care aides or companions |
| Care homes | Hospice and doctor visits for residents | Room, board and supervision |
| Equipment | Medically necessary durable equipment | Home modifications |
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.
