Is Your Maui or Hawaii Doctor in Network for 2027?

Getting care in Hawaii often means more than one island. You may see your primary care doctor on Maui and travel to Honolulu for a specialist, surgery, or advanced treatment. Medicare Advantage networks are set plan by plan and can change from one year to the next, so check both your home-island doctors and any Oahu providers you may need before you choose 2027 coverage.

NW Senior Insurance Solutions is not affiliated with or endorsed by any health system named in this article. Names appear only to help you recognize where you get care.

Island care, and what to ask

• Maui. Maui Health operates Maui Memorial Medical Center in Wailuku. Ask about your Maui doctors by name and location, including any specialists who visit from Oahu.
• Oahu. Many neighbor-island patients are referred to Honolulu. The Queen’s Medical Center is the state’s only Level I trauma center and only organ transplant program. Hawaii Pacific Health operates Straub, Kapiʻolani, and Pali Momi, and Kaiser Permanente operates Moanalua Medical Center.
• Kaiser Permanente. Kaiser is both an insurer and a care provider in Hawaii. If you get care at Kaiser facilities, ask Kaiser directly how they work with the coverage you are considering.
• Off-island care. Ask any plan you are considering how referrals, prior approval, and travel for off-island care are handled. Ask your doctor’s office how they usually arrange it.

How your coverage uses networks

With Original Medicare, you can see any doctor or hospital in the country that accepts Medicare, which can matter if you spend time on the mainland. Most Medicare Supplement (Medigap) policies follow the same rule. Medicare SELECT policies are the exception: they can require network hospitals, and sometimes network doctors, for full benefits. Medicare Advantage HMO plans generally require in-network providers except for emergency care, out-of-area urgent care, and temporary out-of-area dialysis. PPO plans usually allow out-of-network care at a higher cost. Out-of-network/non-contracted providers are under no obligation to treat plan members, except in emergency situations. Call the plan’s customer service number or see its Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Medicare.gov: your coverage options.

Five steps to check your doctors for 2027

1. List everyone on every island. Your primary care provider, specialists on Maui and Oahu, the hospital you would use, and your pharmacy.
2. Call each billing office. Ask: “Will Dr. ___ be in network with this specific Medicare plan in 2027?” Ask Oahu offices the same question.
3. Search the plan’s 2027 directory. Use the exact plan name and the 2027 plan year.
4. Add your prescriptions. Medicare Plan Finder shows plans in your ZIP code and estimates drug costs.
5. Keep a record. Note who confirmed each doctor and when.

State and county retirees: check with EUTF first

If you have retiree coverage through the Hawaii Employer-Union Health Benefits Trust Fund (EUTF), your Medicare choices work differently. EUTF requires Medicare-eligible retirees, and Medicare-eligible spouses or partners on their plans, to enroll in Medicare Part B to keep EUTF retiree medical and prescription drug coverage, and joining an individual Medicare plan can affect group retiree benefits. Talk with EUTF before making any change. EUTF Medicare information. Our Hawaii Medicare guide covers EUTF in more detail.

Don’t assume this year’s plan carries over

Some Medicare plans offered in Hawaii in 2026 will not be offered in 2027, and networks can change even when a plan continues. Read your Annual Notice of Change carefully and check your doctors before December 7.

Frequently asked questions

Why don’t you publish which plans each hospital or clinic accepts?

Networks are specific to each plan, each provider, and sometimes each location, and they can change from year to year and during the year. Medicare also has rules about how agents may advertise plan details. The accurate answer for you comes from checking your own doctors against specific plans, which we do with you one-on-one.

What if I spend part of the year on the mainland?

Medicare Advantage networks are generally local, apart from emergency care, out-of-area urgent care, and temporary out-of-area dialysis. If you travel often, ask how a plan handles care away from home, or consider how Original Medicare works nationwide.

Talk story with Jai

Jai Cusack has lived on Maui for more than 25 years and is our Hawaii-licensed agent. Bring your list of doctors on every island and your prescriptions, and Jai will check them against the 2027 plans we represent at no cost to you. Call Jai at (808) 633-6245 or send us a message.