Guide · When care is a flight away

Medicare on the neighbor islands, and when the specialist is on Oahu

Hawaii Island, Maui, Molokai, Lanai and Kauai each have a hospital or two and a plane ticket for the rest. Here is which plans follow you to Queen’s, Straub, Kaiser Moanalua or a mainland cancer center — and which stop at the shoreline.

Call (702) 706-6564 Request a free review

No cost, no obligation, no pressure.

Talk it through with Darin

No cost, no pressure. Prefer to call? (702) 706-6564.

Your name

Phone

ZIP code or city

What can we help with? (optional)

We never ask about your health on this form. See our Privacy Policy. This is a solicitation for insurance. Not connected with or endorsed by the U.S. government or the federal Medicare program.

At a glance

A Medigap policy with Original Medicare works with any provider in the U.S. that accepts Medicare, on any island or the mainland, with no referral or travel rule. It is the simplest interisland coverage there is. It does not cover Kaiser.
HMSA’s neighbor island Akamai Advantage plans (Standard and Standard Plus, PPOs) include help with interisland travel when HMSA determines the specialty care you need is not available on your island and refers you to a participating specialist elsewhere. Kaiser Senior Advantage refers members within Kaiser, usually to Oahu; its service area does not include Kauai, Molokai or Lanai.
Hawaii was short 833 full-time-equivalent physicians in 2025 according to the University of Hawaii’s workforce report, with the largest gaps on the neighbor islands; Maui County has the highest primary-care shortage in the state.
Medicare Part B covers medically necessary emergency ambulance transport, including air ambulance when ground transport cannot get you to the care you need; you pay 20% after the deductible with Original Medicare, which a Medigap policy covers.
Moving your permanent residence to another island, or to Hawaii from the mainland, opens a Special Enrollment Period. A federally declared disaster — the August 2023 Maui wildfires triggered one — does too.

Most of the state’s subspecialists work on Oahu, and a lot of the rest work in Seattle, San Francisco or Los Angeles. A resident of Hilo, Kihei, Kaunakakai or Kapaa can expect that some of their care will involve an airport. The Medicare rules are not complicated, but they are unforgiving, so here they are plainly.

Which plans travel

How each plan type behaves once you leave your home island. Emergencies are covered by every plan, everywhere in the U.S.
Plan type	Care on another island	Care on the mainland
Original Medicare + Medigap	Any provider that accepts Medicare, no referral; the supplement pays its share the same as at home	Same — any Medicare provider in the country
HMSA Akamai Advantage (neighbor island PPO)	In-network providers statewide; interisland travel help when HMSA refers you off-island for care not available at home	Out-of-network costs, except in states covered by HMSA’s visitor/traveler program, where in-network costs apply
Kaiser Permanente Senior Advantage	Care within Kaiser; referral to Kaiser on Oahu for what your island’s Kaiser office does not provide	Emergencies and urgent care; some Kaiser regions honor visiting-member arrangements — ask before you travel
National-carrier Advantage HMO/PPO	Per the plan’s network and rules; HMOs generally require in-network care	Emergencies only on most HMOs; PPOs cover out-of-network at higher cost
Part D (standalone or built in)	National pharmacy networks; mail order	Same; check that a preferred pharmacy exists where you are going

Read the actual travel benefit, not the brochure. HMSA’s interisland travel help applies when HMSA determines the care is not available on your island from a participating provider and refers you; it is not a general airfare benefit. Kaiser’s referrals stay inside Kaiser. If a travel benefit is the reason you are choosing a plan, we get it in writing from the Evidence of Coverage before you enroll.

Island by island

Hawaii Island. Hilo Benioff Medical Center and Kona Community Hospital are the public acute-care hospitals; Queen’s North Hawaii in Waimea is a rural hospital in the Queen’s system; Kaiser has a Kona office and Senior Advantage covers most of the county. Subspecialty care often means Oahu. See Hilo, Kailua-Kona and Waimea.
Maui. Maui Memorial in Wailuku is the island’s only acute-care hospital, run by Maui Health and open to all patients; Kaiser has offices in Maui Lani, Wailuku and Kihei and a temporary Lahaina clinic in Kaanapali while a permanent one is built. Kaiser Senior Advantage covers the island of Maui. See Kahului, Kihei and Lahaina.
Molokai and Lanai. Molokai General (Queen’s) and Lanai Community Hospital (Maui Health) are small critical-access hospitals; complex cases leave by air. Kaiser Senior Advantage is not sold on either island. See Kaunakakai.
Kauai. Wilcox in Lihue (Hawaii Pacific Health), Kauai Veterans Memorial in Waimea and Samuel Mahelona in Kapaa; no Kaiser service area. Most specialty care is a flight to Honolulu. See Lihue and Kapaa.

When it is an emergency: air ambulance

Medicare Part B covers ambulance transport to the nearest appropriate facility when it is medically necessary and any other transport could endanger your health, and that includes air ambulance when ground transport cannot get you there fast enough or at all — the normal situation for a serious case on Molokai, Lanai or the rural ends of Hawaii Island. With Original Medicare you pay 20% of the Medicare-approved amount after the Part B deductible; a Medigap Plan G covers that 20%. Advantage plans cover emergency ambulance too, with their own copays. Non-emergency interisland travel for a scheduled appointment is a different thing: Original Medicare does not pay for the plane ticket, and only certain Advantage plans help.

Moving between islands, or moving here

Advantage and Part D plans are sold by county, and you must live in the plan’s service area. Moving your permanent residence from Oahu to Kona, or from Maui to Molokai, ends a plan that does not serve the new county and opens a Special Enrollment Period to choose one that does. Moving to Hawaii from the mainland works the same way: an Advantage HMO from California or Washington generally covers only emergencies here, and changing your legal residence lets you pick from what is sold in your new county. A Medigap policy is different — once issued it stays in force wherever you live, though the premium may be re-rated. Our agency is licensed in Hawaii and fifteen other states, so we can move coverage cleanly in either direction; the state-by-state switching rules are on switching Medigap plans.

After a disaster

The August 2023 Maui wildfires triggered a federal public health emergency, and CMS opened a Special Enrollment Period for people who could not enroll, disenroll or switch plans because of it, and required Part D plans to cover prescriptions at out-of-network pharmacies for displaced members. The same mechanism applies to any federally declared disaster or emergency in Hawaii. If a disaster changed where you live, where you get care or which pharmacy you use, tell us; the relief has dates and rules of its own.

Caring for a kupuna at a distance

A lot of the calls we get from the neighbor islands are from an adult child on Oahu or the mainland helping a parent in Hilo or Hanapepe. Two state programs are worth knowing alongside Medicare. Kupuna Care, run by the Executive Office on Aging through the county Aging and Disability Resource Centers, provides home-delivered meals, personal care, homemaker help, adult day care and transportation to help older adults stay at home. The Kupuna Caregivers Program helps working family caregivers — those employed 30 or more hours a week caring for someone 60 or older — with up to $70 a day toward those same services; it is not an entitlement, so funding limits apply. Both start with a call to the statewide ADRC at 808-643-2372. On the Medicare side, we help you understand a parent’s plan, whether a Medicare Savings Program could pay their Part B premium, and whether an Institutional SNP fits if they are in a care home.

Part D away from home

Every Part D plan has a national pharmacy network, so filling a prescription in Honolulu or Seattle is not a problem. Pricing can be: plans have preferred pharmacies where copays are lowest, and the preferred chain on Oahu may not have a store on Lanai. Mail order at 90-day supplies solves most of it. We check your island’s pharmacies when we compare plans.

Good to know

Frequently asked questions

I live on Kauai and fly to Honolulu for a specialist. Which plan covers that?

Original Medicare with a Medigap policy covers any provider that accepts Medicare, on any island, with no referral or travel rule. HMSA’s neighbor island Akamai Advantage plans include interisland travel help when HMSA refers you to a participating specialist on another island. Kaiser Senior Advantage is not sold on Kauai. We read the plan’s travel rules with you before you enroll.

Does Medicare pay for my flight to Oahu for an appointment?

Original Medicare does not pay for non-emergency travel. It does cover medically necessary emergency ambulance transport, including air ambulance when ground transport cannot get you to care. Certain Advantage plans, including HMSA’s neighbor island plans, help with interisland travel when they refer you off-island; the terms are plan-specific.

I have Kaiser on the Big Island. What happens when I need care Kaiser does not offer here?

Kaiser refers you within Kaiser, usually to its Moanalua Medical Center and specialists on Oahu. Ask Kaiser what travel assistance applies to a referral; it is set by the plan, and we help you read it.

Can I get treatment on the mainland with a Hawaii plan?

With Original Medicare and a Medigap policy, yes, at any provider that accepts Medicare. With an Advantage plan, emergencies are covered everywhere; routine or planned care on the mainland depends on the plan, and HMSA’s visitor/traveler program extends in-network costs to a list of states. We confirm before you book.

I am moving from Oahu to Maui. What happens to my plan?

Changing your permanent residence to another county opens a Special Enrollment Period. An Advantage or Part D plan that does not serve Maui County ends; you choose from what is sold there. A Medigap policy stays in force. We handle the switch.

Ready when you are

Care on another island? Let’s make sure your plan follows you.

A short, friendly conversation — no pressure, no cost.

Call (702) 706-6564 Request a free review Get a quote online

Sources we used on this page

Figures are checked against the source at the review date in the byline below. If a source has changed since, the source wins.

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.