More than 1.4 million people reside in the tropical state of Hawaii. The archipelago continues to grow as a destination for older adults due to its high-quality medical care and health system access. Nineteen percent of the population is aged 65 and older. Financial assistance is also available to low-income seniors who are seeking long-term care.

The median monthly cost of assisted living in Hawaii is $5,375 according to the 2021 Genworth Cost of Care Survey. While it’s more expensive than the national average, it’s more affordable than other states on the Pacific coast. Hawaii is often ranked as one of the healthiest states for seniors in America.

This guide covers the cost of assisted living in Hawaii as well as options for financial assistance and local resources regarding long-term care.

How Much Does Assisted Living Cost in in Hawaii?

In Hawaii, the median monthly cost for assisted living $5,375, according to the 2021 Genworth Cost of Care Survey. Assisted living is $875 more expensive than the national average. The cost of assisted living is also higher than in California, which has median monthly costs of $5,250. To the north in the Pacific Northwest, care costs are higher. In Washington assisted living has a median cost of $6,000 per month, $625 more expensive than Hawaii. Meanwhile, in Oregon, the median monthly cost is slightly lower at $5,045 per month. To the east in Arizona, assisted living costs are also lower with a median monthly cost of $4,000.

The Cost of Living in Hawaii’s Top Cities

Assisted living costs vary in Hawaii from island to island. In Honolulu, the state capital, the median monthly cost is $5,375, which is the same as the state average. In Kahului, located on the island of Maui, costs are significantly lower with a median monthly cost of $3,825. The cost of assisted living in Hilo is also lower than the state average and similar to Kahului at $3,825. 

The Cost of Assisted Living vs. Other Types of Care

Hawaii’s excellent health care system provides seniors with many different long-term care options. Assisted living is less expensive than in-home care services in Hawaii. Homemaker services and home health aides share a median monthly cost of $5,720. These types of care include assistance with daily household tasks, and they cost, on average, $345 more per month than assisted living in Hawaii.

Seniors who only require adult day health care can expect to pay an average of $1,625 per month. Adult day health care includes case management, social programming, physical therapy and other services that support the well-being of older adults. Nursing home care is the most expensive at $12,501 because it provides ongoing medical care 24/7. 

Can You Use Medicaid to Pay for Assisted Living in Hawaii?

The state of Hawaii has a special managed Medicaid program to help seniors cover the costs associated with assisted living. The Med-QUEST Integration program provides Medicaid reimbursements for assisted living services.

Medicaid’s Coverage of Assisted Living in Hawaii

There are no waiver programs in Hawaii for Medicaid. Reimbursements are done through Med-QUEST and include assistance with activities of daily living (ADLs), such as personal care and some homemaker services. Benefits of this program include:

• Adult day health care
• Personal emergency response systems (PERS)
• Home modifications
• Private-duty nursing
• Self-directed care

There are no waiting lists or enrollment caps for the Med-QUEST Integration program. This allows for older adults to quickly access the services they need. Care needs are determined during quarterly assessments administered by the Department of Human Services.

Eligibility for Medicaid in Hawaii

To receive Medicaid, seniors must meet specific requirements for income limits. These limits change based on factors like marital status and whether both spouses need Medicaid. In Hawaii, single applicants must have an income of less than $14,820 in order to qualify. Married couples, on the other hand, must earn less than $20,400 per year.

2022 Medicaid Income Limits for Seniors in Hawaii

	Income  Limits*	Asset Limits
Single Applicant	$14,820	$2,000
Two-Person Household (Only One Person Applying)	$20,040	$2,000 for applicant $137,400 for nonapplicant
Two-Person Household (Both People Applying)	$20,040	$3,000

*per year

To be eligible for Medicaid coverage, applicants must meet specific income limits and be:

• 65 or older or disabled
• A U.S. citizen or lawful resident
• A resident of Hawaii

Applying for Medicaid In Hawaii

Seniors can complete an online application at MyBenefits.Hawaii.gov. There are also Med-QUEST application centers located throughout the state that provide in-person application assistance. Visit one of the Med-QUEST locations or call toll-free (877) 628-5076 for additional information. TTY/TDD users can reach them at (855) 585-8604.

Before You Apply

Seniors wishing to apply for Medicaid need to prepare documents verifying their identity, assets and income. Here are some documents to prepare:

• Birth certificate
• Passport, driver’s license or green Card
• Proof of income sources
• Proof of assets
• Proof of residence
• Medicare card or other insurance documents

Where to Go to Get Help

Seniors can contact local organizations in Hawaii to better understand what coverage options are available to them. Below are resources for people seeking Medicaid assistance.

Resource	Contact	Service
My Benefits Hawaii	MyBenefits.Hawaii.Gov	The state’s official online portal allows seniors to apply for and access information about their Medicaid beneifts.
Med-QUEST Hotline	(877) 628-5076	This statewide hotline provides information regarding the Med-QUEST Integration program. Seniors can determine their eligibility by speaking directly with a Med-QUEST representative.
Med-QUEST Website	MedQuest.Hawaii.Gov	A comprehensive overview of services as well as instructions on how to apply for Medicaid can be found on the Med-QUEST website. Information about additional covered benefits is available along with a list of community resources.

Can You Use Medicare to Pay for Assisted Living in Hawaii?

Unfortunately, Medicare does not cover the cost of assisted living in Hawaii. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

For more information about what Medicare visit medicare.gov.

Are There Other Financial Assistance Options for Assisted Living in Hawaii?

	How to Apply	How It Works
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free and Low-Cost Resources for Seniors in Hawaii

There are many free and low-cost resources available in Hawaii that promote the well-being of older adults. Below is a list of community initiatives, recreational programs and administrative services that help support the elderly in Hawaii.

Resource	Contact	Service
The Hawaii Healthy Aging Partnership	(808) 643-2372	Health programs backed by science are offered to empower and engage older residents in Hawaii. Programs, such as “Enhance Fitness” and “Better Choices,  Better Health,” are designed to promote well-being and prevent disease. The statewide partnership was established in 2003 and includes more than 60 local organizations.
Department of Veterans Affairs	(800) 827-1000	The federal Veterans Benefits office in Honolulu helps veterans and their families receive support to cover the costs associated with assisted living. The Aid and Attendance benefit directly supports elderly veterans who need assitance with daily care. Eligible veterans can apply online for long-term care programs, geriatric research and Home- and Community-Based Services.
Kupuna Legal Aid Services	(808) 536-0011 (Oahu) (888) 536-0011 (Neighboring Islands)	Legal advice is available to seniors aged 60 and over through Kupuna Legal Aid Services. This includes advance planning services for health care and asset management. Attorneys can help residents prepare powers of attorney, simple wills and transfer on death deeds. A dedicated hotline is available to seniors.
Executive Office on Aging	(808) 961-8600	This statewide system of support services is available to both the elderly and their caregivers. Programs, such as Senior Medicare Patrol (SMP Hawaii) and the Hawaii State Health Insurance Assistance Program (SHIP), help ensure that seniors can age with dignity and receive the health care that they need. Individual counseling and support groups are also available.
Hawaii’s Office of the Ombudsman	(808) 587-0770	The Office of the Ombudsman is a volunteer effort that protects the rights of resdients in assisted living facilities throughout Hawaii. Complaints against individuals and agencies are investigated at the state and county level.

COVID-19 Rules for Assisted Living in Hawaii

The following information is based on research done on several government websites, including cdc.gov/coronavirus and health.hawaii.gov/coronavirusdisease2019. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/7/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?	No
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?	Not Available*
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

*NOTE: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	No (Conditions Apply)
Are senior living facilities required to cancel all group outings?	No
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

Assisted Living Laws and Regulations in Hawaii

The Office of Health Care Assurance, a divison of the Department of Health, regulates assisted living communities in Hawaii to make sure they meet specific quality standards. These regulations cover staffing, medication administration, and licensing requirements to protect the health and safety of older adults in Hawaii.