Native Hawaiian Health Care Systems and Medicare

The five Native Hawaiian Health Care Systems serve approximately 328,000 Native Hawaiians across the islands. They coordinate with Medicare and Med-QUEST to provide culturally grounded primary care, prevention, and traditional healing — often at no cost to the patient.

The Native Hawaiian Health Care Improvement Act

The Native Hawaiian Health Care Act, passed by Congress in 1988, created Papa Ola Lokahi as the coordinating board for Native Hawaiian health and authorized the establishment of community-led Native Hawaiian Health Care Systems on each major island. The federal Health Resources and Services Administration (HRSA) administers the program.

The five Native Hawaiian Health Care Systems

The coordinating board is Papa Ola Lokahi, headquartered at 677 Ala Moana Boulevard, Suite 720, Honolulu — phone (808) 597-6550.

Services available through the systems

Each NHHCS offers a different mix of services based on community needs and grant funding, but services typically include:

• Primary care — physical exams, chronic disease management, preventive screenings
• Behavioral health — counseling, substance use treatment, support groups
• Diabetes and cardiovascular disease management — Native Hawaiians have disproportionately high rates of both
• Cancer prevention and screening
• Traditional Hawaiian healing practices — lomilomi (massage), la'au lapa'au (herbal medicine), ho'oponopono (mediation), where offered
• Health education — nutrition, exercise, smoking cessation, prenatal classes
• Care coordination — helping patients navigate Medicare, Med-QUEST, and other systems
• Outreach to remote and underserved communities

Eligibility

NHHCS services are open to all Native Hawaiians regardless of income or insurance status. Services are also generally available to family members and others in the household. Many programs are open to non-Native Hawaiian community members as well, though Native Hawaiian patients are the primary mission.

How NHHCS coordinates with Medicare

NHHCS clinics typically bill Medicare and Medicare Advantage plans for covered services, just like any other primary care provider. The systems also offer programs and services that Medicare does not cover — community health education, traditional healing, peer support — funded through their HRSA grants and other sources.

For Medicare beneficiaries who identify as Native Hawaiian, the NHHCS on your island is a valuable resource:

• Primary care delivered with cultural understanding
• Help navigating Medicare enrollment and plan selection
• Coordination with traditional healing alongside Western medicine
• Connections to other community resources — Kupuna Care, ADRC, food assistance, transportation

Native Hawaiian health disparities

Native Hawaiians experience higher rates of diabetes, heart disease, certain cancers, and chronic kidney disease compared to other groups in Hawaii. Life expectancy is several years shorter on average. The NHHCS Program exists specifically to address these disparities through community-based, culturally grounded care.

For Native Hawaiian Medicare beneficiaries, accessing your NHHCS in addition to your primary care provider can provide complementary services not typically covered by Medicare alone.

Native Hawaiian Health Scholarship Program

Papa Ola Lokahi also administers the Native Hawaiian Health Scholarship Program (NHHSP), which has trained over 330 Native Hawaiian healthcare professionals — physicians, nurses, behavioral health clinicians, dentists, and others — many of whom go on to serve in the NHHCS clinics or in underserved communities across the islands.