Of the more than 240,000 Hawaii residents with Medicare Part A and B, 131,073 people have a Medicare Advantage plan. Participant rates for Medicare Advantage represent 54.25% of all beneficiaries.

Below, we’ll discuss the available Medicare Advantage plans in Hawaii.

Hawaii Medicare Advantage Plans Work

Private carriers offer Medicare Advantage or Part C plans in Hawaii and cover your expenses instead of Medicare. These all-in-one plans cover Part A and Part B charges. Some carriers include prescription drug coverage and other benefits, but not all.

Knowing what each plan entails is vital to selecting the right one. Between nine and 18 plans are available in Hawaii, depending on the island where you reside.

Medicare Advantage Plans Offers in Hawaii

Unlike supplemental Medicare plans, Hawaii Medicare Advantage plans aren’t standardized. Instead, benefits and plans vary depending on your location. Each ZIP code’s plans offer unique benefits.

Below, we’ll examine Hawaii’s plans with a zero-dollar premium, a zero-dollar drug deductible, a couple with a five-star rating, and some offering a Part B giveback.

Medicare Advantage Plans with a Zero Dollar Premium in Hawaii

Medicare Advantage plans with a zero-dollar premium may be suitable for Hawaiians who don’t need frequent healthcare. You’ll pay higher out-of-pocket costs before 100% coverage begins.

Wellcare (HMO) offers a three-star plan with no premium and up to $5,700 maximum out-of-pocket. People choose it for its low monthly cost and additional benefits such as prescription drug coverage and transportation perks.

Humana (Local PPO) has no premium and up to $7,550 MOOP. However, its four-star rating indicates excellent performance.

HMSA Akamai (Local PPO) features a zero-dollar premium and $6,700 max out-of-pocket. You get many extra benefits for fitness and travel. Beneficiaries also indicate satisfaction with this four-star plan.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
Wellcare $0 $5,700 HMO 3
Humana $0 $7,550 LOCAL PPO 4
United Healthcare $0 $6,700 LOCAL PPO 4
HMSA Akamai $0 $6,700 LOCAL PPO 4

Medicare Advantage Plans with a Zero Dollar Drug Deductible in Hawaii

Zero-dollar drug deductibles allow full coverage with no waiting period or payment requirement. However, premiums are higher for these Medicare Advantage plans. The following plans have no deductible.

Kaiser Permanente (HMO) features a plan costing Hawaiians $59 monthly and up to $7,550 maximum out-of-pocket. This plan boasts a perfect five-star rating.

HMSA Akamai (Local PPO) is another top choice for $127 monthly. Patients can pay up to $3,450 MOOP. Many beneficiaries find the plan’s four-star rating and additional benefits worth the cost.

Another Kaiser Permanente (HMO) plan offers even more benefits and requires no specialty referrals. Beneficiaries pay a $163 premium and up to $5,100 MOOP. This plan also has a five-star rating.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
Kaiser Permanente $59.00 $7,550 HMO 5
HMSA Akamai $127.00 $3,450 LOCAL PPO 4
Kaiser Permanente $163.00 $5,100 HMO 5

Medicare Advantage Plans with a 5-Star Rating in Hawaii

You can switch to the better option if a five-star Medicare Advantage plan is available in your ZIP code. You may be eligible for a Special Enrollment Period.

Kaiser Permanente (HMO) offers multiple plans with five-star ratings. The first option will cost you $59 each month. You’ll pay up to $7,550 maximum out-of-pocket.

The second option from Kaiser Permanente (HMO) costs $163. You could pay up to $5,100 MOOP.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
Kaiser Permanente $59.00 $7,550 HMO 5
Kaiser Permanente $163.00 $5,100 HMO 5

Medicare Advantage Plans with a Part B Reduction in Hawaii

Some Medicare Advantage plans cover some or all of Part B’s premium. As these plans vary by ZIP code, a Part B reduction may not be available in your area. The following plans include a Part B giveback.

A Wellcare plan features no star rating but does have a $40 Part B reduction. You’ll pay no monthly premium and up to $7,550 maximum out-of-pocket.

Humana offers a plan with a zero-dollar monthly premium and a $30 Part B giveback. Patients may pay up to $7,550 in out-of-pocket costs. The plan boasts a four-star rating.

United Healthcare also offers a plan with no premium and a $7,550 maximum out-of-pocket. Zero-dollar copays and additional benefits make it a solid choice for many beneficiaries.

PLAN PREMIUM MOOP PART B REDUCTION STAR RATINGS
Wellcare $0 $7,550 $40.00 N/A
Humana $0 $7,550 $30.00 4
United Healthcare $0 $6,700 $30.00 4

Ancillary/DVH

Some Hawaii Medicare Advantage plans include additional benefits that Original Medicare doesn’t offer. You can find plans providing dental, vision, and hearing coverage, among other helpful perks. You may also receive travel and wellness benefits depending on your chosen carrier.

FAQs

Do Medicare Advantage plans replace Original Medicare in Hawaii?

Medicare Advantage plans combine Medicare Part A, Part B, and often Part D coverage in Hawaii. Many offer additional benefits. You’ll still have Original Medicare after enrolling in a Medicare Advantage plan, but your Medicare Advantage carrier covers the costs.

What are the four types of Medicare Advantage plans in Hawaii?

The four types of Medicare Advantage plans in Hawaii include Health Maintenance Organization plans, Preferred Provider Organization plans, Special Needs Plans, and Private Fee-for-Service plans.

Depending on your plan’s type, you may have limitations on where you can seek healthcare. Some plan types also include specific benefits.

When can I first enroll in a Medicare Advantage plan in Hawaii?

You can first enroll in a Hawaii Medicare Advantage plan during the seven-month Initial Enrollment Period occurring three months before you turn 65. The other option is to register during a Special Enrollment Period.

Is Medicare Advantage based on income in Hawaii?

In Hawaii, how much you pay for Part B premiums depends on your income and increase with yearly inflation. Beneficiaries with a Modified Adjusted Gross Income (MAGI) past a certain amount will pay higher rates.

Can my Medicare Advantage plan deny my coverage in Hawaii?

Your carrier can deny your coverage in Hawaii. However, Original Medicare enrollment and prior treatment approvals prevent this. If a plan denies you coverage, you can file an appeal.

How to Get Help Enrolling in a Hawaii Medicare Advantage Plan

To get help enrolling in a Hawaii Medicare Advantage plan, contact the professionals at Medigap.com. We’re the leading experts on Medicare Advantage and supplemental options. We work with all carriers and compare your area’s top plans to help you find the best one.

The services are completely free. Contact Medigap.com by phone or fill out our online rate form to get Hawaii Medicare Advantage plan quotes today.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.