Hawaii Medicare Advantage Plans 2027

A Wellcare Medicare Advantage plan in Hawaii ends December 31, 2026. You should have gotten a non-renewal letter, and you have a Special Enrollment Period plus, generally, a guaranteed issue right to buy certain Medigap plans.

Source: company announcements and CMS 2027 landscape data reported by Becker’s on October 1, 2026. For 2027, Wellmark, Blue Cross Blue Shield of North Dakota and Blue Cross Blue Shield of Mississippi are exiting Medicare Advantage as well.

If you live on a neighbor island but need specialty care on Oahu, or you spend part of the year on the mainland, find out how each plan handles that care. HMOs generally pay only for in-network care, aside from emergencies and urgent care. Original Medicare paired with a Medigap plan works with any U.S. provider that takes Medicare, which can help those who divide their time between Hawaii and the mainland.

Medicare Advantage, sometimes called Part C, lets you receive your Medicare benefits through a Medicare-approved private insurer. These plans cover everything Original Medicare Part A and Part B cover, with the exception of hospice care, which Original Medicare continues to pay for. Most also bundle Part D drug coverage, and many may tack on extras like routine dental, vision and hearing benefits.

The trade-off is that Medicare Advantage plans generally rely on doctor and hospital networks and may call for referrals or prior authorization for certain services. Each Medicare Advantage plan sets a yearly out-of-pocket maximum for covered medical care, something Original Medicare lacks. You still pay your Part B premium, along with the plan’s premium if there is one.

If Original Medicare is your preference, a Medicare Supplement (Medigap) plan covers some or all of what Medicare leaves unpaid and lets you use any U.S. provider that accepts Medicare. Since benefits are standardized by plan letter, compare what insurers charge for the same letter.

Plan letter determines Medigap benefits, which are standardized. Prices differ by insurer, age, ZIP code and tobacco use.

If you keep Original Medicare in Hawaii, add a standalone Part D plan. Compare plans with your exact drugs and pharmacies using the 2027 Part D plan finder.

A non-renewal notice should have reached you in early October if your plan won’t be available in your county for 2027. Coverage doesn’t end immediately; it runs through December 31, 2026, which gives you time to decide.

Special Needs Plans (SNPs) are Medicare Advantage plans designed for particular groups. Their benefits, networks and drug lists are shaped around the members they serve, and many come with care coordinators. In 2027, SNPs are one of the few places large insurers are adding plans, even while cutting PPOs.

When you turn 65 in 2027, you get a seven-month Initial Enrollment Period: the three months before your birthday month, the birthday month itself and the three months that follow. If you sign up in the first three months, coverage begins on the first day of your birthday month.

When your income and savings are limited, two programs can greatly lower your Medicare costs:

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

Hawaii SHIP (State Health Insurance Assistance Program), the State Health Insurance Assistance Program in Hawaii, provides free, unbiased Medicare counseling. You may also call 1-800-MEDICARE at any hour or compare plans with a licensed agent for free.

Gather your Medicare card, a list of your drugs and doses, your doctors and your preferred pharmacies before you call. That way a long conversation becomes a quick one.

The Annual Notice of Change must reach members by September 30. It is the most useful single document you receive each fall, since it spells out exactly how your plan will change on January 1.

Outside of the fall and early-year windows, changing plans generally requires a Special Enrollment Period. Typical reasons include:

Every Special Enrollment Period has a separate time limit, so move as soon as the event occurs.

Prior authorization is required by most Medicare Advantage plans for certain services, including some surgeries, advanced imaging, skilled nursing stays and some drugs. While your doctor usually submits the request, ask whether a scheduled service needs approval so you are not caught off guard by a denial.

You or your doctor can appeal a denied request. Medicare rules give plans deadlines for decisions, and those deadlines are shorter when a wait could seriously harm your health.

Emergency and urgent care are covered by every Medicare Advantage plan anywhere in the U.S., whether in or out of network, and an emergency does not require prior approval. Routine care while traveling is different: HMOs generally do not cover it, and PPOs cover out-of-network care at a higher cost.

If you’re away from home for months each year, ask every plan how it covers care where you stay. This is among the most frequent reasons people change plans partway through the year.

You have the right to appeal if your plan denies a service, a drug or payment for care. The denial notice from the plan explains the process. Appeals have several levels, beginning with the plan and moving on to independent reviewers.

If your issue isn’t about coverage, such as wait times or customer service, you can file a grievance with your plan. For help, you can also reach out to 1-800-MEDICARE or your State Health Insurance Assistance Program.

Of the major figures, only the Part B premium is not published alongside the plans. CMS typically announces it in November. Projections in the 2026 Medicare Trustees Report put the 2027 standard premium at about $209.50 a month and the deductible at about $292, up from $202.90 and $283 in 2026. You continue paying it even with Medicare Advantage.

Miss the Annual Enrollment deadline and your current plan automatically renews for 2027, including the changes listed in your Annual Notice of Change. Medicare Advantage members get one more opportunity, from January 1 to March 31, 2027, to change Medicare Advantage plans or go back to Original Medicare and join a Part D plan.

Many Medicare Advantage plans may cover telehealth for some services, at times with a lower copay than an in-person office visit. It is handy for follow-ups and minor problems, but you still need to confirm that your regular doctors are in network.

Each fall, Medicare gives every Medicare Advantage and Part D plan a rating of 1 to 5 stars, based on factors such as preventive care, how well chronic conditions are managed, member complaints, customer service and accuracy of drug pricing. You can see the ratings in Medicare Plan Finder.

A drug you take may not be on a plan’s 2027 formulary, or it may come with a rule such as prior authorization. Even then, you have options:

See steps to appeal a Medicare Part D denial.

Original Medicare leaves gaps, and a Medicare Supplement plan is designed to fill them. It can pay these costs: