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:
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.
