Medicare by Hawaii county

Hawaii has five counties. Medicare plan availability is determined by county and zip code, so the county you live in directly shapes your plan options. Select your county for a detailed local guide.

All five Hawaii counties

Medicare in Hawaii is county-based, but most people think island-based

Most Hawaii residents identify with their island, not their county — and for good reason. Maui County alone covers four islands (Maui, Molokai, Lanai, and uninhabited Kahoolawe), each with very different healthcare landscapes. If you're more comfortable thinking by island, see our Medicare by island guide.

Why county matters for Medicare

• Medicare Advantage plans are sold by county and zip code. The plans available in Honolulu County are not the same as those in Hawaii County, even when offered by the same carrier.
• Medicaid (Med-QUEST) office assignments follow county lines.
• Area Agencies on Aging — which administer Kupuna Care, ADRC, meals, and senior services — are organized by county.
• Provider networks for Medicare Advantage HMOs often correspond to county boundaries.

The unusual case of Kalawao County

Kalawao County, on the Kalaupapa peninsula of Molokai, is the smallest county in the United States by both area and population (roughly 80 residents). It exists because of the historic Kalaupapa Settlement — established in 1866 to isolate people with Hansen's disease (leprosy). Unlike Hawaii's other four counties, Kalawao does not have its own elected county government; it's administered by the Hawaii State Department of Health. For Medicare purposes, Kalawao residents access services through Maui County's Area Agency on Aging and federal facilities on the peninsula.

How county affects your Medicare costs

Federal Medicare costs (Part A and Part B premiums, deductibles, IRMAA brackets) are identical across all 50 states and Hawaii's counties. But your actual Medicare costs vary by county because:

• Medicare Advantage premiums vary by county. A $0-premium MA plan available in Honolulu County may have a $40/month premium in Hawaii County, or not be sold at all on Molokai or Lanai.
• Medigap availability and pricing is statewide in Hawaii — same rates regardless of county — but a major advantage versus most states where Medigap is age-rated.
• Part D premiums are the same statewide; pharmacy networks and preferred-pharmacy availability vary.

Free Medicare help in every Hawaii county

Two free resources serve every county equally:

• Sage PLUS Hawaii — Hawaii's free, unbiased Medicare counseling. Statewide line: 1-888-875-9229. Phone counseling reaches every county; in-person appointments are scheduled through the local county Area Agency on Aging.
• Licensed Hawaii Medicare agents — free help comparing plans, including plans Sage PLUS counselors cannot enroll you in. Find a Hawaii agent.

Each county's Area Agency on Aging

• Honolulu County: Elderly Affairs Division, (808) 768-7700
• Hawaii County: Hawaii County Office of Aging, (808) 961-8626
• Maui County: Maui County Office on Aging, (808) 270-7774 (also serves Kalawao)
• Kauai County: Kauai Agency on Elderly Affairs, (808) 241-4470
• Statewide ADRC: Aging and Disability Resource Center, 643-ADRC (808-643-2372)