Honolulu Senior AdvisorWhat does senior care cost in Hawaii?
CareScout's 2025 Cost of Care Survey puts Hawaii's annual medians at $145,065 for assisted living (about $12,089 a month, the highest of any state), $185,679 for a semi-private nursing home room (about $15,473 a month), $196,735 for a private room, $93,808 for 44 hours a week of non-medical home care and $30,615 for five days a week of adult day health care.
| Care type (Hawaii, 2025) | Annual median | About per month | Change | U.S. median | State rank |
|---|---|---|---|---|---|
| Assisted living community | $145,065 | $12,089 | +7% | $74,400 | 1 |
| Nursing home, semi-private room | $185,679 | $15,473 | +3% | $114,975 | 4 |
| Nursing home, private room | $196,735 | $16,395 | 0% | $129,575 | 4 |
| Home care, non-medical (44 hrs/week) | $93,808 | $7,817 | -2% | $80,080 | 9 |
| Adult day health care (5 days/week) | $30,615 | $2,551 | n/a | $24,700 | 15 |
| Private duty nurse (1 hr/week, 52 weeks) | $3,380 | $282 | n/a | $4,680 | 42 |
CareScout 2025 Cost of Care Survey, Hawaii results (released March 2, 2026). Monthly and hourly figures are our arithmetic from CareScout's published annual medians (annual / 12; home care annual / 2,288 hours). Ranks run from most to least expensive state. CareScout does not survey adult residential care homes or community care foster family homes, and publishes no Honolulu-only figure.
What does a care home (ARCH) cost on Oahu?
No public survey publishes a median price for Hawaii adult residential care homes or foster family homes; CareScout does not survey them, and the state does not collect private rates, so each home sets its own price and families have to ask.
What families can say with confidence is that a care home is usually priced as a single monthly rate covering room, meals, supervision and personal care, sometimes with added charges for higher care needs, incontinence supplies or a private room. Get the rate, what it includes and the notice period for increases in writing before move-in.
The most useful comparison is not a median but three written quotes from homes that can actually meet your parent's care level, in the part of the island where the family can visit.
Why is Hawaii more expensive than the mainland?
Hawaii's care costs are high mainly because of labor and housing costs on an island economy and because licensed capacity is scarce; CareScout ranks Hawaii first nationally for assisted living, fourth for nursing homes and ninth for home care in 2025.
Home care is a partial exception: at about $41 an hour, Hawaii's 2025 home care median fell 2% from 2024, while the national median rose 3%. For someone who needs only a few hours of help a day, staying home may cost less than any residential option. Run the numbers.
How should an Oahu family budget for care?
Budget from the care need, not the setting: estimate hours of help per day, whether nursing-level care is needed, and how long savings must last, then compare the realistic monthly cost of home care, a care home, assisted living and a nursing home against income plus savings.
- Add up monthly income: Social Security, pensions, annuities, rental income.
- List assets that could be spent down, and whether a spouse still lives at home.
- Decide early whether Med-QUEST is likely within two or three years; it changes which settings make sense.
- Ask about veterans' benefits if your parent or their late spouse served.
Call the Elderly Affairs Division at (808) 768-7700 for free help sorting out the options.
At a glance
| This page gives you | This page does not give you | |
|---|---|---|
| Prices | Hawaii's published 2025 medians | A care home median that no one publishes |
| Geography | Statewide figures | A Honolulu-only number |
| Planning | A way to compare settings by care need | A quote from any facility |
| Advice | Free places to get help | Legal or tax advice |
Sources include Hawaii Administrative Rules chapters 11-100.1, 11-90 and 11-800, HRS 321-481 and 321-1.8, Office of Health Care Assurance rosters and pages, the 2026 HHS poverty guidelines, CMS, CareScout and VA rate tables as cited above; see our editorial standards.
