Hawaiians looking for additional Medicare coverage may consider enrolling in a Medicare Advantage Insurance plan. Learn more about plan benefits, cost, and eligibility to decide if Medicare Advantage is right for you.
If you’re enrolled in Original Medicare ( Medicare Part A and Part B), you may find yourself looking for more coverage. To increase your coverage and better prepare for the future, you can enroll in a Medicare Advantage plan, also called Medicare Part C or MA plans.
MA plans offer a number of health insurance benefits, though it can be difficult to pick the right one since you likely have many options in your county.
Ready to take a closer look at the Hawaii Medicare Advantage plans available to you? Compare plan benefits using the Insurify Medicare comparison tool.
Reviewing the top Medicare Advantage plan options in Hawaii for 2021 will give you a better idea of how the plans you’re interested in compare to the competition. Below, the top eight plans are compared, taking into consideration premiums, Part D plan deductibles, out-of-pocket maximums, co-payments, and the plans’ Medicare star rating.
1. Kaiser Permanente Senior Advantage Basic
2. Kaiser Permanente Senior Advantage Enhanced
3. Kaiser Permanente Senior Advantage Hawaii Island
4. Kaiser Permanente Senior Advantage Maui
5. AARP Medicare Advantage Choice
6. AARP Medicare Advantage Choice Plan 1
7. AARP Medicare Advantage Choice Plan 2
8. HumanaChoice
You can learn more about Medicare Advantage’s overall benefits at Medicare.gov. Check with each plan provider for more information on specific benefits and a formulary outlining covered drugs and costs.
Monthly premium: $78
Annual deductible: $0
Out-of-pocket maximum: $7,550
Counties where plan is available: Honolulu
This five-star plan offers low Tier 1 drug costs of $0–$9. It features a $0 co-pay for preventive care and relatively low co-pays for doctor visits: $20 for primary care and $45 for specialist care. Hearing and vision exams have a $20 co-pay, and preventive dental services are covered with a $0 co-pay. The only comprehensive dental benefit is for non-routine services at 30 percent coinsurance.
Monthly premium: $176
Annual deductible: $0
Out-of-pocket maximum: $5,100
Counties where plan is available: Honolulu
Like the basic Kaiser plan, this five-star plan also features $0–$9 Tier 1 drug costs. Preventive care has a $0 co-pay, and doctor visits have a low $10 co-pay for primary care and $35 for specialist care. Hearing and vision exams have a $10 co-pay, most preventive dental care has a $0 co-pay, and the only comprehensive dental benefit (non-routine services) requires 30 percent coinsurance.
Monthly premium: $196
Annual deductible: $445
Out-of-pocket maximum: $5,100
Counties where plan is available: Hawaii
For this five-star plan, Tier 1 drugs have a higher co-pay than the first two Kaiser plans at $6–$18. Preventive care has a $0 co-pay, and doctor visit co-pays are low, at just $15 for a primary visit and $35 for specialist care. A hearing or vision exam requires a $15 co-pay, most of the covered preventive dental benefits have a $0 co-pay, and non-routine comprehensive dental service requires 30 percent coinsurance.
Monthly premium: $196
Annual deductible: $445
Out-of-pocket maximum: $5,100
Counties where plan is available: Maui
The last five-star plan on the list, this Kaiser plan features $0–$9 Tier 1 drug co-pays. Preventive care has a $0 co-pay, and doctor visit co-pays are low, at $10 for primary care and $35 for specialist care. This plan covers the same hearing, dental, and vision benefits as the other Kaiser plans, with $10 vision and hearing exam co-pays, $0 co-pays for most preventive dental services, and 30 percent coinsurance for non-routine comprehensive dental services.
Monthly premium: $28
Annual deductible: $250
Out-of-pocket maximum: $5,700
Counties where plan is available: Kauai and Maui
The first four-star plan on the list, this option features $0–$9 Tier 1 drug co-pays. This plan also has $0 co-pays for in-network preventive care and primary care, along with a $40 co-pay for specialist care. A hearing exam, all preventive dental benefits, and all covered vision benefits have a $0 in-network co-pay, but the plan doesn’t offer comprehensive dental coverage.
Monthly premium: $0
Annual deductible: $300
Out-of-pocket maximum: $6,700
Counties where plan is available: Honolulu
Like many other plans on the list, this four-star plan has a $0–$9 co-pay for Tier 1 drugs. Preventive care has a $0 in-network co-pay, along with $10 for primary care and $50 for specialist care. A hearing exam and all covered in-network vision benefits have a $0 co-pay. Unfortunately, the plan doesn’t cover preventive or comprehensive dental services.
Monthly premium: $55
Annual deductible: $150
Out-of-pocket maximum: $5,100
Counties where plan is available: Honolulu
This four-star plan has $0–$9 Tier 1 drug co-pays. Preventive care and primary care both have a $0 in-network co-pay, and specialist care visits have a low $30 co-pay. The plan also has $0 co-pays for hearing exams, all preventive dental services, and the covered vision benefits, though the plan does not cover comprehensive dental services.
Monthly premium: $55
Annual deductible: $150
Out-of-pocket maximum: $5,350
Counties where plan is available: Maui and Kauai
This four-star plan’s Tier 1 drug plan costs are the highest at $3–$30. In-network preventive care and primary care have a $0 co-pay, and in-network specialist visits have a relatively low $30 co-pay. The plan does not cover any vision benefits, and it has the highest cost for a hearing exam, with a $35 in-network co-pay. The covered preventive dental benefits have a $0 in-network co-pay, and the few covered comprehensive dental benefits require 50 percent coinsurance for in-network care.
Although the federal Medicare program provides MA plan guidelines, private insurers provide the plans to Medicare beneficiaries. This causes plan costs to vary from state to state and possibly even from county to county.
Understanding the average plan costs will give you an idea of whether a plan option offers enough value. See the average costs below for Hawaii MA plan members ’ monthly premiums, out-of-pocket maximums, and drug plan deductibles.
MA health plans are provided by private insurance companies, and they include additional benefits that you won’t find with Original Medicare coverage. These plans can be a great way to get Medicare benefits such as Medicare Part D prescription drug plan coverage, hearing, vision, dental, and skilled nursing facility care.
When comparing plans online, be sure to filter them by your ZIP code to see the correct options.
Like most states, Hawaii offers a number of MA plan types to those looking for coverage. The top four plan types are health maintenance organization ( HMO ) plans, preferred provider organization ( PPO ) plans, private fee-for-service ( PFFS ) plans, and special needs plans ( SNPs ).
If you choose an HMO plan, prescription drug coverage is typically included, and you’ll usually have to see an in-network healthcare provider. You’ll also usually need to select a primary care doctor and get a referral to see a specialist.
With PPO plans, you’ll usually receive prescription drug coverage, and you’ll pay less if you see an in-network provider, but you can go out of network. Unlike HMO plans, PPO plans typically don’t require you to select a primary care physician or get a referral for specialists.
PFFS plans may or may not provide prescription drug coverage. They will either allow you to see any provider or only providers who agree to treat your plan’s members (with lower costs for in-network providers). Usually, you don’t need to select a primary care doctor or get a referral for specialists.
SNPs will only allow individuals who have certain diseases and characteristics to enroll. These plans must provide prescription drug coverage, and they require you to see in-network providers. They also require you to have a primary care doctor or care coordinator in addition to requiring specialist referrals.
Ready to see which Hawaii MA plans are available in your area? Time to try the Insurify Medicare comparison tool! Get started comparing your options.
This depends on your budget, current health needs, and future preparedness. However, if you’re looking to bundle coverage such as hearing, vision, and dental and currently require additional services like nursing home care, then it may be worth considering an MA plan.
You must live in a county where the plan is available, and you’re required to already have Medicare Parts A and B to enroll, unless you have end-stage renal disease (beginning January 2021).
The Medicare Advantage Open Enrollment Period is January 1–March 31. You can visit Medicare.gov for more information on enrollment and eligibility and to contact a representative (with support for TTY users).
Deciding on the right healthcare plan or mix can be difficult. If you’re eligible for Medicaid services, keep in mind that some benefits of Medicare and Medicaid overlap. You may also be eligible for dual enrollment.
You aren’t eligible to use benefits from Medicare Supplement plans (Medigap plans) and MA plans at the same time. If you’re torn between the two, then you’ll have to closely compare the benefits and choose the best option for you.
If you need help comparing your options, you can contact the Hawaii State Health Insurance Assistance Program (SHIP), provided by the Hawaii State Department of Health, for assistance.
Whether you know exactly which type of plan you want or you’d like to consider all your options, doing some research now can save you money later. However, examining all your options can be time-consuming when considering that plan eligibility in Hawaii varies by county and that private insurers determine plan costs.
Luckily, closely comparing premiums, deductibles, and other costs as well as cross-checking plan benefits doesn’t have to be difficult. In fact, finding the right plan option in your county can be quick and easy with Insurify.
Ready to save time and money in your search for the right Medicare Advantage plan? Start your plan comparison today with the Insurify Medicare comparison tool!
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