Last Updated on
October 6, 2016
As a Medicare beneficiary in Hawaii, you may want to apply for a Medicare Supplement (or Medigap) plan, which may help pay for out-of-pocket expenses that you may incur under Original Medicare, Part A and Part B. You may have several Medigap plan options in Hawaii, depending on where you live in the state. Understand what each Medigap insurance plan covers, and get help selecting the one that may work for your health and budget needs.
Medigap plans in Hawaii (as in other states) are designed to help cover out-of-pocket health-care costs associated with Original Medicare, Part A and Part B – such as copayments, coinsurance, and deductibles, for example. There are 10 standardized plans in 47 states, identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N), with all plans of the same letter offering the same benefits. Massachusetts, Minnesota, and Wisconsin offer different types of Medigap plans. Note that some companies may offer additional innovative benefits.
You can apply for Medigap in Hawaii if you’re already enrolled in Original Medicare, Part A and Part B. The best time to join Medigap is generally during your Medigap Open Enrollment Period, which starts the first day you are both age 65 or older and enrolled in Medicare Part B, This enrollment period lasts for six months. During this time, you can sign up for any Medicare Supplement plan available in your area and not have to undergo medical underwriting or face any restrictions about pre-existing conditions (although waiting periods may apply). If you apply for a Medigap plan in Hawaii outside of this time, you may be denied coverage or charged more for your insurance policy.
Even if you choose to sign up for a Medigap plan, you must remain enrolled in Original Medicare, Part A and Part B, and go on paying your Medicare Part B premium, in order to remain enrolled in Medicare. Since Medigap plans are meant to supplement and not replace Original Medicare, failure to pay your Medicare Part B premium may result in you losing your health coverage.
Medigap plans currently sold in Hawaii (or other states) do not offer prescription drug coverage. If you would like this coverage, you may want to enroll in a stand-alone Medicare Part D Prescription Drug Plan, available through private insurance companies approved by Medicare.
Take a quick look at the 10 standardized Medigap plans that may be available in Hawaii so that you can understand what each plan covers. In this chart, X indicates that the service (or item) is 100% covered; a percentage indicates what percent of the service/item is covered; and a blank cell indicates it is not covered.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted||X||X||X||X||X||X||X||X||X||X|
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B excess charges||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out-of-pocket limits apply.**|
*Medicare Supplement Plan F offers a high-deductible version in which beneficiaries pay a certain deductible amount before the plan begins coverage. This amount may change from year to year.
**Once you reach the out-of-pocket limits (including the Part B deductible), both Medicare Supplement Plans K and L pay 100% of covered services in the above chart for the remainder of the calendar year.
***Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, except for a copayment of up to $20 on doctor visits and up to $50 on emergency room visits that don’t result in an inpatient admission.
Medicare Supplement plans with the same letter designation don’t vary in coverage or benefits, as stated earlier. However, each independent insurance company offering Medicare Supplement plans can determine its own monthly premium structure. This means that if you live in Pearl City in Honolulu County, you may pay more or less than a resident of Lahaina in Maui County for an identical Medicare Supplement plan. With the difference in costs, it may be a good idea to compare all Medicare Supplement plans available in your area, and then choose a Medigap plan based on your individual budget and health needs.
For additional information about Medicare insurance in Hawaii, view the following articles:
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.