Medicare in Hawaii

Last Updated : 09/16/20185 min read

Are you shopping for Medicare in Hawaii? You may want to consider all of the options first. Let be your resource for facts about Medicare coverage while offering the use of our plan comparison tool to examine plan details and pricing options.

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About Medicare in Hawaii

Medicare beneficiaries in Hawaii can receive their coverage through Original Medicare, Part A and Part B, and add additional coverage in the form of a stand-alone Medicare Part D Prescription Drug Plan and/or a Medicare Supplement (Medigap) insurance plan. They may also enroll in a Medicare Advantage plan (Medicare Part C), which provides their Original Medicare coverage by offering all the benefits included under Part A and Part B (with the exception of hospice care), and could also include routine vision, dental, and even prescription drug coverage.

If you choose to enroll in a Medicare Advantage plan in Hawaii, you will continue to pay your Medicare Part B premium.

Types of Medicare coverage available in Hawaii

Original Medicare is the federally administered program. It comes in two parts: Medicare Part A provides inpatient hospital and skilled nursing facility coverage; while Part B covers doctor visits, preventive care, and durable medical equipment.

Medicare Advantage plans are an alternative to Original Medicare and are also available in Hawaii through private insurance companies that have contracted with Medicare. Plan costs and details will vary.

Medicare Part D is prescription drug coverage. You can get this coverage through a Medicare Prescription Drug Plan, which offers stand-alone prescription drug coverage that can be added to Original Medicare. Or, Medicare Part D coverage may be offered through a Medicare Advantage Prescription Drug plan. Not every plan may be available in each area, and cost may vary by plan.

Medicare Supplement insurance, also called Medigap, is an optional policy that covers “gaps” in Original Medicare like deductibles, copayments, coinsurance, and, in some cases, foreign travel emergency health-care coverage.

Local resources for Medicare in Hawaii

  • Medicare Savings Programs in Hawaii: Hawaii offers savings programs for Medicare beneficiaries whose income falls below a government-set level. These programs can help pay for out-of-pocket costs like Medicare Part A and B premiums, deductibles, and prescription drug costs.
  • Hawaii State Health Insurance Counseling and Assistance Program (SHIP): Hawaii beneficiaries may visit the Sage PLUS Program website to learn more about Medicare. Sage PLUS, a program sponsored by the State Health Insurance Counseling and Assistance Program (SHIP), provides Medicare education at no cost to the beneficiary.

How to apply for Medicare in Hawaii

As in the rest of the country, to be eligible for Medicare, you must be age 65 or older and either a United States citizen or a legal permanent resident of at least five continuous years. You may also qualify for Medicare before 65 through disability or by having end-stage renal disease or amyotrophic lateral sclerosis (or Lou Gehrig’s disease).

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In some circumstances, you do not have to take any action to enroll. You will be enrolled automatically in Medicare Part A and Part B if you meet one of these criteria:

  • You are receiving Social Security benefits or Railroad Retirement benefits before you turn 65.
  • You are under age 65 and receive disability benefits from Social Security, or certain disability benefits from the Railroad Retirement Board, you can get Medicare once you enter into the 25th consecutive month of receiving those benefits.
  • You qualify for Medicare because you have amyotrophic lateral sclerosis. You’ll automatically be enrolled in Medicare Part A and Part B the month your disability benefits begin.

You will know that you have been enrolled automatically because a “Welcome to Medicare” packet will arrive in the mail a few months before you turn 65.

You generally get Medicare Part A for free if you or your spouse has worked long enough in employment where Medicare taxes were paid (10 years or 40 quarters). If you qualify for premium-free Medicare Part A, but are not yet receiving retirement benefits, you’ll automatically get Part A, but will need to manually enroll in Part B. You can do so during your seven-month Initial Enrollment Period, which starts three months before you turn 65, includes the month you turn 65, and ends three months later.

Those who need to apply for Medicare manually may visit their local Social Security Administration office or do so online, over the phone, or in person:

  • Visit the Social Security website.
  • Call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778), Monday through Friday, 7AM to 7PM.
  • Apply in person at a local Social Security office.
  • If you worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772 (TTY users call 312-751-4701), Monday through Friday, 9AM to 3:30PM.

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