Medicare by Hawaiian island

Most Hawaii Medicare beneficiaries think and search by island, not county. Each island has its own healthcare landscape — provider availability, hospitals, and inter-island travel needs vary significantly.

All Hawaiian islands

How island geography shapes Medicare in Hawaii

Hawaii is the only state where the geographic unit that matters most for Medicare access is not the county or city, but the island. Each island has different specialty availability, different hospital options, and different inter-island travel demands for specialty care.

• Oahu has the largest provider network and most hospitals in the state, including Queen's Medical Center, Straub Medical Center, Kaiser Moanalua, and Tripler Army Medical Center.
• Hawaii Island has Hilo Medical Center on the windward side and Kona Community Hospital on the leeward side, with significant gaps in specialty care for the island's interior and rural areas.
• Maui has Maui Memorial Medical Center in Wailuku as the main facility; West Maui has had reduced access since the 2023 Lahaina wildfires.
• Kauai has Wilcox Medical Center in Lihue and Kauai Veterans Memorial Hospital in Waimea.
• Molokai has Molokai General Hospital — one of the smallest hospitals in the state.
• Lanai has Lanai Community Hospital with limited services; almost all specialty care requires travel to Maui or Oahu.

For neighbor-island residents, inter-island healthcare travel is a routine part of receiving Medicare-covered specialty care.

Medicare Advantage availability differs sharply by island

Federal Medicare (Parts A and B) works identically anywhere in the United States — same providers accept it, same costs apply. But Medicare Advantage plans are sold by zip code, and Hawaii's Medicare Advantage landscape varies dramatically across islands:

• Oahu has the broadest selection of Medicare Advantage plans. Most major Hawaii MA carriers compete here, network depth is excellent, and $0-premium plans are common.
• Hawaii Island, Maui, and Kauai typically have fewer MA plan options. Networks are narrower; some plans don't include neighbor-island hospitals at all.
• Molokai and Lanai have very limited MA plan availability. Original Medicare with Medigap is often the more practical choice for residents of these islands because of provider freedom — you can use any Medicare-accepting provider on any island.

Original Medicare with Medigap may serve neighbor islands better

For Hawaii residents on neighbor islands, Original Medicare with a Medigap policy often makes more sense than Medicare Advantage because:

• No network restrictions. When you fly to Oahu for specialty care (cardiac surgery, oncology, neurosurgery), Original Medicare covers you anywhere — no out-of-network surprises.
• Hawaii Medigap is community-rated. Premiums are the same regardless of age in Hawaii, unlike most states. This makes Medigap meaningfully more affordable for older Hawaii residents.
• Predictable costs. Medigap covers most of Medicare's out-of-pocket costs — no surprise hospital bills after a serious illness.

This isn't a universal recommendation — the right choice depends on your providers, prescriptions, budget, and travel patterns. See our guides on Medicare Advantage in Hawaii and Medigap in Hawaii, or talk to a licensed Hawaii Medicare agent for free help comparing options for your island.

Free Medicare counseling on every island

Sage PLUS Hawaii — the state's free SHIP program — provides Medicare counseling to residents on every Hawaiian island. Phone counseling is always available statewide; in-person appointments can be scheduled through your county's Area Agency on Aging:

• Statewide Sage PLUS line: 1-888-875-9229
• Statewide ADRC: 643-ADRC (808-643-2372)