How much does a nursing home cost in Hawaii?
The median nursing home cost in Hawaii is $14,850 per month for a private room and $13,420 per month for a semi-private room in 2026, based on the Genworth Cost of Care Survey. That's roughly $178,200 per year for a private room.
Hawaii has among the highest senior care costs in the country — 53% above the national median — driven by high labor costs and limited facility capacity across the islands.
2026 Hawaii senior care costs at a glance
| Care type | Hawaii median/month | National median | Difference |
|---|---|---|---|
| Nursing home (private) | $14,850 | $9,733 | +53% |
| Nursing home (semi-private) | $13,420 | $8,669 | +55% |
| Memory care | $7,850 | $6,244 | +26% |
| Assisted living | $6,200 | $4,995 | +24% |
| Home health aide (hourly) | $36 | $33 | +9% |
See your exact spend-down timeline for Hawaii
Enter your savings, income, and care type to see how long your money lasts before reaching Hawaii Medicaid asset limits.
Open the Hawaii calculator →Nursing home costs by Hawaii city
Costs vary by metro area within the state. Urban markets typically run 10–25% above state medians, while rural areas can be 10–20% below.
City-level estimates are based on 2026 Genworth metro-area data. Individual facility costs vary 20–40% from these medians depending on amenities, staffing ratios, and room type.
Hawaii Medicaid for nursing home care
Hawaii Medicaid covers nursing home care for residents who meet both medical eligibility (need for skilled nursing care) and financial eligibility (limited assets and income). Understanding the rules before you need them can save your family hundreds of thousands of dollars.
Hawaii Medicaid 2026 asset limits
Individual applicant: $2,000 in countable assets
Married couple, one spouse applying: Community spouse may keep up to $148,620 under the Community Spouse Resource Allowance, plus the home, one vehicle, and personal belongings
The 5-year look-back period in Hawaii
Hawaii Medicaid reviews all asset transfers made within 60 months (5 years) of your application date. Gifts to family, property transfers below market value, or large unexplained withdrawals trigger a penalty period that delays Medicaid eligibility — during which you must private-pay.
Hawaii's 2026 penalty divisor is approximately $390 per day. A $50,000 unexplained transfer would create roughly a 128-day penalty period, costing your family approximately $63,360 in private-pay costs.
This is why elder law attorneys consistently advise families to begin Medicaid planning at least 5 years before nursing home care is needed.
Find a Hawaii elder law attorney
The National Academy of Elder Law Attorneys maintains a state-by-state directory of certified elder law attorneys.
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