🧭 Overview
Long-term care is one of the most significant financial risks facing Hawaii residents, and one of the least planned for. This page brings together the numbers that matter: what care actually costs in Hawaii, how many people are currently protected by long-term care insurance (LTCI), what the state offers in tax incentives, and what Medicaid will and won't cover.
💰 The Cost of Long-Term Care in Hawaii
These figures track real rates paid by families in Hawaii last year.
| Care Setting | Annual Cost | Monthly Cost | National Rank |
|---|---|---|---|
| In-Home Non-Medical Caregiver | $93,808 | $7,817 | #9 of 50 |
| Assisted Living Facility | $145,155 | $12,096 | #1 of 50 |
| Nursing Home: Private Room | $196,735 | $16,395 | #4 of 50 |
Source: CareScout Cost of Care Survey
Hawaii ranks #9 out of 50 states for in-home care costs, placing it among the ten most expensive states for in-home care. For a couple in their mid-60s planning for the future, a two-to-three year care event could easily consume $475,989 or more, funds that would otherwise go to a surviving spouse, children, or retirement income.
📊 How Long-Term Care Insurance is Used in Hawaii
Hawaii has 81,740 residents currently covered by long-term care insurance policies, below the national average for larger states compared to the national average. Most recently, LTCI paid out $127,490,000 to 651 Hawaii claimants, with an average payout of $195,837 per claimant.
💸 Hawaii State Tax Incentives for LTCI Premiums
Hawaii allows a state income tax deduction for qualifying LTCI premiums, which reduces your taxable income at your marginal state rate.
Benefit type: Deduction
An individual state tax deduction is allowed for LTC insurance premiums. This deduction is limited in the same manner as the deduction on the federal level.
Statutory reference: Haw. Rev. Stat. §235-2.3
Source: AHIP
🤝 Hawaii LTC Partnership Program
Hawaii does not currently participate in the federal Long-Term Care Partnership Program. No state LTC Partnership program as of 2025. Standard Medicaid spend-down rules apply. See the Medicaid thresholds section below.
🏥 Medicaid and Long-Term Care in Hawaii
Medicaid is the payer of last resort for long-term care, but qualifying requires spending down most of your assets first. Here are Hawaii's current Medicaid thresholds:
| Threshold | Amount |
|---|---|
| Medicaid Spend-Down (individual asset limit) | $2,000 |
| Community Spouse: Minimum Asset Allowance | $148,620 |
| Community Spouse: Maximum Asset Allowance | $162,660 |
| Minimum Monthly Income Allowance (spouse) | $2,643 |
In Hawaii, an individual must spend down assets to $2,000 before qualifying for Medicaid long-term care coverage. A community spouse may retain between $148,620 and $162,660. For most families, this means exhausting the majority of retirement savings before any Medicaid coverage begins, which is precisely the gap that long-term care insurance is designed to fill.
🏠 For Hawaii Residents: Is LTCI Right for You?
Long-term care insurance isn't right for everyone, but for most middle- and upper-middle-income families in Hawaii, it is the most efficient way to protect assets, preserve choices, and avoid placing a financial burden on family members. At current Hawaii care costs, even a modest policy with a $150–$200/day benefit and a three-year benefit period could offset hundreds of thousands of dollars in out-of-pocket exposure.
Most people apply in their 50s or 60s, when they're more likely to qualify in good health and lock in lower premiums.
💼 For Financial Advisors and CPAs in Hawaii
Long-term care planning intersects directly with retirement income planning, estate planning, and tax strategy, three areas your clients rely on you to coordinate. The data on this page (care costs, LTCI claims history, tax incentives, Medicaid thresholds) gives you and your clients a factual foundation for the conversation.
If you work with clients in Hawaii and want help with quotes, a quick health pre-screen, or a partner for long-term care planning, connect with Jesse.
This page is updated annually. Data reflects the most recent available surveys as of 2025–2026. For current personalized quotes or benefit design questions, contact us.