Can I get paid to care for my spouse in Hawaii?
Yes — Hawaii lets a spouse be paid.
Hawaii is one of the states where the person who needs care can hire their own husband or wife and have the program pay for it. You do the caring you are already doing. The state pays you for it.
What has to be true
- Your spouse lives in Hawaii and needs long-term care help at home.
- Your spouse has Medicaid, or can qualify. We check that with you for free.
- You pass a background check. No license or certificate is needed.
- The care your spouse needs is written into their plan — that is what the hours are paid against.
What Hawaii pays family caregivers
$14–$23/hr
Your exact pay is set by the program and your care plan. We'll tell you your real number before you enroll.
Source: Hawaii Medicaid program data · Updated September 2026
What Hawaii's rule actually says
yes — relatives including spouses and adult children can be hired under QI self-direction
The programs this runs through in Hawaii: QUEST Integration self-direction. Who runs them: Hawaii Dept. of Human Services, Med-QUEST Division (MQD); 800-316-8005 (O'ahu 808-524-3370); ADRC 808-643-2372
310,300 people in Hawaii are 65 or older. Most of them are cared for at home, by a relative — usually without being paid for it.
How to start in Hawaii
Apply for Med-QUEST online at MyBenefits or with form DHS 1100 at a Med-QUEST Service Center (800-316-8005); once enrolled, request a long-term-services assessment through the QI health plan.
self-directed: participant hires the caregiver; a financial management services (FMS) agency handles payroll/taxes; services authorized through the member's QI health plan (MCO)
See if you qualify →Spouse questions in Hawaii, answered
Can I get paid to care for my husband or wife in Hawaii?
Yes. Hawaii allows it. The published rule: yes — relatives including spouses and adult children can be hired under QI self-direction
Why do some states allow this and others don't?
Medicaid has long treated care between spouses as a family duty rather than paid work. Self-directed programs changed that in many states by making the person who needs care the employer — they choose their own worker, and in some states that can be a spouse. It is a state-by-state policy choice, not a federal rule.
How much would I earn in Hawaii?
Reported pay in Hawaii runs around $14–$23/hr, though your exact rate is set by the program and the care plan.
Does my spouse need Medicaid first?
Yes. These are Medicaid programs, so your spouse has to qualify for Hawaii Medicaid and need long-term care help. Many families assume they earn too much and never apply. The rules for long-term care are not the same as regular Medicaid — check before you rule yourself out.
Is there a waitlist in Hawaii?
Medicaid/QI enrollment is an entitlement, but HCBS/LTSS participant slots can be limited — waitlist can form when full
How do we start?
Apply for Med-QUEST online at MyBenefits or with form DHS 1100 at a Med-QUEST Service Center (800-316-8005); once enrolled, request a long-term-services assessment through the QI health plan.
Sources: medicaidplanningassistance.org · medquest.hawaii.gov · Updated September 2026. Rules change — always confirm with the program.
Where most Hawaii caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Hawaii — pick yours for the local picture.
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