Medicare by region · Hilo, Puna, Hamakua & Kau
Hilo Benioff Medical Center, the state’s largest public hospital, plus the Hilo VA clinic, Kau Hospital and Hale Hoola Hamakua — with Oahu a 50-minute flight away for what the island does not have.
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Medicare in the region
East Hawaii is rain, rainforest and one big public hospital. Hilo Benioff Medical Center is the largest facility in the Hawaii Health Systems Corporation and the anchor for Puna, Hamakua and Kau; the Hilo VA clinic and the Yukio Okutsu State Veterans Home serve the island’s veterans; and Kau Hospital in Pahala and Hale Hoola Hamakua in Honokaa cover the rural ends. What the island does not have — a range of subspecialists — means a flight to Oahu.
That is why the Advantage-versus-Medigap choice is sharper here than in Honolulu. A Medigap policy covers Hilo Benioff and Queen’s without a referral rule; an Advantage plan is only as good as its Hawaii Island network and its travel benefit. Kaiser members on the Big Island are referred within Kaiser, and HMSA’s neighbor island plans handle interisland travel when they refer you off-island.
Local plans to know: Kaiser Permanente Senior Advantage covers most of Hawaii County, and Kaiser’s Hawaii Island plan is the largest by enrollment in the county; HMSA’s neighbor island Akamai Advantage plans cover the whole island and include interisland travel help for approved treatment. Hilo Benioff Medical Center — renamed in 2024 with an $80 million expansion under way — is the public hospital the whole east side depends on.
Counties: Hawaii (East Hawaii: Hilo, Keaau, Pahoa, Volcano, Honokaa, Laupahoehoe, Naalehu, Pahala).
Each contracts differently with each plan; we check your doctors first.
Turning 65? Your Initial Enrollment Period is the 7 months around your birthday. Already on Medicare? The Annual Election Period is Oct 15–Dec 7, and Medicare Advantage Open Enrollment runs Jan 1–Mar 31. Moving to another island or losing a plan opens a Special Enrollment Period.
Your options
All-in-one Part C plans, often $0 premium, that use a local network — in Hawaii that usually means choosing between Kaiser, HMSA and a few national carriers, island by island.
How Advantage worksMedigap pairs with Original Medicare and lets you see any provider that accepts Medicare — Queen’s, Straub, Hilo Benioff, or a specialist on the mainland.
How Medigap worksStandalone drug coverage chosen around your medications and pharmacy. 2026 out-of-pocket cap: $2,100.
How Part D worksAdvantage plans built for a chronic condition, for nursing-facility care, or for people with both Medicare and Med-QUEST.
About SNPsQuestions from East Hawaii
Hawaii County typically offers Medicare Advantage plans from Kaiser Permanente (most of the county), HMSA’s neighbor island plans and some national carriers, every Medigap company licensed in Hawaii, and the full Part D lineup. Availability is set by county and changes each plan year.
Original Medicare with a Medigap policy covers any provider that accepts Medicare on any island or the mainland, with no referral and no travel rule. HMSA’s neighbor island Akamai Advantage plans include help with interisland travel when HMSA refers you to a participating specialist on another island; Kaiser refers within its own system. We read the plan’s travel rules with you before you enroll.
Nothing. Independent agents are paid by the carriers when you enroll, so comparing plans and reviewing your coverage each year is free to you.
Ready when you are
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Written and reviewed by Darin Weidauer — licensed insurance agent (NPN 18580338, HI License #18580338), Gerontologist (USC Leonard Davis School of Gerontology), MBA, Registered Social Security Analyst, and 22-year U.S. Air Force veteran.Last reviewed September 13, 2026. Plan availability, benefits and costs change every plan year — verify current details at Medicare.gov, 1-800-MEDICARE, or Hawaii SHIP at 1-888-875-9229.