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Medicare in Hawaii

April 6, 2022

Medicare in Hawaii

Living in Hawaii can be a dream come true — beautiful sand, ocean, and scenery abound. Life on the islands seems to move at a slower pace.

If you’re drawing close to age 65 and you live in Hawaii, you probably have a lot of questions about Medicare. There are so many parts and different coverage options, it can be confusing.

This guide aims to make the process easier. Take a look at what Medicare coverage is and how you can enroll. Let’s get started!

Does Medicare Cover Me in Hawaii?

The first question many people have is, can I use Medicare in Hawaii? The answer is yes! Medicare is a national health coverage program that operates the same in Hawaii as the other states and helps those who qualify under the federal guidelines get medical care.

For example, someone of retirement age (65) is generally eligible, as are those who are disabled or have specific health conditions.

There are two primary Medicare plans: Original Medicare and Medicare Advantage. Original Medicare has multiple parts, including Part A (hospital coverage), Part B (medical coverage), and Part D (prescription drug coverage).

Medicare Advantage is a full replacement for Original Medicare, where you get a single plan that gives you the coverage you need for one price. These are sold by private health insurance companies and may include additional benefits Original Medicare doesn’t cover.

Knowing your Medicare options and comparing them allows you to find the right coverage for your needs.

Medicare in Hawaii Eligibility

As we mentioned, Medicare is intended for those who are less likely to have employer health insurance coverage. As a result, eligibility is based on age and health status.

To qualify for Medicare in Hawaii, you must be a U.S. citizen or permanent resident who’s lived in the United States for at least five years, for whom at least one of the following apply:

  • Age 65 or older
  • Under 65 but disabled and receiving disability benefits from Social Security or the Railroad Retirement Board
  • Having Amyotrophic Lateral Sclerosis (ALS), better known as Lou Gehrig’s disease
  • Having end-stage renal disease (ESRD)

Your initial enrollment period will be a specific length of time, for example, seven months surrounding your 65th birthday. After that period, you’ll be able to update your plan coverage during annual enrollment (AEP) each fall.

How to Apply for Medicare in Hawaii

Once you become eligible for Medicare, you might ask “How do I apply for Medicare in Hawaii? Should I just accept automatic enrollment?”

Most Americans who become eligible will be automatically enrolled in Original Medicare Part A and Part B if they don’t take other action. However, that might not be right for you. For instance, the default enrollment options don’t give you any coverage for prescription drugs, and you miss your chance to secure a Medigap plan to pay for your out-of-pocket costs.

Also, it’s worthwhile to explore Medicare Advantage plans in your area, especially if you don’t travel much. You can look at your Medicare plan options online or contact a licensed agent over the phone. Comparing your options helps ensure you have the medical coverage that matches your needs

Does Hawaii Have Medicare Advantage Plans?

Like other states, Hawaii has private insurance companies that offer Medicare Advantage plans. These plans provide at least as much coverage as Original Medicare and often have additional benefits such as the availability of vision or dental coverage.

Some Advantage plans cost the same as your Part B premium, while others will cost a bit more. Be sure to shop around to find a plan that makes sense for you.

The important thing to keep in mind is that a Medicare Advantage plan will have a limited medical provider network that is based on your local area. Most plans do not offer non-emergency coverage outside the network. You’ll need to make sure your providers are included before you commit to a plan, and if you travel often, it might be best to choose Original Medicare and its national provider network.

There are likely to be multiple Medicare Advantage options in your area, so be sure to compare them so you get the right choice for your situation.

Contact us to Learn More About Medicare in Hawaii

This guide answered the most common questions about Medicare in Hawaii, but you might have questions based on your specific circumstances. We’re here to help. If you’d like to learn more about Medicare in Hawaii or talk to a licensed agent to compare your options, contact us today!

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