2026 Medicare Plans Hawaii

Medicare is a federally funded health insurance program that provides health care coverage for people aged 65 or older. If you are under the age of 65, you may qualify for Medicare coverage if you are afflicted with certain disabilities.

If you are likely to be eligible for Medicare coverage soon, you should learn more about the options you have for Medicare coverage.

Original Medicare

The standard form of Medicare coverage, Original Medicare, has two main components: Medicare Part A and Medicare Part B.

Medicare Part A provides benefits that cover hospital care services, including:

Inpatient care delivered in a hospital
Care in a skilled nursing facility
Inpatient nursing home care
Home health care services
Hospice care

Medicare Part A also covers a lifetime limit of up to 190 days of inpatient mental health care in a psychiatric hospital for each beneficiary.

Medicare Part B Provides benefits that cover medical services, including:

Medically necessary services
Preventive services
Clinical research participation
Ambulance transportation
Durable medical equipment purchases
Mental health care services delivered in inpatient, outpatient, and partial hospitalization settings

Once you sign up for Original Medicare, you will have access to all of these benefits, but ensure that you check with your health care provider before receiving services to confirm that your care will be covered under Medicare.

Medicare Part D (Prescription Drug Coverage)

Original Medicare does not provide comprehensive prescription drug coverage. If you need prescription drug benefits, Medicare Part D can provide you with affordable access to prescription medications that are prescribed to you by your health care providers.

If you choose to enroll in this optional benefit, Medicare will cover some of the costs for medications listed in their formulary. The formulary is a list of prescription drugs that are covered under the policy. Medicare Part D plans can choose which drugs they cover and place them into different tiers that determine their cost to the consumer.

Medicare Supplement Insurance

Medicare Supplement Insurance (Medigap) policies are designed to help Original Medicare beneficiaries cut down out-of-pocket costs. There are currently 10 available plans, each offering different benefits. If you are interested in purchasing a Medigap policy, Proinsurance Hawaii can point you in the direction of the best plan for your unique situation.

Medicare Advantage

Medicare Advantage Plans are Medicare plans offered through private companies that have contracted with Medicare to deliver Part A and Part B benefits directly to consumers. Therefore, if you choose to enroll in a Medicare Advantage plan, you are guaranteed to at least have coverage matching the benefits of an Original Medicare Plan.

Medicare Advantage Plans also frequently include Prescription Drug coverage and may include additional benefits, such as dental, hearing, or vision benefits. As these plans are purchased through private insurance providers, they have more flexibility in the benefits that they can provide. However, this often means Medicare Advantage Plans may come at a higher cost.

Enrollment

If you are eligible for Medicare benefits, you can enroll in your preferred plan during the following standard periods:

Initial Medicare Enrollment Period: This period begins three months before you turn 65 and ends three months after you turn 65. The Initial Enrollment Period also includes your birth month, adding up to a total of 7 months where you are eligible for enrollment
General Medicare Enrollment Period: The General Medicare Enrollment period is for people who do not enroll during their Initial Enrollment Period. It spans January 1 to March 31. People who enroll during this period will receive coverage on July 1.
Special Enrollment Period: Under certain conditions, you may be eligible for a Special Enrollment Period that falls outside of the standard periods listed above. Consult with an expert to learn if your situation qualifies you for a Special Enrollment Period.

Are You Planning To Enroll In Medicare?

Having help with the Medicare enrollment process can ensure that you select coverage that effectively covers your long-term healthcare needs. Allow Proinsurance Hawaii to support you.

Contact us now to schedule a meeting. We will help you find the coverage you need to secure a long, healthy, and happy life.

Enroll in Medicare Coverage

Medicare is a health insurance program funded by the federal government. It primarily offers free or low-cost healthcare to those 65 and older. However, if you’re under 65 and have certain disabilities, you may also qualify.

You might think enrolling in Medicare plans in Hawaii is as simple as clicking a button, but the process is a bit more complex. When it comes to choosing a plan, you have several different options. Before enrolling, it’s a good idea to understand how Medicare works and what types of 2023 Medicare plans in Hawaii may be available to you.

Types of Medicare Plans in Hawaii

Medicare isn’t a single insurance plan — there are several types of care that fall under the Medicare umbrella. Here’s a quick breakdown:

Medicare Part A: Covers hospital care (part of Original Medicare)
Medicare Part B: Covers medical care (part of Original Medicare)
Medicare Part C/Medicare Advantage: Private plans that contract with Medicare to deliver Part A and Part B services
Medicare Part D: Covers prescription drugs
Medigap/Medicare Supplement Insurance: Can cover services not included in your current Medicare plan

Not sure which parts you need? Below is a more detailed guide to the various parts of 2023 Medicare plans in Hawaii.

Original Medicare

Medicare Part A covers hospital services and Medicare Part B covers medical care. Both are components of Original Medicare.

Medicare Part A

Part A covers most types of in-hospital care:

Skilled nursing services (in a nursing facility)
In-hospital care (inpatient services only)
Home health care
Hospice care
Up to 190 days of inpatient care in a psychiatric hospital

Notably, Part A does not cover outpatient services. Most of these are covered by Part B.

Medicare Part B

Medicare Part B covers most medical equipment and services not covered by Part A:

Preventive care
Ambulance transportation
Medically necessary procedures and services
Participation in clinical research
Inpatient, outpatient, and partial hospitalization mental health care services
Purchases of durable medical equipment (like wheelchairs, walkers, insulin pumps, etc.)

As with any type of health insurance, these services should be covered. But it’s a good idea to double-check with your healthcare provider before you enroll. Medicare coverage can be hard to understand, particularly if you’re enrolling for the first time! If you aren’t sure if Original Medicare covers an existing service or item you need for your health, Medicare offers online tools to help you check. The helpful agents at Proinsurance Hawaii can also verify that a plan covers what you need.

Optional Add-On Coverage

Depending on your unique healthcare situation, you may find that most 2023 Medicare plans in Hawaii don’t cover all your healthcare needs. If you’re looking for more comprehensive coverage than what Original Medicare offers, you might be interested in Medicare Part D and/or Medicare Supplement Insurance (also called Medigap).

Medicare Part D

You may have noticed that while Original Medicare plans in Hawaii cover many medical costs, they do not cover prescription drugs at all. If you take any type of prescription or think you might in the future, Medicare Part D is worth considering.

However, Medicare Part D may not cover every single prescription drug. Medicare has a “formulary,” or a list of covered prescription drugs. Like many health insurance plans, Medicare divides those prescriptions into tiers.

Different tiers of drugs will cost different amounts. It’s wise to check for your prescription before you enroll. Medicare coverage includes many drugs, but it doesn’t cover them all. Medicare Part D also doesn’t always cover the full cost of a prescription. However, in many cases, it dramatically reduces what you need to pay out of pocket.

Not sure if Part D is worth getting? We can take a look at your healthcare situation and tell you how much you might save.

Medicare Supplement Insurance (Also Called Medicare Part C or Medigap)

Sometimes, even if you have both Original Medicare and Medicare Part D, you might find that you still have gaps in coverage. There are 10 specific Medigap plans:

Plan A (Different From Medicare Part A): Covers the 20% coinsurance for outpatient care not covered by Medicare
Plan B (Different From Medicare Part B): Covers what Plan A covers plus Medicare Part A hospital deductible
Plan C (Different From Medicare Part C): Covers Part A and Part B deductibles plus 20% outpatient coinsurance (everything but Medicare excess charges)
Plan D (Different From Medicare Part D): Covers many expenses minus the Part B deductible and Medicare excess charges
Plan F: Covers all out-of-pocket costs
Plan G: Covers all of what Plan F covers minus the Part B deductible
Plan K: Covers part (usually 50%) of the costs not covered by Part A and Part B
Plan L: Covers part (usually 75%) of the costs not covered by Part A and Part B
Plan M: Covers part of the costs not covered by Part A and Part B, and also covers medical services received abroad
Plan N: Offers low premiums in exchange for small copays on most services

As you may have guessed, Plan F’s comprehensive coverage makes it the most popular Medigap plan. Depending on your healthcare needs, you may find that one or more Medigap plans can give you the coverage you want.

Medicare Advantage

Medicare Advantage plans are an alternative to Medicare Part A and Part B. These are plans offered by private companies, but the companies contract with Medicare. When you enroll, Medicare coverage benefits will include all Part A and Part B benefits.

With a Medicare Advantage Plan, you at least get the coverage you would get with Original Medicare. However, most Advantage Plans offer additional benefits like vision, hearing, and dental care.

Advantage Plans offer flexible benefits, so they’re easier to customize to your specific needs. They may be more expensive than some forms of Medicare, but many people like you find that to be a worthy trade-off.

At Proinsurance Hawaii, we offer a range of Medicare Advantage Plans to suit every need. You can choose different levels of coverage to ensure you get everything you need and nothing you don’t.

When Can You Enroll in 2023 Medicare Plans in Hawaii?

Medicare restricts the times you can enroll in a plan. To make sure you get the coverage you need, it’s a good idea to take the time to research and talk to insurance experts before committing.

Once you’ve decided on a plan, there are a few enrollment periods. Medicare offers the following windows of time to enroll:

Initial Enrollment Period

This enrollment period works differently than the enrollment period for most insurance plans. Rather than giving you a set period of time during the year, the Initial Enrollment Period gives you a large enrollment window:

Three months before your 65th birthday (coverage starts the month you turn 65)
Your birth month (coverage starts the next month)
Three months after your 65th birthday (coverage starts the month after you enroll)
Luckily, even if you haven’t started looking at Medicare plans yet, this period of time gives you plenty of opportunity to research and consider plans.

General Enrollment Period

If you forget to enroll during the Initial Enrollment Period, don’t worry — you can still enroll. Medicare coverage offers a General Enrollment Period that lasts from January 1 through March 31. However, if you enroll during this time, your coverage will not start until July 1 of the same year.

Special Enrollment Period

Not everyone can qualify for a Special Enrollment Period. Generally, you can only qualify if you’ve experienced a certain event that has caused you to need to update your insurance coverage.

These events may include losing your existing health insurance (like if you leave a job with employer-sponsored health coverage) or moving to an area outside of your current Medicare plan’s coverage area.

It can be hard to know whether a given event qualifies you for a Special Enrollment Period. Our helpful insurance experts can talk to you about your situation and tell you whether you qualify.

Looking at Medicare Plans in Hawaii?

Your health is key to your well-being, so choosing the right health insurance coverage is essential. At Proinsurance Hawaii, our experts get to know you and your healthcare needs before recommending a policy. We’ve been in business for 22 years and are committed to the health of our community.

Contact us today to schedule a meeting with one of our friendly experts! We’ll help you find the right coverage for a long, happy, healthy life.