Assisted Living Cost in Hawaii
Hawaii is the most expensive state in this survey for assisted living, and the island spread is the story: Honolulu at $12,993 and Kahului at $5,500 sit $7,493 apart, and two places families ask about return no calculator figure at all. If your parent lives on an island other than Oahu or Maui, do not borrow the Honolulu figure. The other fact to get right first is the Medicaid route, which covers assisted living services but does not pay rent and meals.
Sources: CareScout Cost of Care Survey 2025, released March 2026, ranked state tables and Cost of Care calculator, accessed November 2026; Hawaii Department of Human Services Med-QUEST Division QUEST Integration information; Hawaii Office of Veterans Services and VA Pacific Islands Health Care state veterans home information.
Hawaii assisted living costs, against the national median
The table below is the CareScout 2025 survey for Hawaii, with the national median beside it. The survey collected more than 25,000 provider rates between July and November 2025 and reports medians, the middle price, not averages pulled up by luxury buildings. Assisted living figures are for a private one-bedroom apartment for 12 months of care. Hawaii's ranked-table monthly figure is $12,089, from the $145,065 annual median; a separate CareScout data table prints $12,096 for the same state, and this page follows the ranked table used for every other state page, so the figure stays consistent across the series.
| Care type | Hawaii median | National median |
|---|---|---|
| Assisted living, per month | $12,089 ($145,068 per year) | $6,200 ($74,400 per year) |
| Home care, non-medical caregiver, per hour | $41 ($93,808 per year at 44 hours a week) | $35 ($80,080 per year at 44 hours a week) |
| Adult day health care, per day | $118 ($30,615 per year at 5 days a week) | $95 ($24,700 per year at 5 days a week) |
| Nursing home, semi-private room, per month | $15,473 ($185,676 per year) | $9,581 ($114,975 per year) |
| Nursing home, private room, per month | $16,395 ($196,740 per year) | $10,798 ($129,575 per year) |
The assisted living cost Hawaii median runs $5,889 a month above the national median, which is $70,665 over a full year (145,065 minus 74,400). Home care at $41 an hour sits $6 above the $35 national rate. Adult day care at $118 a day sits $23 above the $95 national rate. A semi-private nursing home room at $15,473 sits $5,892 above the $9,581 national figure, and a private room at $16,395 sits $5,597 above the $10,798 national figure. For the full national picture, read how much does assisted living cost and how much does a nursing home cost.
Assisted living cost Hawaii by place
Place medians come from the same CareScout survey, through its Cost of Care calculator, which reports the closest survey region for each place. All figures are 2025 monthly medians for a private one-bedroom apartment. Only two Hawaii places in this table return a calculator figure: Honolulu, mapped to the Urban Honolulu region, and Kahului, mapped to the Kahului region. Hilo and Kailua both map to the non-metropolitan region in the calculator, which returns no assisted living figure for that region, so this page states none for either place rather than estimating one.
| Place | Assisted living median per month, 2025 | Against the Hawaii median |
|---|---|---|
| Honolulu | $12,993 | $904 above |
| Kahului | $5,500 | $6,589 below |
Honolulu at $12,993 sits $904 above the $12,089 state median, while Kahului at $5,500 sits $6,589 below it, a spread of $7,493 a month between the two places with figures. That gap is a warning against using one island's price for another island's move. Use the place figure where one exists, and where the calculator returns no figure, get three written quotes in that place, with apartment size and care level stated, before you budget at all. For how to use competing quotes, read can you negotiate assisted living costs.
What the monthly bill includes, and what it leaves out
The median buys the building and the base service: a private apartment, meals, housekeeping, supervision, and activities, with staff on site around the clock. It does not buy every charge a resident actually pays. Care is priced in levels, and the level rises as help needs grow, so the second year costs more than the first even before any annual rate increase. Medication handling, a higher care level, and a second occupant are commonly billed on top of the base rate, and many buildings charge a one-time community fee at move-in.
Hawaii licenses assisted living facilities through the Office of Health Care Assurance, within the Department of Health, under Hawaii Administrative Rules Title 11, Chapter 90. The state also licenses smaller, home-like options: adult residential care homes and community care foster family homes, which care for a small number of residents in a home setting rather than a large facility. Ask at the tour, in writing, which license the setting holds, which services the base rate covers and which are billed as extras, and what each extra costs. The tour checklist on assisted living checklist groups those questions for you.
Medicaid in Hawaii: QUEST Integration
Hawaii's Medicaid program is Med-QUEST, run by the Department of Human Services Med-QUEST Division, and long-term services and supports are delivered through QUEST Integration, the state's managed care program. QUEST Integration lists assisted living services among the home and community-based services it covers for members who meet the required level of care, and it also covers community settings such as expanded adult residential care homes and community care foster family homes. Under federal rules, Medicaid home and community-based services do not pay the room and board portion of an assisted living stay, so rent and meals stay private pay, from income, VA benefits where eligible, or family funds. This page states no Hawaii Medicaid assisted living rate, because none was verified on an official page in this run. For the national Medicaid rules, read does medicaid pay for assisted living, and for the full payment map, read how to pay for assisted living. Medicare does not pay for assisted living room charges or custodial care; see does medicare pay for assisted living for the exact boundary.
VA resources in Hawaii
For a veteran parent, two Hawaii routes sit beside the private market. The first is VA Aid and Attendance, a monthly cash benefit added to a VA pension for a veteran or surviving spouse who needs help with daily living; the amounts and rules are on VA Aid and Attendance requirements and veterans affairs assisted living. The second is the state's own veterans homes. Hawaii has two state veterans homes: the Yukio Okutsu State Veterans Home in Hilo, opened in 2007, and the Daniel Kahikina Akaka State Veterans Home in Kapolei, opened in March 2025. They are state veterans homes, not private assisted living communities, so treat them as a separate application track, not as a price comparison. For VA health care, use VA.gov to find the facility nearest your parent.
Hawaii against the national median, in one row
Hawaii assisted living at $12,089 a month sits $5,889 above the $6,200 national median, home care at $41 an hour sits $6 above the $35 national rate, adult day care at $118 a day sits $23 above the $95 national rate, and a nursing home semi-private room at $15,473 a month sits $5,892 above the $9,581 national figure. Hawaii is the most expensive state in this survey on assisted living and nursing home care. At $15,473 a month, a semi-private nursing home room costs $3,384 a month more than the $12,089 assisted living median in the same state, so a parent whose needs are close to the nursing facility line should still price both settings in the same place.
Frequently asked questions
Does Hawaii Medicaid pay for assisted living rent and meals?
No. QUEST Integration can cover assisted living services for members who meet the required level of care, but under federal rules Medicaid home and community-based services do not pay room and board. Rent and meals stay private pay, from income, VA benefits where eligible, or family funds.
Why do Hilo and Kailua have no place figure in this table?
Because the CareScout calculator maps both places to the non-metropolitan region, and that region returns no assisted living figure in the calculator. This page leaves both cells out rather than borrowing the Honolulu figure or estimating one from another source. Budget a Hilo or Kailua move from written quotes from communities in that place itself.
What is a community care foster family home, and how is it different from assisted living?
A community care foster family home is a private residence licensed by the state to provide 24-hour care to a small number of adults in a family home setting, rather than a large facility. It is one of Hawaii's community residential options under QUEST Integration, alongside expanded adult residential care homes. It is not the same license as an assisted living facility, so ask which license a setting holds before comparing its price to the assisted living median.
Does the $12,089 median cover two people sharing one apartment?
No. The CareScout median is for a private one-bedroom apartment occupied by one person. A second occupant adds a second-person fee set by each community, on top of the median, not inside it. Couples should budget the median plus the community's written second-person fee, plus a care level for each spouse who needs help, since care is priced per person. See average cost of assisted living for a couple for how couples totals are built.
Your next step is to take the place median for the island and city where your parent will actually live, get three written quotes that state apartment size, care level, and every extra fee, and check QUEST Integration and VA eligibility before you sign. Start with assisted living checklist and assisted living costs.