For adults 65 and up, Medicare provides medical coverage from the federal government (and some disabled people). It is accessible in all 50 states, including Hawaii. About 45 percent of Hawaii’s Medicare recipients have chosen Medicare Advantage over traditional Medicare. By reading on, you can learn about your options for Medicare plans in Hawaii and decide if Medicare Advantage or another private plan is right for you.
Medicare plans in Hawaii include:
- Medicare’s original Parts A and B
- Part C of Medicare Advantage
- Drug coverage for prescriptions — Part D
- Medicare supplemental insurance — Medigap
Getting the right Medicare coverage depends on knowing how it all works.
Medicare in Hawaii: Details
According to data released by CMS for the 2022 fiscal year, Medicare usage patterns in the Aloha State have been as follows:
- As of this year, 287,287 Hawaii citizens were registered with Medicare.
- Compared to the previous year, Hawaii’s Medicare Advantage monthly premiums dropped from $56.34 in 2021 to $54.47 in 2022.
- Hawaii will have 33 Medicare Advantage plans in 2022, up from 30 plans in 2021.
- Medicare recipients in Hawaii may select from a wide variety of Medicare Advantage plans, including those with no monthly premiums.
- In 2022, Hawaii residents can choose from 12 unique Medigap policies.
Medicare Plans in Hawaii
Medicare beneficiaries in Hawaii who are at least 65 years old have a few different plans from which to choose. You qualify if you’re younger than 65 and receiving Social Security Disability Insurance (SSDI) because of a long-term disability (24 months or more). Let’s have a look at some Medicare Plans in Hawaii.
Original Medicare: It consists of Part A & B Medicare coverage. Medicare Part A. Part B pays for things like regular doctor visits, urgent care, outpatient lab work, diagnostic imaging, wellness checkups, and prescription drugs, hospital, home health, hospice, and skilled nursing facility care. This type of insurance may also cover some medications that cannot be used at home.
Medicare Advantage: Often known as Medicare Part C or Medicare MA, is a private insurance company-offered alternative to traditional Medicare. In addition to covering your prescriptions, some plans may also pay for your gym membership, dental treatment, vision care, hearing aids, and even transportation to and from your doctor’s visits.
Medigap: Medigap plans are private insurance plans that add to Original Medicare. Plans are meant to fill in the financial gaps left by Original Medicare.
Medicare Part D: Part D of Medicare is supplemental insurance for prescription drugs that can be purchased in addition to basic Medicare or Medicare Advantage. Medicare controls the plans supplied by commercial insurance firms.
Hawaii Medicare Eligibility
There are a few ways to be eligible for Medicare plans in Hawaii. You may be eligible for Medicare if you:
- Turning 65
- Getting a diagnosis of ALS
- Getting a diagnosis of ESRD
- Having reached your 25th month of SSDI
Medicare Advantage Plans in Hawaii 2022
Private insurance firms are the providers of these packages. They offer the same protections as traditional Medicare, with the potential for expanded protections in areas like pharmaceuticals, dental, and vision.
This comprehensive package is designed to streamline your access to the necessary medical attention. Some Medicare Advantage (Part C) plans also capped out-of-pocket costs.
The following insurance companies will be providing Medicare Advantage plans in Hawaii 2022:
- Lasso Healthcare
- Kaiser Permanente
- HMSA Akamai Advantage
In several of Hawaii’s counties, you can sign up for coverage from one of these providers. Medicare Advantage plan availability varies by county, so it’s important to use a ZIP code search to find a plan in your area.
Right Medicare Advantage Plans in Hawaii 2022
The right Medicare Advantage Plans in Hawaii 2022 depend on each person’s individual needs. Our research indicates that HumanaChoice H5216-233 (PPO) is the right option for a hypothetical Hawaii buyer in search of a PPO plan that includes prescription coverage, six core benefits, and a high CMS star rating.
The second most popular choice in the state is PPO plans due to their wider network. They eliminate the referral requirement, so policyholders can see doctors and specialists in and out of the network. However, the plans’ adaptability comes at a price.
HMO Right Medicare Advantage Plans in Hawaii
Again, while selecting an HMO Medicare Advantage Plan, it is important to consider your individual healthcare needs. Humana Gold Plus H0028-048 (HMO) is the optimal choice for the average Hawaii buyer since it provides drug coverage, six essential features, and a high star rating from CMS.
Despite their lower cost, HMO plans limit coverage to those inside the HMO’s network of hospitals and physicians. As needed, your PCP will refer you to a network specialist. Plans like these only pays for care received from non-participating doctors and hospitals in the event of an actual emergency. They’re for you if you’re looking for lower premiums and convenient access to in-network doctors and hospitals.
Medicare Supplement Plans in Hawaii
Medicare Supplement plans in Hawaii help offset part of the costs of Original Medicare (Parts A and B). Prescription medications are not covered by Medicare, for example. If you need help paying for your medications, you’ll have to join a Medicare Part D plan. Part B also has a monthly premium that enrollees must pay to be covered for outpatient services. The inpatient care portion of Medicare Part A is provided at no cost to most Americans, but those who aren’t qualified must pay a premium.
The right way to fill in the gaps left by Original Medicare is with a Medicare Supplement plan and a Part D plan (Parts A and B). You may be assured that this insurance package will keep your cash safe if you have health problems.
Medicare Advantage is a supplementary insurance plan that may be available to you. Prescription drugs are covered by these programs, which are offered county-by-county. Many offer free or extremely low-cost premium services. But if you pay a modest premium, your out-of-pocket costs will be high. This might mean a lot of extra cash for your bills if you have medical issues.
Right Medicare Supplement Plans in Hawaii
The Right Medicare Supplement plans in Hawaii are the same as those nationwide. Plan F in Hawaii provides the same coverage as elsewhere. Compared to other Medigap policies, Plan F offers complete protection. However, because Medigap’s first-dollar coverage has been phased out, there is a Medicare eligibility year cutoff for enrolling in Plan F (and Medigap Plan C).
Plan G provides the second-highest benefits. Additionally, since Plan F’s retirement was announced, enrollment in Plan N has increased. Beneficiaries of Plan N are responsible for slightly higher out-of-pocket costs due to the inclusion of copayments. However, the monthly payments may be far more affordable than those for the other two insurance.
You should know your alternatives inside and out before making any decisions. This will help you figure out which policy is right for you. Licensed insurance agents can assist you in filling out your Medigap policy application and answering any questions you may have.
How to Choose the Right Medicare Supplement Plans in Hawaii?
Various Medigap policies provide different benefits. Choose a plan that covers most of your spending to maximize your health insurance. Consider both the plan’s coverage and the premium cost while making your decision. You can compare and assess different plans by using a third-party comparison tool, such as NewMedicare.com.
Medicare Costs in Hawaii
Original Medicare: Costs associated with Medicare Part A can start at $0 and go up to $499 per month. For any coverage gap, Medicare Part A patients must pay a hospital deductible of $1,556. To participate in Medicare Part B, most people spend the regular monthly payment of $170.10. Medicare Part B has a deductible of $233.
Medicare Advantage Plan: In 2022, a Medicare Advantage Plan in Hawaii will cost, on average, $54.47 per month. The initial payment on specific plans is nothing.
Part D Plans: The cheapest Medicare Part D plan has a monthly payment of $7.80.
Medigap Plans: If you’re a 65-year-old nonsmoker living in Honolulu, you may get Medigap Plan G for $110 and $368 per month.
Medicare in Hawaii: By Numbers
|Original Medicare beneficiaries||Average plan cost||Hawaii’s annual spending on each recipient||Spending per recipient compared to the average for the country|
|147,456||Part A: $0 to $499 per month*
Part B: $170.10 **
To sum up, about 280,000 people in Hawaii are enrolled in Medicare. Many private insurance providers serve the state, each providing its unique Medicare Supplement and Medicare Advantage plans. Hawaii Medicare Advantage premiums for 2022 are down overall from what they were in 2018. In addition, Hawaii residents searching for supplemental health insurance coverage can choose from many different Medigap policies.