Hawaii Medicare plans are very similar to most other states. Hawaii offers all 10 of the standardized Medigap plans – Medigap Plan A, B, C, D, F, G, K, L, M, and N. There are Hawaii Medicare Advantage plans available as well.
Keep in mind that Hawaii Medigap plans are also referred to as Medicare Supplement plans. Also, Medicare Advantage plans are can be called Medicare Part C.
Hawaii Medigap Plans
Hawaii Medigap plans cover the cost-sharing expenses that Original Medicare (Part A and Part B) leave for you to pay. Cost-sharing expenses include deductibles, co-payments, and coinsurance, to name a few.
Hawaii Medigap Plan G covers all of Medicare’s cost-sharing expenses except the Part B annual deductible. You can find out the current Part B deductible here. Plan G will be the most comprehensive Medigap plan offered to new Hawaii Medicare beneficiaries as of 2020.
An alternative to Plan G is Hawaii Medigap Plan N. Plan N covers everything Plan G covers except for the Part B excess charges. Excess charges are charges you can experience if you see a Medicare doctor who doesn’t accept Medicare assignment.
If the doctor doesn’t accept Medicare assignment, then they can charge you up to 15% more than Medicare’s approved price. Therefore, if you choose Plan N, be sure to only see doctors who accept Medicare assignment.
Another difference between Hawaii Medigap Plan G and Plan N is that with Plan N you will have small copays for office and emergency room visits. For office visits such as doctor exams, you will have an up to $20 copay. If you visit the ER, you will have an up to $50 copay. Plan N is a good alternative to Plan G if you don’t go to the doctor all that often and you want a smaller monthly premium.
Medicare Advantage Plans in Hawaii
Medicare Advantage plans are a popular choice for Hawaii Medicare beneficiaries. According to the Kaiser Family Foundation (KFF), 45% of Medicare beneficiaries in Hawaii choose Medicare Advantage over Original Medicare.
When you choose to be covered by a Medicare Advantage plan over Original Medicare, you agree to follow your plan’s specific rules. Medicare Advantage plans have doctor networks you must stay within as well as their own coverage rules.
Under Original Medicare, Medicare Part B pays 80% of covered services, while you pay 20%. Under Medicare Advantage, the carrier sets their own copay or coinsurance that you’re in charge of. For example, a doctor visit may have a $45 copay, while an X-ray may have a 10% coinsurance.
Every Medicare Advantage plan is different since they are sold by private insurance carriers. Each carrier is able to adjust the coverage guidelines as they see fit. However, Medicare Advantage plans must cover their beneficiaries as well as Original Medicare does.
A plus side to having a Medicare Advantage plan is the extra benefits they usually offer. Carriers are allowed to offer some benefits that Original Medicare doesn’t cover on their Medicare Advantage plans. Drug, dental, vision, and hearing are usually benefits offered as extra on Medicare Advantage plans.
Medicare Part D in Hawaii
If you don’t have a Hawaii Medicare Advantage plan that includes drug benefits, you’ll need a stand-alone Hawaii Part D drug plan. According to KFF, there are 24 Part D drug plans available in Hawaii.
Every Part D drug plan is structured the same way. They each have four stages – the deductible, initial copay, donut hole, and catastrophic coverage. However, each plan’s costs are different since the carriers set them. Another thing that will vary from Part D plan to Part D plan is the formulary.
The formulary is basically a list of drugs that the plan covers. The formulary will include the drug name, its tier, and whether it has any restrictions or not. Medigap, Medicare Advantage, and Part D all have premiums you pay each month in addition to your Original Medicare premiums. The national average for Part D is currently around the $35 range.
Best Way to Compare Hawaii Medicare Plans
To be sure you find the most cost-effective plan for you, compare plans with a Medicare broker like Boomer Benefits. We represent multiple carriers and can compare plans from each of them so you can find the best fit for your situation.