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Ultimate Guide to Hawaii Medicare Plans

Medicare is the federal health insurance program for those over the age of 65 (and some disabled people). It’s available in all 50 states, including Hawaii. In Hawaii, about 45% of Medicare beneficiaries enrolled in a private Medicare Advantage plan instead of sticking with only Original Medicare. Read on to learn more about Medicare and find out if Medicare Advantage or another private plan is right for you.  

Click below to learn more about Hawaii Medicare:

Hawaii Medicare Eligibility

There are a few ways to qualify for Medicare in Hawaii. You can qualify for Medicare by:

Entering your 25th month of SSDI

Turning 65 Checklist | Medicare Plan Finder

What Does Hawaii Medicare Cost?

Your Hawaii Medicare costs will depend on what plans you enroll in and what savings programs you qualify for. If you stick to Original Medicare, you’ll be responsible for 20% of the costs for your covered Medical (Part B) services (this can change if you enroll in a Medicare Supplement plan or are eligible for other savings).

In 2019, the Part B deductible 2019 is $185, and the premiums range from $135.50 per month to $460.50 per month (depending on your income). 

Medicare Part A costs in 2019 include*:

  • Deductible: $1,364
  • Copayments/Coinsurance: Depends on length of hospital stay
  • Premium:
    • $0/month if you worked and paid Medicare taxes for more than 39 quarters
    • $240/month if you worked and paid Medicare taxes for between 30-39 quarters
    • $437/month if you worked and paid Medicare taxes for less than 30 quarters

*Costs can change based on savings programs and supplemental policies.

Part A Costs

What Does Medicare Cover in Hawaii?

The traditional Medicare program provides the same coverage in all 50 U.S. states. Your coverage can be different if you decide to enroll in a private plan. Original Medicare includes Part A, which covers inpatient hospital-related benefits, and Part B, which covers outpatient medical benefits. Part A covers inpatient and outpatient hospital stays, hospice, and some home health services. Part B covers preventative care like your annual wellness visit, outpatient mental health, lab tests and X-rays, durable medical equipment, and ambulance travel.

If you’re looking for other benefits, like dental, vision, and prescription drugs, you’ll want to look at Medicare Advantage plans. If you’re looking for more financial coverage, you might want to consider Medicare Supplements.

Hawaii Medicare Part A

Medicare Part A covers hospital care, skilled nursing facility care, hospice, and some home health services. Uniquely, as you may have read, emergency transportation (ambulance travel) is actually a Part B benefit, even though hospital stays are a Part A benefit.

Hawaii Medicare Part B

Medicare Part B covers preventative health services (like the Medicare annual wellness visit), outpatient mental health services, lab tests and X-rays, emergency transportation, durable medical equipment, and more.

Does Medicare Cover me While Traveling in Hawaii?

Hawaii is treated like any of the other 50 states, which means that no matter which state you live in, your Medicare coverage follows you. This does not apply if you have a Medicare Advantage or other private insurance plan. Private plans sometimes have their own networks, which means you may be limited to certain doctors and typically do not cross state lines. If you have a plan like that, your plan may not travel with you - but Original Medicare always does (only for U.S. travel - it does not travel with you internationally).

medicare supplements | Medicare Plan Finder

Hawaii Medicare Plan Finder

Our Medicare Plan Finder tool allows you to search through some of the plans available in Hawaii so that you can make educated choices regarding your healthcare. Our licensed agents can then be available to help answer your questions and help you sort through all of your options for Medicare in Hawaii.

Hawaii Medicare Advantage Plans (MA)

Hawaii Medicare Advantage plans are offered by private companies, not the federal government. That means that even though they are still regulated by Medicare, they are able to offer additional benefits that Original Medicare cannot offer. That can include fitness benefits, dental, vision, prescription drugs, and even meal delivery

You’re probably thinking that all those extra benefits are expensive. They can be, but some people are eligible for Medicare Advantage plans with $0 premiums! Costs depend on your location, the type of Medicare Advantage plan, any assistance you may receive, and how much coverage you’re looking for.

Supplemental Insurance for Medicare Hawaii

Supplemental insurance can mean a few different things, but in Medicare, it often means Medicare Supplements. Don’t get confused - Medicare Supplements are ALSO called Medigap plans.

Medicare Supplements are different from Medicare Advantage plans. Even though they are another form of private health insurance that works alongside Medicare, Medicare Supplements do not typically add health coverage. Instead, they can add financial benefits by covering your copayments, deductibles, etc. If you think Medigap is right for you, head straight to our Medicare Plan Finder tool to find out which plan may be best for you, or call 833-438-3676 during business hours to get connected with a licensed agent.

Medicare Prescription Drug Plans in Hawaii (PDPs)

You can get Medicare prescription drug coverage in Hawaii in two different ways. You can either enroll in a Medicare Advantage plan that comes with a prescription drug benefit, or enroll in a stand-alone prescription drug plan. Keep in mind that you cannot have both a Medicare Advantage plan and a prescription drug plan at the same time, so you’ll have to choose one.

Free Prescription Discount Card | Medicare Plan Finder

Hawaii Doctors That Accept Medicare

A great way to find Hawaii doctors who accept Medicare is by visiting Medicare.gov’s provider finder tool. 

If you have a Medicare Advantage plan or other private insurance, your network may be a little different. Find out if your plan carrier has its own doctor finder tool. Use your plan’s doctor finder or ask your agent for help to make sure that your favorite doctors, hospitals, and specialists are in your network.

Hawaii Senior Resources

Healthy Aging Partnership: A Hawaii state public/private partnership that hosts disease prevention programs and healthy programs like “EnhanceFitness,” the Arthritis Self Management Program (ASMP), and more.

Medicare Plan Finder: We have licensed agents who provide free assistance with selecting Medicare plans! It doesn’t cost anything more to speak with an agent than if you had applied directly through the carrier. The difference is that an agent can offer you multiple plans, providing a bias-free approach. We also have a Medicare Plan Finder tool that you can use to compare plans before you meet with an agent.

Senior Medicare Patrol Hawaii (SMP Hawaii): A volunteer program that makes sure Medicare is not billed for false medical treatments. If you suspect any fraud on your Medicare bills, SMP is a good organization to contact.

Medicare Course

Gettin Both Medicare and Medicaid in Hawaii

If you qualify for both Medicare and Hawaii Medicaid and there is a plan available in your area, you may be able to enroll in a Medicare Advantage Dual-Eligible Special Needs Plan. These plans generally have very low or no out of pocket costs to you and can provide benefits for Medicare and Medicaid covered services. Medicaid qualifications are based on income and other Hawaii state regulations. For help with finding plans in your area, call 833-438-3676.

How to Apply for Medicare in Hawaii

If you receive benefits from the Railroad Retirement Board or Social Security, you may be automatically enrolled in Medicare. If you are not automatically enrolled, you can enroll through the Social Security website, in-person at a Social Security office, or by calling 1-800-772-1213. 

To enroll in Part D, Medicare Advantage, or Medicare Supplements, start searching for Hawaii Medicare plans here or get in touch with an agent, here. You can also call our office at 833-438-3676 during our business hours (8 AM to 4:30 PM CST/MST).

Have questions? Call a Licensed Agent!