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What You Need to Know About Medigap Policies in Hawaii

Updated: Dec 28, 2021

There are only a few more days of Annual Open Enrollment (AEP), which closes on December 7. This is the time where seniors can decide if they want to switch from Original Medicare (Parts A & B) to a Medicare Advantage (MA) Plan (Part C), from one MA Plan to another or from a MA Plan to Original Medicare. Medicare Advantage delivers Parts A & B and often, Part D as well (prescription drug coverage). If you have decided to switch from Medicare Advantage to Original Medicare, you may be considering adding a Medicare supplement plan called Medigap to help pay for some of the out of pocket expenses that Original Medicare doesn’t cover. It’s important to understand the rules, coverage and costs that apply to Medigap so you don’t end up with an unpleasant surprise.

Speak to a Medicare Agent at Premier Benefit Consultants who can walk you through all your Medicare options, including supplement plans, at no charge.

What You Need to Know if You’re Switching to Original Medicare with a Medigap Policy

If you are considering adding a Medigap plan to your Medicare coverage during AEP, you will want to know this basic information:

Medigap plans are sold by private insurance companies. There are thirteen insurers that offer Medigap plans in Hawaii.

Note that the best time to purchase a Medigap policy is when you first enroll in Part B. You get a six-month window to buy without being asked any questions about your health. If you choose to apply for a Medigap policy during AEP instead, apply as soon as possible and wait for approval before canceling your MA Plan.

Medigap plans help to partially or fully cover the out of pocket parts of Original Medicare, such as deductibles, copays and coinsurance. They do not cover additional benefits such as dental care that are often covered in an MA Plan.

Medigap plans can only be paired with Original Medicare (Parts A & B), not a Medicare Advantage Plan.

Since 2006, Medigap plans do not include prescription drug coverage so kupuna who choose a Medigap plan today will need to purchase a separate Part D prescription drug plan.

In Hawaii, Medigap plans are categorized according to the type of benefits they offer. There are 10 standardized plans identified by the letters A-N. While each plan with a particular letter category includes identical benefits, the cost of the plan may vary from insurer to insurer and depending on the plan’s location. If you are shopping around and you’re unsure about why the cost of the plan varies so much from insurer to insurer, we recommend asking how the agency is “rating” their plans. You may also wish to know how many insurance companies they work with and whether they offer a household discount.

As of this year, Medigap plans are no longer able to cover the Part B deductible. Those who were already enrolled in the plans that covered the deductible (plans C & F) were grandfathered in.

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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