Joint Replacement HawaiiPaul N. Morton, MD · Hip & Knee
(808) 439-6201Schedule Appointment

Insurance & access

Most major plans accepted — and we verify yours before you visit

Insurance shouldn't be a maze you navigate alone. The practice accepts most major Hawai‘i and national plans, our team verifies benefits and referral requirements before your appointment, and self-pay options cover everyone else.

  • 18+ plans accepted
  • Benefits verified for you
  • TRICARE & VA welcome
  • Self-pay available
Book a ConsultationCall (808) 439-6201
The Pacific Bone & Joint team throws shakas at the front desk of their Honolulu clinic.

At a glance

Plans accepted
18+ major plans
Referrals
Needed for managed care & Medicaid plans
Verification
We check your benefits before your visit
No insurance?
Transparent self-pay packages

Plan networks change — call (808) 439-6201 and we'll confirm your specific plan and any referral requirement the same day.

Which insurance plans does Dr. Morton accept? The short answer

Dr. Paul Morton and Pacific Bone & Joint participate with most major Hawai‘i and national plans — HMSA, Medicare, Medicaid/Quest, UHA, HMAA, TRICARE, VA Community Care and more — at clinics in Honolulu (Ala Moana), West O‘ahu (Kunia), Hilo and Kona. Our team verifies your benefits and any referral requirement before you're seen. Call (808) 439-6201 to verify your plan, or book online and we'll confirm it when we schedule you. The full list:

  • HMSA
  • Medicare
  • Medicaid / Quest
  • AlohaCare
  • UHA
  • HMAA
  • United Healthcare
  • Aetna
  • Cigna
  • Humana
  • TRICARE
  • VA Community Care (Veterans Affairs)
  • Kaiser Added Choice (with referral)
  • Queen's Health Plan
  • HMA
  • MDX Hawai‘i
  • DMBA
  • HYGEIA Travel Health

Referrals: who needs one

Managed-care plans — including most Medicaid/Quest plans and some HMO products — require a referral from your primary care physician before a specialist visit. PPO plans and traditional Medicare generally allow self-referral. Not sure which you have? Don't guess: call us at (808) 439-6201 and our schedulers will check your plan and handle the referral logistics with your PCP's office. Kaiser members can be seen through the Added Choice program with a referral.

  1. Step 1

    Call or book

    Give us your plan name and member ID — or book online and a scheduler calls you.

  2. Step 2

    We check your plan

    Network status, referral rules, and prior-authorization needs — usually the same day.

  3. Step 3

    Referral handled

    If your plan needs a PCP referral, our schedulers coordinate it with your doctor's office.

  4. Step 4

    Your visit

    Bring photo ID, insurance card, medication list, and any prior imaging — costs are known before care.

What joint surgery actually costs you with insurance

With coverage, your out-of-pocket cost is set by your deductible, co-insurance, and out-of-pocket maximum — often far less than patients fear for a major operation. Before surgery you'll receive a clear picture of expected costs, and prior authorization is handled by our team. For the uninsured and high-deductible situations, compare with self-pay package pricing — sometimes the bundle genuinely wins. The cost guide explains the whole landscape.

Which path fits you?

  • Commercial insurance (HMSA, UHA, HMAA, United, Aetna, Cigna and others): deductible plus co-insurance up to your out-of-pocket maximum; prior authorization handled by our team
  • Original Medicare: self-referral; a supplement often shrinks the remaining share to very little — see the Medicare knee replacement guide
  • Medicare Advantage, HMO and Medicaid/Quest plans: a PCP referral is usually required first — we coordinate it
  • Veterans and military families: VA Community Care referral or TRICARE — routine here
  • No insurance or a high deductible: compare the self-pay package; we'll run both numbers
  • Injections: cortisone and gel are usually covered; PRP and BMAC are cash-pay and quoted in writing
Close-up of a printed medical invoice showing a customer number and total payable amount.
We verify benefits before surgery so the bill holds no surprises.

Traveling and international patients

US insurance travels with you to Honolulu — that's a key reason patients from Guam and Saipan, American Samoa, and the neighbor islands choose Hawai‘i over foreign hospitals. TRICARE families and Medicare patients are routine here. HYGEIA Travel Health is accepted for covered travelers, and international self-funded patients receive written package quotes before booking travel.

Medically reviewed by Paul N. Morton, MD, FAAOS, FAAHKS — board-certified orthopedic surgeon, fellowship-trained in adult hip & knee reconstruction and orthopedic trauma. Last reviewed: .

This page is for education only and isn’t a substitute for an exam and personalized advice — schedule a consultation to discuss your situation.

The difference

Why patients choose Dr. Morton

  • Benefits verified before your first visit — no billing surprises
  • Referral logistics handled with your PCP's office
  • Prior authorizations managed by our team
  • TRICARE, VA, Medicare & Medicaid patients welcome
  • Self-pay packages when insurance isn't the answer
  • One office number for every question: (808) 439-6201

Frequently asked questions

Do you take HMSA?
Yes — HMSA is accepted, along with most major Hawai‘i and national plans. Call the office and we'll verify your specific HMSA product and any referral requirement. That includes HMSA PPO and HMO products, Akamai Advantage, and Quest Integration; HMO and Quest members usually need a referral from their primary care physician first, which our schedulers coordinate.
Do I need a referral to see Dr. Morton?
PPO plans and traditional Medicare generally don't require one. Managed-care and Medicaid/Quest plans usually do, and Kaiser members come through the Added Choice program with a referral. We check for you before scheduling. Have your card handy when you call (808) 439-6201. If a referral is needed, our schedulers coordinate it with your PCP's office so your first visit isn't delayed.
Does insurance cover robotic joint replacement?
Robotic assistance doesn't change how joint replacement is billed — it's how Dr. Morton performs the operation, not an upcharge. Coverage follows your plan's normal surgical benefits. Deductible, co-insurance, and prior authorization apply exactly as they would for conventional surgery, and the office verifies all three before anything is scheduled.
Do Medicare Advantage plans need a referral?
It depends on the plan type. Original Medicare allows self-referral. Medicare Advantage plans replace it with a private plan that has a network and often a prior-authorization step: HMO-style Advantage plans usually require a referral from your primary care physician, while PPO-style Advantage plans generally don't. Call (808) 439-6201 with your card and we'll confirm the rule for your specific plan before scheduling.
Does insurance cover PRP or BMAC injections?
Typically no. Cortisone and hyaluronic-acid gel injections are usually covered as standard benefits, but PRP, BMAC, and A2M are generally considered investigational by insurers and are offered as cash-pay treatments. You'll receive a written quote for any out-of-pocket cost before you decide — nothing is guessed at. The consultation itself is usually a covered specialist visit.
I'm a veteran — can I see Dr. Morton through the VA?
Yes. Veterans are seen through the VA Community Care program: ask your VA provider for a community-care referral for hip or knee care, and our office coordinates the authorization from there. TRICARE beneficiaries and military families are also routine here.
What if my plan isn't on the list?
Call anyway. Networks change, out-of-network benefits sometimes apply, and the self-pay package is always available as a transparent comparison point. Bring your card details and we'll check network status and out-of-network benefits the same day; if the numbers favor the self-pay package instead, we'll say so in writing.
I'm visiting from off-island — will my mainland or territory insurance work?
US plans generally travel with you, and the office verifies out-of-area benefits routinely for patients from Guam, American Samoa, and the mainland. International visitors typically use self-pay packages or travel-health coverage like HYGEIA. Bring your card and photo ID, and the office verifies benefits before you travel — or starts the process by telehealth when an in-person visit isn't yet practical.

Related services

Self-Pay Packages

Transparent bundled pricing without insurance.

Cost of Hip & Knee Replacement

The complete cost picture, explained.

Joint Injections

What's covered, what's cash-pay, and how long each option lasts.

Schedule a Consultation

We'll verify your benefits when you book.

VA & Veteran Knee Replacement

Using VA Community Care for surgery with Dr. Morton.

Surprise Medical Bills — Your Rights

Your billing protections under federal law.

Not sure about your coverage? We'll check it for you

Consultations in Honolulu, West Oahu, Hilo and Kona — most new patients are seen within one to two weeks — with telehealth when an in-person visit isn’t practical.

Book a ConsultationCall (808) 439-6201

Paul Norio Morton, MD, FAAOS, FAAHKS · Hawai‘i’s first robotic hip & smart knee · Read patient reviews →

Most major plans accepted — we verify benefits before your visit. Traveling from off-island? See the fly-in patient program →

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