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Assisted Living in Hawaii

With its breathtaking scenery and comfortable year-round climate, Hawaii is an idyllic retirement destination. Nearly one-fifth of the state’s 1.4 million residents are aged 65 or older. The number of older adults is expected to increase 33% by 2030, which means that demand for assisted living and other age-related supports is on the rise.

Whether you live on Oahu, Maui or one of the lesser-trafficked islands, Hawaii offers retirees a high quality of life and plenty of options for geriatric care, so it’s not surprising that the state ranked fifth in the nation for its overall livability in our 2024 Senior Living Report. Although Hawaii goes by the nickname Paradise of the Pacific, it ranks 18th in the nation for its affordability. Assisted living costs $5,375 per month on average. This is about 20% higher than the national average, but it’s more affordable than many states, including those on the West Coast.

This guide covers everything you need to know about assisted living in the Aloha State, including average long-term care prices, financial assistance programs and assisted living regulations. You’ll also find a number of free resources for seniors that are available at the state and local levels.

The Cost of Assisted Living in Hawaii

When trying to decide how to pay for assisted living, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of assisted living in Hawaii and its 2 cities.

The Cost of Assisted Living in Hawaii's Top Cities

Hawaii's assisted living prices average $6,039 per month. However, there's a $740 difference between price norms in the state's top cities. In the state capital, Honolulu, prices average $5,299, whereas in Kapolei, prices average $6,039. In Los Angeles, CA, monthly costs are around $119 cheaper. Prices are considerably more affordable in Seattle, WA, averaging $4,711 — 22% less than in Hawaii.

Hawaii

$6,039

Honolulu

$5,299

Kapolei

$6,039

Los Angeles, CA

$6,158

Seattle, WA

$4,711

Inflation's Impact on the Cost of Assisted Living in Hawaii

Inflation has had a substantial effect on assisted living costs in Hawaii. Between 2022 and 2023, prices rose by a whopping 32.3%, from $4,564 to $6,039. The U.S. average, meanwhile, rose at a considerably lower rate of 9.6%, climbing to $4,459. Fortunately, the projected rise for Hawaii's prices from 2023 to 2024 is just 0.3%.

Inflation's impacts on prices in mainland states have varied widely. Alaska's and California's prices increased by 3.6% and 6.9%, respectively. Washington and Oregon saw higher price rises of 14.1% and 19.2%, respectively. However, all these rises were considerably lower than Hawaii's 32.3%.

Location2022 Cost (Historical)2023 Cost (Current)2024 Cost (Estimated)
Hawaii$4,564$6,039$6,059
U.S. Average$4,070$4,459$4,802
California$4,625$4,946$5,221
Washington$4,156$4,743$5,051
Oregon$4,681$5,580$5,942
Alaska$6,531$6,768$7,208

The Costs of Other Types of Senior Living

Senior living costs in Hawaii vary based on care types. Assisted living is $6,039, while independent living is nearly 30% cheaper at $4,274. Memory care communities provide specialized, round-the-clock dementia care, so their prices are higher at $7,271. Factors such as amenities, location, staffing levels and signature programs can all influence individual provider prices. Consequently, it pays to remain mindful of specific wants and needs while comparing senior living communities.

Assisted Living

$6,039

Memory Care

$7,271

Independent Living

$4,274

Does Medicaid Cover Assisted Living in Hawaii?

Med-QUEST is Hawaii’s Medicaid program. This acronym stands for quality care, universal access, efficient utilization and stabilizing costs to transform the way health care is provided. Hawaii follows a managed care model that integrates medical care and long-term services and supports, including coverage for assisted living services, personal care, skilled nursing and adult residential care homes.

Beneficiaries are enrolled in health plans administered by one of several commercial insurance providers, and they have the option to change plans once a year and at the time of enrollment. One of the main advantages of this model is that assisted living services are covered directly through Medicaid. This eliminates the waiting lists that typically apply to waiver services in other states, and helps to ensure you get the care you need when you need it.

What Assisted Living Services Are Covered by Medicaid in Hawaii?

In addition to covering primary and emergency medical care, Med-QUEST provides a variety of long-term services and supports that are medically necessary. These include institutional care, such as intermediate or skilled nursing, and home- and community-based alternatives such as assisted living. Here are some of the services that you may be eligible for based on a physician assessment.

  • Assisted living services
  • Case management
  • Move-in assistance
  • Residential care homes
  • Emergency response systems
  • Medical equipment and supplies
  • Level I and II personal care
  • Non Medical transportation

How to Know if You’re Eligible for Medicaid in Hawaii

To qualify for Med-QUEST, you must meet financial eligibility criteria based on your income and assets. In general, monthly income is capped at $1,235 for regular Medicaid or home- and community-based services. Assets are limited to $2,000 per applicant with exclusions for a primary home, vehicle and household items. Individuals whose income is too high may still be able to qualify by transferring funds to their spouse as a monthly needs allowance or by spending the excess on approved medical expenses. If you’re interested in assisted living or other long-term care benefits, a personal needs assessment is required to determine whether you require a nursing home level of care. 

 

2022 Medicaid Income Limits for Seniors in Hawaii

NameAnnual income limitsAsset limits
Single Applicant$14,820$2,000
Two-Person Household
(One Spouse Applying)
$14,820 for applicant$2,000 for applicant
$137,400 for non applicant
Two-Person Household
(Both Spouses Applying)
$29,640$2,000

Med-QUEST long-term services and supports are available to applicants who also meet citizenship, residency and age/functional requirements. You will be asked to show that you’re:

 

  • Aged 65 or older or permanently disabled
  • A permanent resident of Hawaii
  • A U.S. citizen or legal resident
     

 

How to Apply for Medicaid in Hawaii

The fastest and easiest way to apply for Med-QUEST is by completing an online application using the Kolea portal at Medical.MyBenefits.Hawaii.gov. You can also apply over the phone by calling (877) 628-5076. Alternatively, paper applications may be mailed or faxed to your local Med-QUEST Division Eligibility office. If you need help completing your application, a DHS community navigator can provide free assistance.

Information You Will Need

  • Personal information, including name and address
  • Social Security number
  • Date of birth and proof of age
  • Proof of citizenship or legal residency
  • Information about your tax filing status and any dependents
  • Details about any insurance coverage
  • Information about income and assets

How to Get Help Applying for Medicaid

Hawaii provides numerous resources to help you complete your application, enroll in a qualifying health plan and access your benefits. Services may be provided by government agencies and community service organizations.

ProgramContactServices provided
DHS Application CounselorsBy LocationThe Department of Human Services provides a list of authorized community partners who are qualified to help residents with applications for Medicaid and Marketplace coverage. In-person assistance is available at various locations in Maui County and on the islands of Oahu, Hawaii and Kauai.
Med-QUEST Customer Services Call Center(808) 524– 3370 (Oahu) (800) 316-8005 (other islands)For general assistance or to check your application status, contact your local eligibility office or the state’s Customer Services Call Center. Representatives can help you complete routine tasks, such as changing your address, updating your income or personal information and signing up for a health plan.
Med-QUEST Enrollment Services Section(800) 316-8005Eligible beneficiaries are automatically assigned to a health plan once approved for Med-QUEST. If you have questions or would like to change plans during the initial or annual enrollment period, this Med-QUEST department can help.
QUEST Integration Ombudsman(888) 488-7988 (808) 746-3324 (Oahu)If you have questions or concerns about your Med-QUEST benefits or need help with the application process, contact the Medicaid Ombudsman at the number provided. Beneficiaries are encouraged to contact their health plan to resolve coverage-related issues before calling.

Does Medicare Cover Assisted Living in Hawaii?

The short answer is that no, Medicare does not cover the cost of assisted living in Hawaii. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Hawaii.

Other Financial Assistance Options for Assisted Living in Hawaii

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

NameHow To ApplyHow It Works
Aid and AttendanceLearn more and apply online at va.gov.Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.
Reverse MortgagesLearn more about your options and how to apply at ftc.govIf you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
Long-Term Care (LTC) InsuranceLearn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Hawaii

There are many resources in Hawaii that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.

Area Agency on Aging

Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.<

Program NamePhone NumberDescription
Hawaii Area Agencies on AgingThe Hawaii Agency and Disability Resource Centers manage Area Agencies on Aging throughout the state. Services are provided through County Offices on Aging as well as the Kauai Agency on Elderly Affairs. Programs include help with in-home chores, transportation, personal care and housing assistance with the goal of helping elderly residents to continue living in their own homes or community. Eligibility criteria include being 60 years or older, a resident of Hawaii, a U.S. Citizen or a legal alien.

Cash Assistance Programs

Cash assistance programs in Hawaii provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.

Program NamePhone NumberDescription
Hawaii Lifeline Program800-234-9473The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones.

Financial Assistance for Senior Care and Senior Living

Whether living in their own home or in a senior living community, Hawaii seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.

Program NamePhone NumberDescription
Hawaii Medicaid I/DD WaiverThe Medicaid I/DD waiver is Hawaii's 1915c Home- and Community-Based Waiver that the state and federal governments sponsor. It's intended for those with limited incomes and resources. This waiver pays for a wide range of personal care services, including: • Grooming • Housekeeping • Transportation • Meals • Medication administration • Bathing • Toileting • Dressing • Personal emergency response systems (PERS) • Skilled nursing

Food Assistance Programs

Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Hawaii seniors afford the nutritious food they need.

Program NamePhone NumberDescription
Hawaii Supplemental Nutrition Assistance Program (SNAP)The Supplemental Nutrition Assistance Program (SNAP) in Hawaii promotes wellness by offering food benefits to low-income seniors in need. The government-funded program offers electronic benefit transfers that beneficiaries can use at food retailers across the state. The aim of these funds is to increase residents' grocery budgets, enabling them to prioritize buying quality and nutritional foods and snacks. Eligibility is determined based on household size and gross income.
Hawaii Meals on WheelsHawaii's Meals on Wheels provides healthy, home-cooked dishes for adults aged 60 and older with disabilities or limited mobility that prevents them from shopping for food or preparing nutritious meals. Costs for the program vary from zero to full price, depending on the ability to pay. Volunteers delivering food ensure seniors receive regular communication and safety checks to confirm their well-being. Seniors with transportation can socialize and eat at local centers, promoting wellness.

Free Used Medical Equipment

Due to the high cost of purchasing new medical equipment, several organizations in Hawaii collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.

Program NamePhone NumberDescription
Assistive Technology Resource Centers of Hawaii (ATRC)808-532-7111ATRC allows individuals with disabilities to test assistive technologies free of charge to see which ones work best and provide the greatest benefit. The organization also offers training classes on the latest technologies. In addition, the ATRC provides financial aid for wheelchair vans.
Relay Hawaii Equipment Program (RHEP)808-847-9032RHEP provides relay equipment to seniors with communication challenges and those without access to any assistive equipment to keep them connected with family and friends. Training and installation are available at no extra cost. This equipment may include speech-to-speech services (STS) or hearing carry-over (HCO).

Home Repair and Modifications

Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Hawaii have different eligibility criteria and often assist retirees by providing grants or loans.

Program NamePhone NumberDescription
Hawaii Weatherization Assistance ProgramWAP helps seniors on a budget lower their energy costs by updating the weatherization on their homes. This includes installing low-flow showerheads, CFL or LED lighting, advanced power strips, air conditioner replacement, solar water heaters, refrigerator replacement, insulation installation and window and door replacement.

Senior Engagement

Senior engagement resources and programs in Hawaii help older adults remain active and ensure they contribute to the community. Resources include wellness programs, volunteer opportunities, support groups and organizations that help residents connect with the community to live fulfilling lives.

Program NamePhone NumberDescription
Alzheimer's Association Hawaii Chapter800-272-3900As the Hawaii branch of the national organization, Alzheimer's Association Aloha works to advocate for local seniors and offers education and services to those impacted by Alzheimer's. Supportive services include educational workshops and support groups for seniors to connect with others who share their experiences.

Social Security Offices

Social Security offices in Hawaii help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.

Program NamePhone NumberDescription
Hawaii Social SecuritySocial Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working.

Utility & Energy Bill Assistance

Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Hawaii retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.

Program NamePhone NumberDescription
Hawaii Low-Income Home Energy Assistance Program (LIHEAP)Seniors who find it financially challenging to pay their home energy bills can apply for help once a year through the Hawaii Low-Income Home Energy Assistance Program (LIHEAP). This state-wide program provides emergency assistance to pay heating and cooling bills. LIHEAP provides either an energy credit for eligible seniors or an energy crisis intervention for those at risk of utility disconnection due to nonpayment.

Veteran's Services

Hawaii retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.

Program NamePhone NumberDescription
Hawaii VA Benefits and Health CareSeniors who served in the armed forces may qualify for benefits through the Hawaii VA Benefits and Health Care program. This veterans services program provides health care and financial aid to veterans. Some older veterans may also qualify for retirement income. The main medical center and regional benefit office are in Honolulu, but there are clinics and centers in other parts of the state.

Assisted Living Laws and Regulations in Hawaii

Assisted living facilities and adult residential care homes in Hawaii are licensed by the State Licensing Section at the Department of Health, Office of Health Care Assurance. This agency is responsible for enforcing a variety of standards related to health, safety and staffing.

TopicHAWAII LAWS AND REGULATIONS
Assisted Living Service Plan RequirementsAssisted living facilities must develop a personalized plan of care for each resident based on a comprehensive needs assessment. The plan must address all aspects of care as well as the individual’s personal preferences. Service plans must be developed at or before the time of admission and reassessed after 30 days. Designated staff members are responsible for periodically reviewing each service plan.
Assisted Living Admission RequirementsFacilities may not deny residents admission based on their race, national origin, sexual orientation or other protected status. New residents must be advised of their rights and the facility’s policies and procedures. If the facility is unable to provide adequate care or needs to discharge a resident for any reason, they must provide at least 14 days notice in writing.
Assisted Living Scope of CareAssisted living facilities must provide a comprehensive range of personal care services, including 24-hour staffing, help with daily activities, health monitoring, household services, social activities and three daily meals. They must also provide social services, transportation, bill pay assistance and ancillary services, such as hair care, physical therapy and podiatry, either in-house or through contracted providers.
Assisted Living Medicaid PolicyPersonal care and assisted living services are covered by Hawaii’s Med-QUEST managed care system when they are medically necessary. Applicants must meet financial eligibility requirements.
Assisted Living Facility RequirementsEach resident must have access to a mobility-friendly apartment-style unit with a bathroom and cooking facilities, if medically appropriate, including a refrigerator and sink. Each unit must have at least 220 square feet of living space, excluding the bathroom. Residents must also have access to a 24-hour call system, private mailbox and connections for telephone and TV. Facilities must also provide common areas, including recreation spaces, lounges, dining facilities and laundry equipment.
Medication Management RegulationsFacilities may be responsible for administering prescription and nonprescription medications unless the resident has received permission to self-administer from a registered nurse or physician. Facilities must maintain adequate records, and medication protocols must be reviewed at least once every 90 days by a licensed medical professional.
Staffing RequirementsFacilities must employ a qualified administrator or director and provide 24-hour direct-care staffing. A licensed nurse must be available 7 days a week to oversee resident care and monitoring. The administrator is responsible for providing adequate training and ensuring that the facility complies with relevant regulations.
Staff Training RequirementsAssisted living facilities must provide sufficient training to help workers complete their job duties. All staff members must be trained in CPR and first aid, and the state requires at least 6 hours of annual in-service training for direct-care workers as well as orientation for new employees. Nurse aides in Hawaii must complete a 100-hour training program, including 70 hours of clinical experience, which exceeds federal minimums.
Background Checks for Assisted LivingThe state requires background checks for all direct-care workers and volunteers who work in health care facilities. License applications may be denied if an applicant has a criminal conviction or a history of abuse, neglect or misappropriation of property.
Requirements for Reporting AbuseInstances of suspected abuse, exploitation or neglect should be reported to Adult Protective Services by calling one of the regional hotlines: (808) 832-5115 (Oahu), (808) 933-8820 (East Hawaii), (808) 327-6280 (West Hawaii), 808-241-3337 (Kauai) or (808) 243-5151 (Maui and others). Reporting is mandatory for designated health care workers. Reports can also be made anonymously.

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The material on this site is for informational purposes only and is not a substitute for legal, financial, professional, or medical advice or diagnosis or treatment. By using our website, you agree to the Terms of Use and Privacy Policy

Caring.com

Caring.com is a leading online destination for caregivers seeking information and support as they care for aging parents, spouses, and other loved ones. We offer thousands of original articles, helpful tools, advice from more than 50 leading experts, a community of caregivers, and a comprehensive directory of caregiving services.

 

The material on this site is for informational purposes only and is not a substitute for legal, financial, professional, or medical advice or diagnosis or treatment. By using our website, you agree to the Terms of Use and Privacy Policy

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