Medicare in American Samoa: 2025 Guide
American Samoa is a United States territory in the South Pacific with the most limited healthcare infrastructure of any U.S. jurisdiction. Approximately 7,000 residents are enrolled in Medicare, and they face significant challenges accessing the full range of medical services that Medicare covers. Medicare Advantage is virtually unavailable in American Samoa, and most beneficiaries use Original Medicare for coverage. Like all U.S. territories, American Samoa receives Medicaid funding under a fixed federal cap rather than the open-ended matching system available to the 50 states, which restricts the resources available for healthcare coverage and delivery. For many medical needs — particularly specialist care — American Samoa Medicare beneficiaries must travel to Hawaii or the continental United States.
Medicare Advantage Plans in American Samoa
Medicare Advantage is effectively unavailable in American Samoa. The territory's extremely small Medicare population, geographic isolation in the South Pacific, and limited healthcare provider infrastructure make it impossible for insurers to build and maintain the provider networks required to offer Medicare Advantage plans. As a result, virtually all American Samoa Medicare beneficiaries are enrolled in Original Medicare — traditional fee-for-service Medicare using Parts A and Part B. Original Medicare covers medically necessary services from any provider that accepts Medicare assignment, which provides flexibility to seek care from providers in Hawaii or the continental U.S. when needed.
The primary medical facility in American Samoa is the Lyndon B. Johnson (LBJ) Tropical Medical Center in Pago Pago, which serves as the territory's main hospital and primary care hub. LBJ Medical Center provides a range of general medical and surgical services, but specialist availability in American Samoa is very limited. Many medical conditions requiring specialist care — including complex surgery, oncology treatment, cardiology, neurology, and other specialty services — require medical evacuation or travel to Hawaii, which is approximately 2,600 miles away, or to the continental United States. Medicare beneficiaries in American Samoa should work closely with their SHIP counselor and LBJ Medical Center's patient services team to understand how Medicare covers travel and treatment outside the territory.
American Samoa beneficiaries enrolled in Original Medicare can receive covered services from any Medicare-accepting provider in the continental United States, Hawaii, or other U.S. territories, subject to their normal Medicare deductibles and cost-sharing. Planning ahead for any non-emergency specialist care that requires travel off-island is critical, as the costs and logistics of medical travel can be significant. SHIP counselors at (684) 633-2207 can help beneficiaries understand their coverage rights and options for accessing care.
Medicare Savings Programs in American Samoa
American Samoa's Medicaid program receives federal funding under a capped allotment system, as do all U.S. territories. This funding structure differs fundamentally from the arrangements in the 50 states, where Medicaid funding is theoretically unlimited and matches state spending at federally determined rates. The capped funding for American Samoa limits the scope of Medicaid services and the number of residents who can be covered. Medicare Savings Programs — the federal programs that help Medicare beneficiaries with low incomes pay for Part B premiums and cost-sharing — are available in American Samoa through the territory's Medicaid program, but the administrative capacity and resources available to run these programs are more constrained than in the 50 states.
American Samoa Medicare beneficiaries who believe they may qualify for a Medicare Savings Program (QMB, SLMB, or QI) should contact the American Samoa Department of Human and Social Services for eligibility information and application assistance. American Samoa SHIP counselors at (684) 633-2207 can also provide guidance on navigating the application process. Given the territory's limited administrative infrastructure, SHIP counselors are a particularly valuable first point of contact for beneficiaries seeking information about all available assistance programs.
State Pharmaceutical Assistance in American Samoa
American Samoa does not operate a territorial pharmaceutical assistance program for Medicare beneficiaries. American Samoa residents who are enrolled in Medicare and need help with prescription drug costs should apply for the federal Extra Help program (Low Income Subsidy) through the Social Security Administration. Extra Help can significantly reduce Medicare Part D premiums, deductibles, and per-prescription copayments for eligible beneficiaries. Qualifying for a Medicare Savings Program also automatically confers Extra Help eligibility at the full subsidy level.
Medicare Part D prescription drug plans are available to American Samoa Medicare beneficiaries, though the pharmacy network available through any given Part D plan may be limited in the territory. Beneficiaries should verify that their preferred local pharmacy or mail-order option is covered under any Part D plan they are considering. American Samoa SHIP counselors at (684) 633-2207 can help identify the best available Part D option and assist with Extra Help applications at no cost.
Getting Free Medicare Help in American Samoa
The American Samoa State Health Insurance Assistance Program (SHIP) is operated through the Department of Human and Social Services and provides free Medicare counseling to American Samoa Medicare beneficiaries. Given the territory's unique healthcare environment — including the very limited local provider base, the frequent need for off-island medical care, and the territory's capped Medicaid funding structure — American Samoa SHIP counselors are an essential resource for navigating Medicare. Counselors can help with plan enrollment, understanding Medicare coverage for care received in Hawaii or the continental U.S., applying for financial assistance programs, and resolving billing issues. The SHIP contact number is (684) 633-2207.
American Samoa Medicare beneficiaries face some of the most complex healthcare navigation challenges of any U.S. Medicare population, given the combination of limited local healthcare resources, the need for medical evacuation for specialist care, and the territory's constrained public health funding. SHIP counselors are trained to help beneficiaries understand how their Medicare coverage applies in both local and off-island settings, and to identify any available financial assistance that can help defray the costs of medical travel. All American Samoa SHIP services are completely free and confidential — counselors do not sell insurance products. All Medicare beneficiaries in American Samoa are strongly encouraged to contact their SHIP for guidance on navigating the Medicare system in the territory's unique context.
Medicare Advantage is effectively unavailable in American Samoa due to the territory's small Medicare population, geographic isolation, and limited healthcare provider infrastructure. Virtually all American Samoa Medicare beneficiaries use Original Medicare (Parts A and B). You can verify current plan availability using the Medicare Plan Finder at Medicare.gov or by contacting the American Samoa SHIP at (684) 633-2207. SHIP counselors can explain your coverage options under Original Medicare and how Medicare covers care when you travel to Hawaii or the continental United States for specialist treatment.
Original Medicare covers medically necessary services provided by Medicare-accepting providers in Hawaii and the continental United States. However, Medicare does not generally cover the cost of transportation itself — including flights for medical travel — unless the transportation is itself a covered medical service (such as ambulance transport that meets specific Medicare criteria). The cost of travel to Hawaii or the mainland for medical care is typically an out-of-pocket expense for American Samoa beneficiaries. Some supplemental insurance policies may provide travel benefits, and SHIP counselors can help you understand what coverage options may be available. Contact American Samoa SHIP at (684) 633-2207 to discuss your specific situation.
The American Samoa SHIP (State Health Insurance Assistance Program), operated through the Department of Human and Social Services, provides free Medicare counseling to all American Samoa Medicare beneficiaries. Call (684) 633-2207 to speak with a SHIP counselor who can help you understand your Medicare coverage, apply for financial assistance programs like Extra Help or Medicare Savings Programs, and navigate the challenges of accessing care in the territory and outside it. All SHIP services are completely free and confidential — counselors do not sell insurance. Given the unique healthcare access challenges in American Samoa, contacting your SHIP counselor is the recommended first step for any Medicare questions or enrollment decisions.