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Hawaii Medicare Insurance Plans

Medicare Supplement Insurance (Medigap) Policies

Private Medigap plans are available within a six-month enrollment period at age 65. Hawaii has no requirement for insurers to sell Medicare Supplement Insurance policies before then.

High-Risk Pool Information

Hawaii has its own high-risk pool plan that is used in conjunction with the federal Health Insurance Marketplace, which has a sliding fee based on income, as well as a $2,500 deductible.

Mini-COBRA Policies (Small Group)

Hawaii doesn't have mini-COBRA coverage, as Hawaii law requires that employers continue to cover health insurance for employees for three months after termination of employment (or for as long as the employer continues to pay wages, if the severance period is longer).

Hawaii Medicare Savings Program

Hawaii has four Medicare Savings Programs available, depending on your income level.

  • Qualified Medicare Beneficiaries (QMBs): For QMBs, Hawaii covers all premiums for Medicare Part B and all copayments and deductibles for Medicare Parts A and B. This program is for individuals with a monthly income below $1,150 and couples with a monthly income below $1,548.
  • Specified Low-Income Medicare Beneficiaries (SLMBs): For individuals with a monthly income above $1,150 but under $1,375 (or couples with income above $1,548 but under $1,853 per month), the state pays premiums for Medicare Part B under a second-tier plan for Specified Low-Income Medicare Beneficiaries.
  • Qualified Individuals (QIs): The state will pay Medicare Part B premiums for individuals with a monthly income under $1,545 (or couples with a combined monthly income under $2,083).
  • Qualified Disabled and Working Individuals (QDWIs): For individuals with annual income under $20,130 (or couples with combined income below $27,135) the state will cover premiums for Medicare Part A.

Health Insurance Counseling and Advocacy Program (SHIP)

Local Hawaii SHIP centers (previously known as Sage Plus until April 1, 2015) are there to help you understand the variety of Medicare programs available. Hawaii SHIP provides local counseling sessions and personal phone and office consultations for patients throughout the state as a means to educate you about the wide variety of medical care and insurance options available (which can vary from region to region), including:

  • Medicare (Parts A and B)
  • Medicare Advantage Plans (Part C)
  • Medicare Prescription Drug Plans (Medicare Part D)
  • Medicare Supplement Insurance (Medigap)
  • Prescription assistance programs
  • Long-term care and payment options
  • Health care rights and protections
  • Low-income assistance programs

Hawaii SHIP also works on your behalf to deal with claims and disputes through a network of hundreds of trained, certified SHIP volunteers throughout the state of Hawaii

Low-Income Subsidy (Extra Help) for Prescription Drugs

The available low-income subsidy for Extra Help with prescription drugs in Hawaii is $27.91 for 2015.

If you are a Hawaii resident looking for answers about the best plan available to you in your area, consult with an insurance specialist at Knowledgeable representatives can tailor the best solutions to your needs based on both your income and location.