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Hawaii Medicare Plan Options for 2021

Updated: Oct 5, 2021

According to the Centers for Medicare & Medicaid Services (CMS), 280,662 residents of Hawaii are enrolled in Medicare for the 2021 plan year. This includes those who are enrolled in both Original Medicare and Medicare Advantage Plans.

While most seniors 65 years and older – and those with specific requirements under the age of 65 - have access to Medicare, the specific plans available may vary from state to state and even county to county. In Hawaii, seniors have access to the following types of Medicare plans:

  • Original Medicare (Includes Part A and B)

  • Medicare Advantage (Part C) with 30 plans available in Hawaii in 2021

  • Prescription drug coverage (Part D) with 26 plans available in Hawaii in 2021

  • Medicare supplemental insurance (Medigap) with 12 plans available in Hawaii in 2021

Whether you choose Original Medicare or a Medicare Advantage Plan, you will receive coverage for both Parts A & B. Many seniors choose to add prescription drug coverage through a Part D Plan and/or a Medicare supplemental insurance plan to cover some of the costs that Original Medicare doesn’t pay for.

An experienced Medicare agent can help you go over your options and explain the differences between them. Our advice is always free; we are here to help!

Hawaii Medicare Plan Options for 2021

Original Medicare

Original Medicare includes Part A and Part B. Coverage is consistent for all Americans.

Part A is hospital coverage and includes:

  • Hospital care

  • Limited stays at skilled nursing facilities

  • Hospice care

  • Limited home healthcare services

Part B is medical coverage and includes:

  • Visits to the doctor

  • Medical equipment such as walkers and hospital beds

  • Vaccines

  • Preventive care and screenings

  • Lab tests and imaging

Medicare Advantage Plans in Hawaii

All residents of Hawaii have the option to purchase a Medicare Advantage Plan – some with $0 monthly premiums. Medicare Advantage Plans (Part C) are required to cover Medicare Part A and Medicare Part B. Essentially, Medicare Advantage Plans are private insurance plans that replace Original Medicare. Many plans also include additional coverage for dental, vision, hearing aids and prescription drugs. Some Part C plans come with an out-of-pocket annual spending limit, unlike Original Medicare.

Medicare Advantage Plan options vary from county to county, so it’s important to speak with your Medicare Agent to discuss what is available to you.

Medicare Drug Plans in Hawaii

In Hawaii, prescription drug coverage is optional coverage offered through private insurance companies who contract with Medicare. Because Original Medicare does not include prescription drug coverage, the majority of seniors choose a stand-alone Part D Plan that complements Original Medicare or a Medicare Advantage Plan that includes prescription drug coverage.

Each plan has its own drug formulary, which is a list of all the prescription drugs covered under the plan. If you take specific drugs for a chronic health condition, it’s extremely important to sign up for a drug plan that covers your medication or you could end up paying 100% out-of-pocket for those drugs.

Medicare supplement plans (Medigap) in Hawaii

Medigap plans are combined with Original Medicare to cover the costs that are not covered by Original Medicare, including extended hospital stays, copays and coinsurance. Medigap policies cannot be used alongside Medicare Advantage Plans. There are many private Medicare insurance companies that offer Medigap policies in Hawaii.

Choosing the best Medicare option

With so many different options available, it’s important to know which plans make the most sense for your needs. Here are some things to consider:

  • Everyone has specific needs so the best plan for someone else, may not be the best plan for you. Seniors with chronic illnesses may have very different needs from seniors without them, for example.

  • You will want a plan that includes your doctors and health care facilities within the plan’s network.

  • The cost of monthly premiums, deductibles, copays and coinsurance.

  • Star ratings.

Our independent insurance agents are dedicated to assisting people on Medicare and those who are ready to transition from employer coverage to personal retirement coverage. We help kupuna understand their benefits options and apply for additional coverage, as needed. Because we represent all the major Medicare Advantage and supplement plans in Hawaii, we are able to offer unbiased advice; all at no cost to our clients.

At PBC, our clients are our number one priority and we look forward to getting to know you and your needs. Call us today at (808) 738-4500 to see how we may be of assistance.

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