Hawaii Medigap Plans play a crucial role in enhancing Original Medicare coverage by providing additional financial protection. Just like in the rest of the country, these plans serve as supplements, covering a portion or all of the out-of-pocket expenses, such as deductibles and coinsurance, that individuals would typically have to pay if they solely relied on Original Medicare.
Hawaii Medigap Policy Basics
Before enrolling in a Medigap plan, it’s essential to be well-informed about the key factors that can impact your decision:
- Fills in “gaps”: Medigap plans work alongside Original Medicare, providing additional coverage for out-of-pocket costs such as deductibles, coinsurance, and copayments. “Gaps” in payments that Medicare does not cover.
- Standardized Plans: Medigap plans are standardized, meaning the benefits for each plan are the same, regardless of the insurance company offering it. This allows you to compare plans easily.
- Easy Plan Options: There are ten standardized Medigap plans labeled with letters A, B, C, D, F, G, K, L, M, and N. Each plan offers different coverage benefits, allowing you to choose one that aligns with your specific needs. Plan G is currently the most popular in Hawaii. (Source: AHIP)
- Freedom to Choose Providers: With Medigap, you have the freedom to choose any healthcare provider that accepts Medicare (the largest network of Doctors in America), giving you greater flexibility in accessing care. If you want to see a doctor on the Mainland? You can without a referral as long as they accept Medicare! (Source: Medicare.gov)
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Comparing HI Medicare Supplement plans
Plans available for those Medicare-eligible after January 1, 2020:
| Benefits | A | B | D | G** | K | L | M | N |
|---|---|---|---|---|---|---|---|---|
| Medicare Part A Deductible ($1,632) | 100% | 100% | 100% | 50% | 75% | 50% | 100% | |
| Part B Deductible ($240) | ||||||||
| Medicare Part A Hospital Coinsurance and 365 additional hospital days | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Medicare Part B Coinsurance | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| First 3 Pints of Blood for a Transfusion | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Medicare Part A Hospice Coinsurance or Copay | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Skilled Nursing Facility Coinsurance | 100% | 100% | 50% | 75% | 100% | 100% | ||
| Medicare Part B Excess Charges | 100% | |||||||
| Foreign Emergency Healthcare | 80% | 80% | 80% | 80% | ||||
| Max Out-of-Pocket | $7,060 | $3,530 |
**Medigap Plan G High Deductible is $2,800.
If you were Part B eligible before January 1, 2020, you may be able to enroll in a plan that covers your Part B deductible.
Hawaii Medigap Discounts
To learn more about Hawaii discounts click on the following links:
Hawaii Medigap Plans: Under 65 State Rules
In Hawaii, individuals who are enrolled in Part B and are 65 years old have a six-month guaranteed-issue open enrollment window, thanks to federal law. However, HI goes a step further by extending the same protections to those under 65 who qualify for Medicare due to a disability. Interestingly, Hawaii has the lowest percentage of beneficiaries who are eligible for Medicare based on a disability, as previously mentioned. Learn more about Medigap Under 65.
Hawaii Medigap Switching Rules
The AEP Open Enrollment (Oct 15 to Dec 7) isn’t for Medigap plans in your state. If you’re considering switching your Medigap plan, you have the flexibility to do so. However, be prepared for a reapplication process and medical inquiries before approval. This evaluation process is commonly referred to as “medical underwriting.” Expect around 20 health questions on the new Med Supp application. Based on your answers, your rate may vary, or you could be declined for certain conditions. For a comprehensive understanding of your rights and the relevant regulations, we recommend delving into our in-depth article titled “Medicare Insurance Switching: The Ultimate Guide.”
Medicare Part B Excess Charges in Hawaii
Sometimes, doctors and hospitals add an extra 15% to your bill. But with specific Medigap plans, like Plan G, those charges are taken care of. Dive into our article ‘How To Avoid Medicare Excess Charges’ for the full scoop!
Next Steps for adding Medigap
Every special enrollment situation has its own set of eligibility requirements and timeframes. It is essential to carefully research each situation to determine whether you qualify for a special enrollment period to enroll in a Medigap policy.
For personalized assistance and guidance, feel free to contact Senior65.com at 800-930-7956. Our dedicated team is here to help you determine the optimal time for your Medigap enrollment.
There is never a charge or hidden fee to work with us and no one can sell the same Medigap plan for less than Senior65.com can.