Hawaii Medicare questions, answered plainly

Nothing. Independent Medicare agents are paid by the insurance carriers when you enroll, so comparing plans, answering questions and reviewing your coverage each year is free to you. Your premium is the same whether you enroll through us, another agent or the carrier directly.

Yes, through Kaiser Permanente Senior Advantage, Kaiser’s own Medicare Advantage plan. Kaiser is an integrated system, so a Medigap policy does not pay for care inside it. Senior Advantage’s service area is Honolulu County, most of Hawaii County and the island of Maui; it is not sold on Kauai, Molokai or Lanai.

Akamai Advantage is a Medicare Advantage plan built on HMSA’s network, with separate Oahu and neighbor island plans and, on the neighbor islands, interisland travel help when HMSA refers you off-island. A Medigap policy pairs with Original Medicare and pays at any provider that accepts Medicare, on any island or the mainland, with no network and no referral. We set the two side by side with your doctors in front of us.

Original Medicare with a Medigap policy covers any Medicare provider anywhere with no travel rule. HMSA’s neighbor island plans include interisland travel help for approved referrals; Kaiser refers within Kaiser. Our Neighbor Islands guide goes through it island by island.

No. Your six-month Medigap open enrollment when you first have Part B is the guaranteed window, plus guaranteed-issue events such as a plan leaving your county. Outside those, Hawaii insurers can use medical underwriting.

Yes, on the same terms as someone turning 65. Hawaii requires every Medigap insurer to offer every plan, guaranteed issue and without health-based pricing, during the six months after your Part B begins, at the same rates as at 65. You get a fresh open enrollment at 65.

EUTF retiree medical plans require you to enroll in Medicare Part B when you become eligible and to send EUTF proof within 60 days, or the retiree plan is cancelled. EUTF then reimburses eligible retirees for the Part B premium (and IRMAA for those hired before July 1, 2023), but never a late penalty.

Usually neither. TFL pays secondary to Medicare and its pharmacy is creditable drug coverage. An MA-only Advantage plan can add dental or vision without duplicating the drug benefit. Our Pearl Harbor-Hickam, Schofield Barracks and Marine Corps Base Hawaii pages walk through it.

In most cases, yes. VA medical care is not creditable coverage for Part B, so delaying it triggers a permanent penalty and leaves you without coverage at a non-VA hospital. VA pharmacy is creditable for Part D.

Your Initial Enrollment Period is the seven months around your 65th birthday. The Annual Election Period runs October 15 to December 7; Medicare Advantage Open Enrollment runs January 1 to March 31. Moving to another island, losing a plan, qualifying for Med-QUEST, or a federally declared disaster opens a Special Enrollment Period.

Part B premium $202.90 a month, Part B deductible $283, Part A hospital deductible $1,736 per benefit period, Part D out-of-pocket cap $2,100. Higher earners pay IRMAA surcharges above $109,000 (single) or $218,000 (joint) of 2024 income. Our costs page has the full chart and calculators.

Possibly. Hawaii’s Medicare Savings Programs (QMB, SLMB, QI), run by the Med-QUEST Division, pay the Part B premium for people with limited income and resources, and QMB also covers Medicare’s deductibles and copays. Apply at mybenefits.hawaii.gov or 1-800-316-8005, or call Hawaii SHIP at 1-888-875-9229.

Hawaii’s Medicaid managed-care program, run by the Med-QUEST Division of the Department of Human Services. It covers adults 65 and over and people with disabilities alongside everyone else, coordinating the Medicaid side, including long-term services and supports, while Medicare pays first for medical care.

Hawaii SHIP, the Hawaii State Health Insurance Assistance Program, is run by the Executive Office on Aging in the Department of Health: 1-888-875-9229 (Oahu 808-586-7299; TTY 1-866-810-4379). You can also call 1-800-MEDICARE or use Medicare.gov. We are an independent agency, not a government program, and we say so on every page.

No. We represent a number of insurance organizations and products in Hawaii, not all of them, and we will always say so. For the complete list, use Medicare.gov, 1-800-MEDICARE or Hawaii SHIP. For help choosing among the plans we do offer, call (702) 706-6564.

Darin Weidauer holds Hawaii insurance license #18580338 (NPN 18580338). You can verify it through the Hawaii Insurance Division’s licence search on the state open-data portal or through the NIPR.

We work with people across Hawaii by phone and video, which is how most families on six islands prefer it. Our sister agency has walk-in offices in Mesa and Sun City, Arizona.