Medicare Advantage

HMO or PPO? Hawaii Medicare Advantage for 2027: 18 HMO Plans, 28 PPO

HONOLULU — When Hawaii residents open the Medicare Plan Finder this fall for Annual Enrollment 2027, they will be sorting through 46 Medicare Advantage plans from 7 carriers statewide. The split by plan type matters as much as the headline count: 18 of those plans are HMOs (a figure that includes any HMO-POS variants), and 28 are PPOs, according to the CMS MA Landscape Source Files for CY2027.

That difference — HMO versus PPO — shapes which doctors you can see, whether you need referrals, and how your plan treats care you receive on another island or on the mainland. Here is what the 2027 Hawaii landscape looks like and how to think about it before December 7, 2026.

How many HMO and PPO plans does Hawaii have for Medicare Advantage 2027?

Hawaii's 2027 Medicare Advantage lineup includes 46 plans from 7 carriers, divided into 18 HMO plans (including HMO-POS) and 28 PPO plans statewide. Those counts come from the CMS MA Landscape Source File for CY2027 and treat each plan as a single statewide entry, even though a plan is actually offered county by county. In other words, a plan listed in the statewide tally may or may not be sold where you live on Oahu, Maui, Hawaii, Kauai, Molokai or Lanai. The county view on medicare.gov is the one that tells you what you can actually enroll in.

Compared with CY2026, the 2027 file still shows PPO plans outnumbering HMO plans in Hawaii — a useful fact if you have been hearing that the islands are "HMO country." On paper, there are more PPO options statewide than HMO options for the coming plan year.

What do HMO, HMO-POS, PPO and PFFS mean for networks, referrals and out-of-network care in Hawaii?

In plain terms: an HMO (Health Maintenance Organization) asks you to use the plan's network of doctors and hospitals, and often to get a referral from a primary care provider before seeing a specialist. Out-of-network care is generally not covered except in emergencies.

An HMO-POS (Point of Service) is an HMO with a limited "point of service" option that lets you go out of network for certain services, usually at a higher cost share. Hawaii's HMO count of 18 for 2027 includes any HMO-POS plans.

A PPO (Preferred Provider Organization) uses a network too, but typically does not require referrals and does cover out-of-network care, usually at a higher cost share than in-network care. For island residents who travel inter-island or spend time on the mainland, the out-of-network piece is often the deciding factor.

A PFFS (Private Fee-for-Service) plan sets its own payment terms and lets you see any Medicare-approved provider who agrees to those terms. Hawaii's 2027 statewide type breakdown is HMO and PPO only; a reader shopping for a PFFS plan will not find one in this year's file.

What any specific plan actually pays, requires or restricts is spelled out in that plan's Evidence of Coverage and provider directory — not in a landscape count.

Which carriers offer HMO and PPO plans in Hawaii for 2027?

For 2027, five carriers offer HMO plans in Hawaii: AlohaCare, Devoted Health, HMSA Akamai Advantage, Humana and Kaiser Permanente. Five carriers offer PPO plans: Devoted Health, HMSA Akamai Advantage, HMSA Akamai Advantage Dual Care, Humana and UnitedHealthcare.

A few carriers show up on both sides of the aisle — Devoted Health, HMSA Akamai Advantage and Humana each offer both HMO and PPO plans somewhere in the state — so recognizing a carrier name is not the same as knowing the plan type. The full plan-by-plan breakdown is in the tables on this page; use those to see which specific plans each carrier offers in each type, and then confirm county availability on Medicare Plan Finder.

How do I decide whether an HMO or PPO fits my doctors and travel in Hawaii?

Start with two questions: Who are your current doctors, and how often do you leave your home island?

If your providers are already grouped within a single health system and you rarely travel off-island for care, an HMO's network and referral structure may feel natural. If you see specialists across multiple systems, split time between islands, visit family on the mainland for weeks at a stretch, or want the option to see a provider outside the network without pre-approval, a PPO's out-of-network coverage may matter more.

Then check the specifics for each plan you are considering: Is each of your doctors in-network for that plan in 2027? Are your prescriptions on its drug list? Does it require referrals? Those answers live in the plan's own documents and in Medicare Plan Finder — not in any statewide summary, including this one.

What should Hawaii Medicare beneficiaries do before December 7, 2026?

Before December 7, 2026, confirm three things for Annual Enrollment 2027: which plans are offered in your county, whether your current plan is being renewed, changed or discontinued for 2027, and whether your doctors, hospitals and prescriptions are covered under the plan you are considering. Your current plan's Annual Notice of Change, mailed in the fall, lays out what is changing on January 1, 2027.

A practical sequence: read the ANOC, make a list of your providers and medications, run that list through Medicare Plan Finder at medicare.gov for your ZIP code, and compare two or three plans side by side. A choice made during Medicare Open Enrollment 2027 takes effect January 1, 2027.

Where can Hawaii residents get free help comparing 2027 Medicare Advantage plans?

Two free, official resources cover everything in this article and more. Medicare.gov hosts the Medicare Plan Finder, where you enter your ZIP code and medications to see the plans actually sold in your county, with full benefit, cost and star-rating detail. And 1-800-MEDICARE (TTY 1-877-486-2048) is staffed around the clock to answer questions about enrollment periods, plan types and eligibility.