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Medicare in Hawaii

Medicare health insurance can play an important role in the lives of Hawaii residents who have reached the retirement age of 65. A government-sponsored insurance program, Medicare includes Original Medicare, Part A and Part B; optional private Medicare health insurance may also be available through Medicare Advantage (Medicare Part C) and prescription drug coverage under Medicare Part D. The availability of private Medicare plans in Hawaii may vary depending on your specific location.

Original Medicare for Hawaii beneficiaries

Original Medicare consists of two parts: Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Medicare beneficiaries in Hawaii, as in other states, are usually automatically enrolled in Medicare; this happens when you’re collecting Social Security or Railroad Retirement Board benefits and you turn 65 or have a qualifying disability.

If you’re not automatically registered, you can enroll in Original Medicare during the seven-month Medicare Initial Enrollment Period, which begins three months before the month you turn 65 and ends three months after that month. You can also join Original Medicare during the General Enrollment Period, which takes place every year from January 1 to March 31. However, if you miss your Initial Enrollment Period and end up joining Medicare at a later date, you might have to pay higher monthly premiums. This is the Medicare late enrollment penalty.

Medicare beneficiaries in Hawaii, like those in other states, can generally enroll in Medicare Part A for free. There are some exceptions; for example, if you haven’t worked and paid taxes in the United States long enough to be eligible for Social Security benefits. In that case, you may have to pay a monthly premium.

Medicare Part A includes the following health coverage:

  • Hospital care
  • Skilled nursing facility care
  • Nursing home care
  • Hospice care
  • Limited home health services

Medicare Part B, also part of Original Medicare, offers medical insurance and charges a monthly premium. Under Medicare Part B, Hawaii beneficiaries, like those of other states, can receive services and supplies such as (but not limited to):

  • Clinical research
  • Ambulance services
  • Durable medical equipment
  • Mental health (inpatient, outpatient, and partial hospitalization)
  • Second opinion before surgery
  • Limited outpatient prescription drugs

Medicare private insurance in Hawaii

Medicare beneficiaries in Hawaii may have several coverage choices of Medicare plans sold by private insurance companies that contract with Medicare.

Medicare Advantage (Medicare Part C) is an alternative way to get your Original Medicare (Part A and Part B) benefits. Medicare Advantage is required by the government to offer at least the same coverage as Original Medicare. There may be a Medicare Part C plan in your area that has extra coverage, such as dental, vision, or hearing benefits.

If you seek private health and prescription drug coverage through a single private Medicare plan, you can enroll in a Medicare Advantage Prescription Drug plan. You need Medicare Part A and Part B to qualify for any Part C plan. Please note that even if you join a Medicare Advantage plan or a Medicare Advantage Prescription Drug plan, you have to continue paying the Medicare Part B premium, in addition to any premium your Part C provider charges, to maintain your Medicare insurance coverage. To learn more, read about Medicare Advantage plans in Hawaii.

Medicare beneficiaries in Hawaii who are concerned about out-of-pocket expenses associated with Original Medicare, like coinsurance, copayments, and deductibles, can enroll in a Medicare Supplement plan (also called a Medigap plan). Medigap plans can help pay for your Original Medicare expenses. You can find out more about Medigap plans in Hawaii.

Original Medicare doesn’t include prescription drug coverage; you can add this benefit through Medicare Part D. In Hawaii, as in every state, Medicare Part D policies have different costs, depending on the extent of the coverage you select, but most plans require payment of a monthly premium, annual deductible, and copayment or coinsurance. These stand-alone Medicare Part D plans work alongside Original Medicare. For more information, read about Medicare Part D in Hawaii.

As a Hawaii resident, you may have access to various private Medicare plans, depending on the county in which you live. A resident of Honolulu in Honolulu County may have different Medicare plan offerings than a resident of Hilo in Hawaii County. Considering the variety of Medicare plans in Hawaii, we recommend that you customize your search for plans based on your own health and prescription needs.

Hawaii resources for Medicare beneficiaries

There are a number of resources that are designed to help Medicare beneficiaries in Hawaii with Medicare-related issues and concerns. Here are some of the resources that may be helpful to you: