When you turn age 65 in the Aloha State (or are under age 65 and meet certain requirements), you can get health insurance through the federal government with Medicare.
Medicare plans in Hawaii include:
- Original Medicare — parts A and B
- Medicare Advantage — Part C
- Prescription drug coverage — Part D
- Medicare supplemental insurance — Medigap
It’s important to understand each part of Medicare so you get the correct coverage.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Hawaii for the 2022 plan year:
- A total of 287,287 residents of Hawaii are enrolled in Medicare.
- The average Medicare Advantage monthly premium decreased in Hawaii compared to last year — from $56.34 in 2021 to $54.47 in 2022.
- There are 33 Medicare Advantage plans available in Hawaii for 2022, compared to 30 plans in 2021.
- All Hawaii residents with Medicare have access to buy a Medicare Advantage plan, including plans with $0 premiums.
- There are 12 different Medigap plans offered in Hawaii for 2022.
Original Medicare is divided into two separate parts that cover different types of care: parts A and B.
Part A (inpatient care) covers:
Part B (outpatient care) covers:
- doctors’ visits
- medical equipment (wheelchairs, walkers, etc.)
- preventive care and screenings
- lab tests and imaging
In addition to original Medicare, there are also options for additional or alternative coverage through private providers.
Medicare Advantage in Hawaii
All these options are bundled together in a single plan to make it easier for you to get the care you need. Some Medicare Advantage (Part C) plans also have a limit on how much you pay out of pocket each year.
Medicare Advantage plans in Hawaii are offered by these insurance carriers:
These companies offer plans in many counties in Hawaii. However, Medicare Advantage plan offerings vary by county, so enter your specific ZIP code when searching for plans where you live
Medicare supplement plans in Hawaii
Medigap plans are private insurance plans designed to help with the portion of original Medicare costs that you pay, such as deductibles for hospital stays, coinsurance, and copays. Medigap policies cannot be used for Medicare Advantage coverage or expenses.
Many companies offer Medigap plans in Hawaii. In 2021, some of the companies offering Medigap plans throughout the state include:
To be eligible for Medicare, Hawaii residents must be:
- 65 years old or older
- a U.S. citizen or legal resident for at least the past 5 years
You may also qualify if you are under age 65 and:
- have end stage renal disease (ESRD) or a kidney transplant
- receive Railroad Retirement (RRB) or Social Security Disability (SSDI) benefits
- have amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease
When can I enroll in Medicare Hawaii plans?
There are specific time periods when you can enroll in Medicare and Medicare Advantage.
- Initial enrollment period. If you’re first eligible when you turn age 65, you can sign up during this 7-month period. It starts 3 months before the month you turn age 65 and ends 3 months after the month of your 65th birthday.
- Medicare open enrollment period. The annual open enrollment period happens between October 15 and December 7. At this time, you can join a Medicare Advantage plan or switch to a new plan.
- Medicare Advantage open enrollment period. If you’re already in a Medicare Advantage plan, you can switch to another one between January 1 and March 31 every year.
Certain life events, such as losing a job that provides you with health coverage, will trigger a special enrollment period. This gives you an opportunity to sign up for Medicare outside of the standard enrollment periods.
Tips for enrolling in Medicare in Hawaii
Think carefully about your healthcare needs before selecting a plan. If you think you may have higher healthcare costs or need additional coverage, a Medicare Advantage plan may be a better option than original Medicare.
If you’re considering a Medicare Advantage plan, review the available plans carefully for:
- a network of doctors and facilities you prefer
- affordable monthly premiums, deductibles, coinsurance, and copays
- star ratings that reflect high quality care and patient satisfaction
- Hawaii State Health Insurance Assistance Program, SHIP (808-586-7299): Assistance with Medicare for individuals, families, caregivers, and agencies
- Hawaii Employer-Union Health Benefits Trust Fund (808-586-7390): Information about Medicare for State of Hawaii, county, and city employees covered by EUTF
- Hawaii Department of Health (808-586-4400): Information about Medicare facilities in Hawaii and critical access hospitals in Hawaii for rural areas
- Medicare (800-633-4227): Contact Medicare by phone or online
- More than 280,000 Hawaii residents are enrolled in Medicare.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state.
- Overall, monthly premium costs have decreased for 2022 Medicare Advantage plans in Hawaii.
- There are also several Medigap plan options if you live in Hawaii and are looking for additional coverage.