How much does a nursing home cost in Hawaii?
The median nursing home cost in Hawaii is $16,395 per month for a private room and $15,473 per month for a semi-private room, based on the CareScout 2025 Cost of Care Survey released March 2026. That's roughly $196,735 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 (CareScout 2025) | Difference |
|---|---|---|---|
| Nursing home (private) | $16,395 | $10,798 | +52% |
| Nursing home (semi-private) | $15,473 | $9,581 | +61% |
| Memory care (est) | $15,100 | $7,750 | +95% |
| Assisted living | $12,096 | $6,200 | +95% |
| Non-medical caregiver (hourly) | $41 | $35 | +17% |
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 CareScout 2025 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 (2026)
Married couple, one spouse applying: Community spouse may keep up to $162,660 under the federal Community Spouse Resource Allowance (2026 maximum), 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 $16,395 per month (~$539 per day). A $50,000 transfer that violates the look-back rule would create roughly a 91-day penalty period during which Hawaii Medicaid will not cover care 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.
Find a Hawaii attorney →What makes Hawaii different
Hawaii consolidated all Medicaid into a single managed-care program called QUEST Integration under an 1115 Demonstration Waiver — there is no separate senior LTSS waiver, since acute care, behavioral health, and long-term care all flow through the same four MCOs (BCBSHI, Kaiser, AlohaCare, UnitedHealthcare). Hawaii also operates a culturally distinctive residential category: Community Care Foster Family Homes (CCFFHs), private homes licensed to provide 24-hour care to up to two adults (or one medically complex adult) in a family setting. Expanded Adult Residential Care Homes (E-ARCHs) serve as the assisted-living equivalent. CMS approved a new Medicaid assisted-living-facility benefit in 2025. Hawaii's MMNA minimum is set at $3,040 — the second-highest in the country behind Alaska.
Sources: state Medicaid agency program documentation and CMS spousal-impoverishment standards. See our methodology page for the broader data sources used across this site.