Medicare plays a key role in providing health and financial security to beneficiaries residing in Hawaii. With more than 278,700 Hawaii beneficiaries enrolled in Medicare, we’ll cover some very important information below about Medicare in Hawaii. We want to help you better understand your options and make the decision-process as seamless as possible once you’re ready to enroll in Medicare or discover different coverage options.

Who Qualifies for Medicare in Hawaii?

Medicare covers most Hawaii residents who are 65 or older, and it also covers disabled Hawaii residents. In general, Medicare enrollment in Hawaii works the same way as it does in the rest of the country. If you qualify for Original Medicare, also known as Part A and Part B, it will help cover 80% of your health care costs.

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll be responsible for paying this penalty for as long as you have Part B, and you could have a gap in your health coverage.

Once you reach Medicare eligibility, you can begin choosing additional coverage options to help pay for the remaining 20% of your medical expenses through Medicare Advantage (Part C), Medigap, and/or a Medicare Prescription Drug (Part D) plan.

Who Qualifies for Medicare

Hawaii Medicare Enrollments

146,470

Original Medicare Plans
(Part A and B)

132,264

Medicare Advantage & Other Health Plans

198,954

Stand-alone Medicare
Part D (Drug plans)

278,734

Total Medicare Beneficiaries
in Hawaii

Hawaii Medicare Advantage Plans (Part C)

More than 46% of Hawaii Medicare beneficiaries select Medicare Advantage plans.

Medicare Advantage plans are private, Medicare-approved insurance companies. They provide all of your Original Medicare benefits and often include extra benefits such as drug, dental, and vision coverage.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period, Medicare beneficiaries in Hawaii who are already enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare instead.

Medicare Advantage plans are a very popular choice for Hawaii Medicare beneficiaries. In fact, more than 46% of Medicare beneficiaries in Hawaii choose Medicare Advantage over Original Medicare.

As of 2020, 25 Medicare Advantage plans are available in Hawaii. The average monthly Medicare Advantage premium in Hawaii changed from $69.42 in 2019 to $64.20 in 2020. $0 is the lowest monthly premium for a Medicare Advantage plan in Hawaii. 100% of people with Medicare have access to a Medicare Advantage plan. According to the Centers for Medicare and Medicaid Services (CMS), as of May 2020, there are 132,264 beneficiaries enrolled in Medicare Advantage and other plans in Hawaii. Hawaii has a total of five counties, and the availability of Medicare Advantage plans varies by county.

Hawaii Medicare Supplement (Medigap) Insurance Plans

Hawaii law ensures that enrollees under 65 have the same access to Medigap plans as those who are 65 years old and older.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that beneficiaries would otherwise incur if they only had Original Medicare on its own. Typically, Medigap plans are popular for those who want little to no copay when they access healthcare services.

Hawaii Medigap insurance is available to everyone with Medicare in the state, including those who are under 65 and are enrolled in Medicare. Often, Medigap plans in Hawaii can be more expensive if you don’t enroll during your Initial Enrollment Period and wait for an Annual Open Enrollment Period. 

There are two initial times to enroll in a Medigap plan before and after you turn 65:

  • 6 months prior to turning 65
  • Once you turn 65, your 6 month period begins the month you enroll in Part B

During this period, an insurance company can’t use medical underwriting. After this period, going through underwriting could be a requirement.

It’s required that insurance companies selling Medigap plans in Hawaii must offer at least one Medigap plan to disabled Medicare beneficiaries under 65 years old. Medigap insurers in Hawaii aren’t allowed to charge under-65 policyholders different premiums from their over-65 policyholders.

Hawaii Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t cover outpatient prescription drugs. However, Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Medigap plans don’t cover prescription drugs unless they’re covered under Part B.

As of 2020, there are 72,296 Medicare beneficiaries in Hawaii enrolled in stand-alone Part D plans and 127,437 enrolled in Medicare Advantage Prescription Drug plans. For 2020 coverage, there are 25 stand-alone Part D plans available in Hawaii, with premiums ranging from about $14 to $80 per month.

Nearly 95% of people with a stand-alone Medicare prescription drug plan have access to a plan with a lower premium than what they paid in 2019. About 25% of people with a stand-alone Medicare prescription drug plan get Extra Help (also called the low-income subsidy, or LIS).

When deciding on a Part D plan, it’s important to evaluate several factors such as each plan’s premium, formulary, and copays since every plan is different. Learn how you can save money on your out-of-pocket costs with a Medicare Advantage, Part D, or Medigap plan, fill out this form or give us a call.

Local Medicare Health Plan Resources in Hawaii

  • Hawaii’s State Health Insurance Assistance Program (SHIP): SHIP provides free health insurance information, education, counseling, and referral for people with Medicare. Volunteers are trained and certified to assist members and their families with questions about Medicare benefits including Medicare Advantage plans, Medicare Part D – the prescription drug benefit, Medigap, and Medicare Savings Program.
    Contact: Call 1-808-586-7299 for the Island of Oahu, 1-888-875-9229 for neighboring islands, or complete an online contact form on the SHIP Hawaii website.

  • Legal Aid Society of Hawaii: The Legal Aid Society of Hawaii assists low-income seniors with issues related to Medicare Advantage. Beneficiaries can access free and low-cost legal advice related to health insurance, and service is generally delivered through one-on-one appointments. Legal Aid counselors can also refer seniors to local resources related to Medicare.
    Contact: Call 1-808-536-4302

  • Senior Medicare Patrols (SMPs): SMP’s mission is to empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse through outreach, counseling, and education.
    Contact: Call 1-808-586-7281 (Oahu) and those who live on neighboring islands can call the statewide toll-free number at 1-800-296-9422.

  • Hawaii’s Aging and Disability Resource Center (ADRC): ADRC helps older adults, individuals with disabilities, and family caregivers find options for long term supports and services available to them in the State of Hawaii.

    The ADRC is a highly visible and trusted source where people of all incomes and ages can turn for information.
    ADRC staff will help to determine if you are eligible for government-paid programs, assist you in finding providers you may pay for yourself, and work with you to develop an individual plan for meeting your future long-term care needs. The assistance is paid for by the State and Counties (at no cost to you).
    Contact: Call 1-808-643-2372

The licensed agents that are partnered with Timefor65 can help you compare the availability, benefits, and costs of Medicare plans in your specific region of Hawaii. Our process makes it easier for you to access your Medicare eligibility in Hawaii so that you receive personalized, affordable, and easy-to-use coverage options and solutions. Fill out the form or give us a call at (866) 327‑0148 anytime to get a free quote or to ask any questions.

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