Hawaii Medicare: Everything You Need to Know About Medicare Advantage & Supplemental Plans in Hawaii

Choosing the right Medicare plan in Hawaii can feel like navigating a jungle. Let's explore the two main options: Medicare Advantage and Supplemental Plans.

Hawaii’s Medicaid program, known as Med-QUEST, provides financial assistance with the cost of Medicare premiums and prescription drug expenses. It also helps with costs not covered by Medicare – such as long-term care services. In addition to these programs, the state requires Medigap insurance companies to offer all plans on a guaranteed-issue basis during a six-month window when the enrollee is first enrolled in Medicare Part B. This is in contrast to federal law, which grants a guarantee only for those who are newly eligible at age 65.

For applicants who qualify for nursing home Medicaid, Hawaii state has a program called Money Follows the Person, which pays for the cost of moving the beneficiary from a nursing home to their own home or to the home of a relative. This includes paying for the purchase or rental of a home and the cost of long-term care services and support in the new residence.

You may have questions about your coverage if you’re a Hawaii Medicare beneficiary. Fortunately, there are many resources available to assist you. You can find information online or contact your local Medicare insurance agent for help. Hawaii’s State Health Insurance Program also has counselors throughout the state who can answer your questions and provide you with assistance.

How Does the Hawaii Medicare Program Work?

Hawaii residents have multiple Medicare options to choose from. They can select Original Medicare (Part A and Part B) or Medicare Advantage, which bundles the standard coverage you’d get with Parts A and B with additional prescription drug add-ons and supplemental health insurance coverage. They can also opt for a Medicare Supplement plan that helps pay for their out-of-pocket expenses.

In addition to Medicare, the state of Hawaii offers long-term care assistance through Medicaid programs for the elderly and disabled. The state’s Medicaid program is run through the Med-QUEST Division, which contracts with managed care plans to provide services. Applicants can submit their applications at eligibility offices located throughout the state. The statewide income standards for the program vary by coverage group.

Hawaii Medicare Eligibility Requirements

Hawaii Medicare Eligibility Requirements

To qualify for Medicare in Hawaii, you must be a U.S. citizen or permanent resident and be at least 65 years old. You may also qualify if you have end-stage renal disease or amyotrophic lateral sclerosis or if you’ve been receiving disability-based Social Security or Railroad Retirement Board benefits for 24 months.

If a person’s income is too high to qualify for Medicare, they may also be eligible for Medicaid, which operates differently in each state. In Hawaii, the Medicaid program is called Med-QUEST and serves financially limited adults ages 65 and over or blind or disabled. Med-QUEST offers both nursing home- and home- and community-based service waivers. The state may also offer a spend-down program that allows applicants to subtract certain medical expenses from their income when determining eligibility.

If your income is too high to qualify for Medicaid, you can still get help paying for your Medicare premiums and prescription drug costs. The Medicare Savings Programs, or Extra Help, program can provide financial support to Medicare beneficiaries who need help paying their costs.

Medicare Advantage plans in Hawaii offer a variety of options to help you lower your costs. Some of these plans offer preferred provider networks, while others don’t. You can choose a plan that best suits your needs and budget. You can also consider Medicare Supplement (Medigap) policies to fill in the gaps left by Original Medicare. These plans are standardized by federal rules but vary in how they charge premiums and cover benefits.

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