Assisted living in Hawaii costs between $9,050 and $15,100 per month, with a statewide median of approximately $12,100 per month, the highest of any state in the country. On an annual basis, families should plan for roughly $108,600 to $181,200 per year (midpoint ~$145,200/year), based on the CareScout 2025 Cost of Care Survey.
Compared to the national median of approximately $6,200 per month, Hawaii pricing runs nearly double the national average. Higher housing costs, geographic isolation, a constrained labor market, and limited assisted living supply all contribute to Hawaii’s position as the most expensive state for assisted living in the United States.
Major population centers such as Honolulu often exceed the statewide midpoint due to strong demand and proximity to regional healthcare systems, while smaller neighbor island communities may fall closer to the statewide median depending on facility availability.
This guide provides a detailed breakdown of assisted living costs across Hawaii, including city-level pricing, regional patterns, Medicaid considerations, comparisons to other care types, and long-term financial projections.
Families comparing regional pricing may also want to review assisted living costs in California and Washington.
Hawaii Assisted Living Cost Snapshot
| Metric | Estimate |
|---|---|
| Statewide Median | ~$12,100/mo |
| Annual Equivalent | ~$145,200 |
| Lowest Major Markets | Lihue, Kapolei |
| Highest Major Markets | Honolulu, Kailua, Kaneohe |
| Compared to National Median | Highest in the U.S. |
| Most Comparable States | Alaska, Massachusetts, Connecticut |
On This Page
- Average assisted living cost in Hawaii
- Hawaii monthly pricing
- City-by-city assisted living costs
- Regional cost patterns
- Medicaid coverage in Hawaii
- Hawaii vs other states
- Long-term cost planning
- How to compare Hawaii communities
How Hawaii Assisted Living Costs Compare Nationally
Hawaii ranks as the most expensive state for assisted living in the United States, according to the CareScout 2025 Cost of Care Survey. At approximately $12,100 per month, Hawaii’s median cost is nearly double the national median of $6,200 per month, a gap of roughly $5,900 per month.
Between 2022 and 2025, assisted living costs in Hawaii rose by 36.9%, the fastest rate of increase of any state in the country. This growth reflects the combined pressure of rising labor costs, constrained land availability, and accelerating demand from an aging population.
Within Hawaii, regional variation is significant. Honolulu and surrounding communities on Oahu typically reflect the highest pricing due to population density and strong demand, while neighbor island markets may offer somewhat lower pricing depending on facility availability and local housing costs.
For families relocating from the mainland, Hawaii’s cost structure represents a significant step up from nearly every other state, including high-cost markets such as California and Washington.
For a broader benchmark, see our guide to the national average assisted living cost.
What Is the Average Cost of Assisted Living in Hawaii?
The CareScout 2025 Cost of Care Survey reports Hawaii’s assisted living median at approximately $145,155 per year, about $12,100 per month, the highest statewide median in the country.
Estimated Annual Cost
At $12,100 per month:
| Time Period | Estimated Cost |
|---|---|
| 1 Year | $145,200 |
| 3 Years | $435,600 |
| 5 Years | $726,000 |
These projections do not account for annual rate increases, which typically range between 3% and 7%.
How Much Does Assisted Living Cost Per Month in Hawaii?
Most assisted living communities in Hawaii charge between $9,050 and $15,100 per month, with a statewide median of approximately $12,100 per month.
Monthly pricing varies by island, city, care level, and community type. Honolulu and Oahu communities typically exceed the statewide median due to higher real estate costs and concentrated demand, while some neighbor island markets may offer more moderate pricing where facility supply is available.
Assisted Living Costs by City in Hawaii
Assisted living costs vary across Hawaii’s major communities, with pricing influenced by local housing costs, proximity to healthcare systems, and facility availability on each island.
| City | Low Range | High Range | Estimated Median | Annual Equivalent |
|---|---|---|---|---|
| Honolulu | $10,900 | $16,400 | ~$13,650 | ~$163,800 |
| Kailua | $10,500 | $15,750 | ~$13,100 | ~$157,200 |
| Kaneohe | $10,200 | $15,300 | ~$12,750 | ~$153,000 |
| Hilo | $9,900 | $14,850 | ~$12,375 | ~$148,500 |
| Kahului | $9,500 | $14,250 | ~$11,875 | ~$142,500 |
| Pearl City | $9,300 | $13,950 | ~$11,600 | ~$139,200 |
| Waipahu | $9,100 | $13,650 | ~$11,375 | ~$136,500 |
| Kapolei | $8,900 | $13,350 | ~$11,100 | ~$133,200 |
| Lihue | $8,600 | $12,900 | ~$10,750 | ~$129,000 |
Honolulu and surrounding communities on Oahu generally reflect the highest assisted living pricing due to population concentration and strong demand for senior housing. Neighbor island markets such as Hilo, Kahului, and Lihue may offer somewhat lower pricing, though supply constraints on smaller islands can limit options.
Regional Assisted Living Cost Patterns in Hawaii
Assisted living pricing across Hawaii varies by island, driven by population density, housing costs, and the number of facilities available in each market.
Oahu
Oahu — which includes Honolulu, Kailua, Kaneohe, Pearl City, Waipahu, and Kapolei — contains the largest concentration of assisted living facilities in the state. Pricing here consistently trends above the statewide median due to strong demand, limited development space, and higher underlying real estate costs. Honolulu specifically often commands the highest pricing on the island.
Hawaii Island
Communities such as Hilo on Hawaii Island may reflect pricing closer to the statewide median. While housing costs are somewhat lower than Oahu, the limited number of assisted living facilities can constrain family options and affect pricing.
Maui
Maui markets such as Kahului reflect moderate-to-high assisted living pricing influenced by strong retiree demand and elevated housing costs relative to neighbor islands. Limited facility supply in some Maui communities can contribute to pricing pressure.
Kauai
Smaller communities on Kauai such as Lihue may experience lower pricing relative to Oahu, though the limited number of assisted living facilities on the island means families may have fewer options to compare.
Across all islands, geographic isolation and transportation costs influence operating expenses for senior housing communities — a structural factor that contributes to Hawaii’s elevated pricing relative to mainland states.
Hawaii Senior Housing Market Trends (2026)
Hawaii’s assisted living market is shaped by several structural forces that distinguish it from mainland markets.
Fastest-rising costs in the country. Between 2022 and 2025, assisted living costs in Hawaii increased by 36.9%, the highest rate of any state, according to the CareScout 2025 Cost of Care Survey. While cost growth has moderated slightly in 2025 relative to prior years, the baseline cost level remains the highest in the United States.
Labor market constraints. Assisted living providers in Hawaii depend on a caregiving workforce that is both limited in supply and subject to high living costs. Wage pressures have been a consistent contributor to rate increases across the state.
Geographic supply constraints. Limited land availability and high construction costs restrict the development of new assisted living communities, particularly on Oahu. This constraint on supply, combined with growing demand, sustains upward pricing pressure.
Aging population growth. Hawaii’s senior population continues to grow, increasing demand for assisted living services across all islands.
Families considering assisted living in Hawaii should plan for costs that may continue rising faster than national averages, given these structural factors.
What Does Assisted Living Typically Include in Hawaii?
Assisted living communities provide housing, care services, and daily support for seniors who need assistance with activities of daily living.
Typically Included in Base Monthly Cost
- Private or semi-private apartment
- Utilities and building maintenance
- Three daily meals and snacks
- Housekeeping and laundry services
- Assistance with activities of daily living (ADLs)
- Scheduled transportation
- Social and recreational programming
Often Billed Separately
- Medication administration
- Higher levels of personal care
- Memory care services
- Specialized therapies or health monitoring
- Premium housing units
- One-time move-in or community fees (typically $1,000–$3,000)
Communities frequently use tiered care models. As a resident’s health needs increase, monthly charges rise accordingly.
Assisted Living vs. Other Care Options in Hawaii
| Care Type | Average Monthly Cost | Best For |
|---|---|---|
| Independent Living | $5,500–$8,000 | Seniors needing minimal support |
| Assisted Living | ~$12,100 | Seniors needing daily assistance |
| Memory Care | ~$14,000–$17,000 | Dementia and Alzheimer’s care |
| Home Care | $7,800–$10,000+ | Care delivered at home (part-time) |
| Nursing Home | ~$15,500–$16,400/mo | Skilled 24/7 medical supervision |
Assisted living is generally appropriate for seniors who need help with daily activities but do not require continuous skilled medical care. In Hawaii, full-time home care can approach or exceed assisted living costs due to high caregiver wages.
What Affects Assisted Living Costs in Hawaii?
Several structural factors drive Hawaii’s position as the most expensive state for assisted living:
- Geographic isolation: Supply chain costs, transportation expenses, and import dependency raise operating costs for all businesses in Hawaii, including senior care communities.
- Labor market: A limited caregiving workforce and high cost of living for workers create persistent wage pressure.
- Real estate costs: High land values on Oahu and limited development space constrain supply and increase facility operating costs.
- Level of care required: Higher care needs increase monthly fees.
- Private vs. shared units: Private apartments are generally more expensive.
- Memory care add-ons: Specialized dementia programs increase pricing significantly.
- Island location: Oahu communities typically command higher pricing than neighbor island markets.
Does Medicaid Cover Assisted Living in Hawaii?
Medicare does not cover long-term assisted living costs.
Hawaii Medicaid may help cover certain care services through Home and Community-Based Services (HCBS) programs, primarily administered through the QUEST Integration (QI) program, Hawaii’s Medicaid managed care program for eligible seniors and individuals with disabilities.
Through QUEST Integration, some participants may receive personal care and supportive services delivered within assisted living or other community-based settings.
Important limitations to understand:
- Medicaid typically does not cover full room and board costs
- Coverage is generally limited to care services, not housing or meals
- Applicants must meet income, asset, and functional eligibility thresholds
- Waitlists may apply depending on program funding
Because coverage is service-based rather than room-and-board inclusive, families often combine Medicaid assistance with private payment resources to cover total costs.
Families should review official Hawaii Medicaid resources for current program requirements and eligibility criteria.
How Hawaii Assisted Living Costs Compare to Other States
Hawaii’s assisted living costs are the highest in the United States, significantly exceeding even other high-cost states.
| State | Estimated Monthly Median | Relative to Hawaii |
|---|---|---|
| Hawaii | ~$12,100 | — |
| Alaska | ~$9,900 | Lower |
| Massachusetts | ~$9,600 | Lower |
| Connecticut | ~$9,100 | Lower |
| California | ~$7,000 | Substantially Lower |
| Washington | ~$7,600 | Substantially Lower |
| National Median | ~$6,200 | Substantially Lower |
For families evaluating Hawaii vs. mainland alternatives, the cost differential is significant. A move from Hawaii to California, for example, could reduce monthly assisted living costs by approximately $5,100 per month or more than $61,000 per year.
Long-Term Cost Planning in Hawaii
Assisted living should be evaluated not only as a monthly expense but as a multi-year financial commitment. In Hawaii, the most expensive state for assisted living, long-term planning is especially critical.
At $12,100 per month with a 5% annual increase, projected costs may look like:
| Year | Monthly Cost |
|---|---|
| Year 1 | $12,100/month |
| Year 2 | $12,705/month |
| Year 3 | $13,340/month |
| Year 4 | $14,007/month |
| Year 5 | $14,708/month |
Over a five-year period, total cumulative spending may exceed $810,000 depending on care needs and annual increases.
Given Hawaii’s track record of above-average cost growth (36.9% over three years through 2025), families should consider planning scenarios with 5–7% annual increases rather than assuming cost stabilization.
How to Plan for Assisted Living Costs in Hawaii
Common financial strategies families use to fund assisted living in Hawaii include:
- Home sale proceeds (Hawaii’s high real estate values can generate substantial equity)
- Long-term care insurance
- Veterans benefits (Aid and Attendance program)
- Retirement income and savings
- Bridge financing
Because Hawaii’s costs are the highest in the country, families who own property in Hawaii may find that home equity provides a meaningful funding source. Early planning is particularly important given the significant multi-year financial commitment involved.
Who Hawaii Assisted Living May Be Best Suited For
Assisted living in Hawaii may be most appropriate for:
- Longtime Hawaii residents with established community and family ties on the islands
- Seniors whose estate planning accounts for Hawaii’s elevated cost structure
- Families with access to significant home equity or long-term care insurance
- Veterans eligible for Aid and Attendance benefits who wish to remain in Hawaii
For families without strong ties to Hawaii, the significant cost differential versus mainland states, particularly the Pacific Northwest, California, or the Southeast, may make relocation a meaningful financial consideration worth exploring.
How to Compare Assisted Living Communities in Hawaii
Because pricing structures vary across Hawaii, families should request a detailed fee schedule from each community under consideration. Base monthly rates may not fully reflect higher care tiers, medication management services, or specialized programs such as memory care.
When comparing communities, consider:
- What level of care is included in the base rate
- How care levels are assessed and priced
- Whether annual rate increases are capped or discretionary
- Staffing ratios and caregiver training standards
- Proximity to hospitals and regional healthcare systems
- Contract structure (month-to-month vs long-term agreements)
- Island location and family accessibility
In Honolulu and surrounding Oahu markets, premium pricing does not always correspond directly with higher levels of care. Some communities command elevated rates due to location or housing costs rather than materially different care delivery models.
Requesting a written breakdown of all potential fees, including tiered care adjustments and ancillary service charges, helps families avoid unexpected cost increases over time.
Frequently Asked Questions
How much does assisted living cost per month in Hawaii?
Most assisted living communities in Hawaii range between $9,050 and $15,100 per month, with a statewide median of approximately $12,100 per month based on the CareScout 2025 Cost of Care Survey.
Is assisted living more expensive in Hawaii than the national average?
Yes. According to the CareScout 2025 Cost of Care Survey, Hawaii has the highest median assisted living cost of any state in the country at approximately $12,100 per month ($145,155 annually).
How much have assisted living costs increased in Hawaii?
Between 2022 and 2025, assisted living costs in Hawaii rose by 36.9%, the fastest rate of increase of any state, according to CareScout’s analysis. Most assisted living communities also implement annual rate increases of 3%–7%.
Which city in Hawaii has the highest assisted living costs?
Honolulu and surrounding communities on Oahu typically reflect the highest assisted living pricing due to strong demand, population density, and high real estate costs.
Can Medicaid help pay for assisted living in Hawaii?
Hawaii Medicaid may provide limited assistance through the QUEST Integration program and Home and Community-Based Services (HCBS) waivers, though housing and meal costs are generally not covered. Eligibility depends on income, assets, and demonstrated care needs.
Methodology
Pricing estimates are modeled using a range + midpoint planning framework anchored to national industry data. Statewide median figures are sourced from the CareScout 2025 Cost of Care Survey (data collected July–November 2025, published March 2, 2026). City-level estimates are modeled using proportional adjustments to the statewide median based on local market conditions and relative housing costs.
State comparisons reflect standardized median estimates used across SeniorCareCostGuide. Long-term projections are illustrative planning models based on consistent annual growth assumptions and are intended for planning purposes only.
For a detailed explanation of how pricing estimates are modeled, see our Assisted Living Cost Methodology.
Sources
- Genworth Financial & CareScout Cost of Care Survey (2025)
- State-level pricing estimates modeled using a standardized range and midpoint framework
- Local market observations based on publicly available senior living data and community-level pricing trends
Last reviewed: May 2026.