Hawaii Medicare beneficiaries have access to a range of coverage options, state-specific protections, and free counseling services. This comprehensive Hawaii Medicare guide covers your SHIP office contacts, Medigap plan availability, birthday rule protections, Medicare Savings Program eligibility, Medicare Advantage options, and how to compare plans. Whether you are turning 65, helping a parent navigate Medicare, or re-evaluating your coverage, understanding Hawaii Medicare rules is essential for making informed decisions.
All information in this guide has been verified against official state sources, CMS data, and NAIC reports as of April 2026.
In This Hawaii Medicare Guide:
Hawaii SHIP — Free Medicare Counseling
Every state has a State Health Insurance Assistance Program (SHIP) that provides free, unbiased Medicare counseling. Hawaii’s SHIP program can help you understand your coverage options, compare plans, resolve billing issues, and navigate enrollment periods at no cost.
| SHIP Program | Hawaii SHIP (Hawaii State Health Insurance Assistance Program) |
| Phone | 1-888-875-9229 |
| Website | https://www.hawaiiship.org/ |
SHIP counselors are trained volunteers and staff who are not affiliated with any insurance company. They do not sell plans. Contact your Hawaii SHIP office before making any major Medicare decisions.
Hawaii Medigap (Medicare Supplement) Plans
Medigap plans in Hawaii help cover out-of-pocket costs not paid by Original Medicare, including the Part A deductible, Part B coinsurance, and skilled nursing facility copays. Medigap plans are standardized by federal law, meaning Plan G from one carrier covers the same benefits as Plan G from another carrier. The difference is premium cost.
Plans available in Hawaii: A, B, C, D, F, G, K, L, M, N
Most popular plan: Plan G is the most popular Medigap plan in Hawaii. Plan G covers all gaps in Original Medicare except the annual Part B deductible ($240 in 2026). Plan N is the most popular lower-premium alternative, with small copays for some doctor visits and ER visits.
Pricing method: Hawaii uses community-rated Medigap pricing. This is the most favorable method for consumers because premiums are the same regardless of age. Your premium will not increase simply because you get older.
The average monthly Plan G premium for a 65-year-old in Hawaii is approximately $199. Plan N averages approximately $142 per month. Actual premiums vary by carrier, age, gender, tobacco use, and zip code. Always compare quotes from at least three carriers.
Hawaii Medigap Switching Rights
Hawaii does not have a Medigap birthday rule. Your primary opportunity to buy or switch Medigap plans without medical underwriting is during your initial Medigap Open Enrollment Period, which lasts 6 months starting when you first enroll in Medicare Part B at age 65 or older.
After your initial OEP closes, you may face medical underwriting if you apply for a new Medigap policy. However, federal law provides guaranteed issue rights in specific situations, such as losing employer coverage or leaving a Medicare Advantage plan during your first year.
Hawaii guaranteed issue protections: Hawaii extends Medigap guaranteed issue rights to Medicare beneficiaries under age 65 who qualify due to disability — the same 6-month open enrollment window that applies at age 65. Hawaii also prohibits insurers from charging higher Medigap premiums to under-65 disabled beneficiaries; rates must match age-65 rates. These protections exceed federal minimums, which only guarantee GI rights at age 65 plus Part B enrollment.
Hawaii Medicare Advantage (Part C)
Approximately 310594 people in Hawaii are enrolled in Medicare. About 55 percent in Honolulu County; statewide rate UNVERIFIED of Hawaii Medicare beneficiaries choose Medicare Advantage plans, with the remainder on Original Medicare with or without Medigap supplement coverage.
Medicare Advantage plans in Hawaii are offered by private insurers as an alternative to Original Medicare. Most MA plans include prescription drug coverage (Part D) and often add dental, vision, and hearing benefits. However, MA plans use provider networks, which can limit your choice of doctors and hospitals.
Key Medicare Advantage considerations in Hawaii:
- Networks matter: HMO plans require you to use in-network providers except in emergencies. PPO plans allow out-of-network care at higher cost.
- $0 premium plans: Many Hawaii MA plans have $0 monthly premiums (you still pay your Part B premium).
- Maximum Out-of-Pocket (MOOP): MA plans cap your annual spending, unlike Original Medicare which has no cap.
- Star ratings: CMS rates MA plans 1-5 stars. Higher-rated plans often have lower costs and better coverage.
Top Medicare Advantage carriers in Hawaii by enrollment:
- HMSA
- Kaiser Permanente
- UnitedHealthcare
- Humana
- Devoted Health
Hawaii Medicare Financial Help Programs
Hawaii offers Medicare Savings Programs (MSPs) that help low-income Medicare beneficiaries pay for premiums, deductibles, and copays. The four programs are:
- QMB (Qualified Medicare Beneficiary): Pays Part A and Part B premiums, deductibles, coinsurance, and copays.
- SLMB (Specified Low-Income Medicare Beneficiary): Pays Part B premiums only.
- QI (Qualifying Individual): Pays Part B premiums (limited funding, first-come first-served).
- QDWI (Qualified Disabled Working Individual): Pays Part A premiums for disabled workers.
Hawaii MSP eligibility: Hawaii uses higher Federal Poverty Level guidelines than the 48 contiguous states. Approximate 2026 monthly limits — QMB: 1553 individual and 2098 couple; SLMB: 1860 individual and 2514 couple; QI: 2093 individual and 2827 couple. Asset limits: 9950 individual and 14910 couple. Verify exact figures with Hawaii Med-QUEST Division.
Apply through your local SHIP office or your state Medicaid agency for free help determining eligibility.
Top Medicare Insurance Companies in Hawaii
Top Medigap carriers in Hawaii:
- State Farm
- USAA
- Transamerica
- Globe Life
- Mutual of Omaha
When comparing carriers, focus on premium cost (for identical standardized Medigap plans, benefits are the same — only price differs), financial strength ratings from AM Best (A or higher), customer satisfaction ratings, and claims processing speed.
Hawaii Medicare Enrollment Periods
Understanding Medicare enrollment deadlines prevents costly late enrollment penalties:
- Initial Enrollment Period (IEP): 7-month window around your 65th birthday (3 months before, birthday month, 3 months after). Enroll in Parts A and B during this period.
- Medigap Open Enrollment: 6 months starting when you are both enrolled in Medicare Part B and age 65 or older. Hawaii extends this same 6-month guaranteed-issue window to disabled beneficiaries under 65 when they first enroll in Part B.. During this period, insurance companies cannot deny you Medigap coverage or charge higher premiums based on health conditions.
- Annual Enrollment Period (AEP): October 15 through December 7 each year. Switch between Original Medicare and Medicare Advantage, change MA plans, or add/change Part D drug plans.
- Medicare Advantage Open Enrollment Period (OEP): January 1 through March 31. Switch MA plans or return to Original Medicare (and add a Medigap plan, subject to underwriting).
- Special Enrollment Periods (SEP): Available when you lose employer coverage, move, or qualify for other life events.
Additional Hawaii Medicare protections: Hawaii requires Medigap insurers to offer guaranteed issue to disabled Medicare beneficiaries under age 65 during their 6-month Part B open enrollment window. Insurers cannot charge higher premiums based on disability status for under-65 enrollees — rates must be the same as age-65 rates. These protections significantly exceed federal minimum requirements.
Compare Hawaii Medicare Plans
Ready to compare Medicare options in Hawaii? Use the official Medicare Plan Finder or contact your local SHIP counselor for free, unbiased help.
Official Sources & Resources
- Medicare.gov: medicare.gov
- Hawaii Department of Commerce and Consumer Affairs (DCCA), Insurance Division: https://cca.hawaii.gov/ins/
- Hawaii SHIP (Hawaii State Health Insurance Assistance Program): https://www.hawaiiship.org/
- CMS.gov: cms.gov
- NAIC: naic.org
This Hawaii Medicare guide was last verified against official sources in April 2026. If you notice outdated information, please contact us.