Medicare in Hawaii offers free SHIP counseling through the Executive Office on Aging, and its Medicare Savings Program income limits are higher than the 48-state standard.
In This Guide
- Key Takeaways
- Original Medicare: Parts A and B
- Medicare Advantage in Hawaii (Part C)
- Medicare Part D: Prescription Drugs
- Medigap in Hawaii
- Help Paying for Medicare in Hawaii
- Medicare Enrollment Periods
- Free Medicare Help: Hawaii SHIP
- Frequently Asked Questions
About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs change every year. For the most current figures, contact Medicare at 1-800-633-4227 or Hawaii SHIP at 808-586-7299 (Oahu) or 1-888-875-9229 (neighbor islands).
Original Medicare: Parts A and B
Original Medicare is run directly by the federal government. The mechanics and costs are the same in Hawaii as in every other state.
Part A (Hospital Insurance)
Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.
| Cost | Amount |
|---|---|
| Monthly premium | $0 for most people (40+ quarters of work history) |
| Hospital deductible | $1,736 per benefit period |
| Hospital coinsurance, days 61-90 | $434 per day |
| Lifetime reserve days | $868 per day |
| SNF coinsurance, days 21-100 | $217 per day |
The hospital deductible applies per benefit period, not per calendar year. A benefit period starts the day you're admitted and ends 60 days after discharge; get readmitted after that gap and the deductible resets.
Part B (Medical Insurance)
Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. Routine dental, vision, and hearing are not covered.
- Monthly premium: $202.90 (higher if your 2024 income exceeded $109,000 single or $218,000 married, under the income-related adjustment)
- Annual deductible: $283
- After the deductible: 20% of the Medicare-approved amount for most outpatient services
Delay Part B without other creditable coverage and you'll owe a permanent 10% premium penalty for every 12-month period you could have had it.
Medicare Advantage in Hawaii (Part C)
Medicare Advantage plans are offered by private insurers as an alternative to Original Medicare. They cover everything Parts A and B do, except hospice, which Original Medicare continues to cover. Most plans bundle Part D drug coverage along with extras like dental, vision, and hearing.
Plan availability in Hawaii is uneven by island. Honolulu and Oahu generally have the widest selection. Maui, Hawaii Island (Big Island), Kauai, and Molokai typically see fewer plan options and narrower networks. Before enrolling, use the Medicare Plan Finder to check what's available in your specific county.
How These Plans Work
- You continue paying your Part B premium ($202.90 a month) regardless of any plan premium. The average Medicare Advantage plan premium is about $14 a month in 2026, and many plans charge $0 extra.
- Most plans run on HMO or PPO networks. Confirm your doctors are in-network before you enroll.
- Plans typically require prior authorization for certain services; Original Medicare generally does not.
- Every plan caps your annual in-network out-of-pocket spending at no more than $9,250 in 2026 (many plans set it lower). Original Medicare has no such cap.
Hawaii SHIP counselors can help you compare available MA plans for free on any island.
Medicare Part D: Prescription Drugs
Part D covers outpatient prescription drugs. You can add a standalone Part D plan to Original Medicare or get drug coverage built into a Medicare Advantage plan.
The Inflation Reduction Act restructured Part D. The coverage gap (donut hole) no longer exists starting in 2025. The redesigned benefit has three phases:
- Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).
- Initial coverage: you pay copays or coinsurance while your plan and drug manufacturers cover the rest.
- Catastrophic: once your out-of-pocket costs reach $2,100, you pay $0 for covered drugs for the rest of the year.
The $2,100 cap is the figure that matters most in 2026 Part D. The average standalone Part D premium is about $46.50 a month, though plan premiums vary. Every plan must offer the Medicare Prescription Payment Plan, which lets you spread out-of-pocket drug costs across monthly payments during the year instead of paying in full at the pharmacy.
People who qualify for Extra Help pay much less.
Not sure which Part D plan fits your prescriptions? Chat with Brevy's care navigator at brevy.com.
Medigap in Hawaii
Medigap policies fill the gaps in Original Medicare: the deductibles, coinsurance, and copays. They work only with Original Medicare, not with Medicare Advantage.
Hawaii offers the federally standardized plans, lettered A through N. Plans C and F are closed to anyone who first became Medicare-eligible on or after January 1, 2020. Plan G is the most common choice for people newly eligible: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving only the $283 Part B deductible out of pocket.
Your best window is the federal Medigap Open Enrollment Period: six months that begin the month you are 65 and enrolled in Part B. During that window an insurer must sell you any plan at the standard rate, with no medical underwriting. Outside it, Hawaii insurers may use medical underwriting, meaning they can review your health history, charge more, or decline you.
Hawaii does not have a birthday rule or other state-added Medigap guaranteed-issue protections beyond the federal standard. Once your six-month open-enrollment window closes, the ability to switch is limited unless a qualifying event (such as losing other coverage) triggers a Special Enrollment Period.
Medigap or Medicare Advantage?
You cannot hold both at the same time. Medigap means staying on Original Medicare with the freedom to see any provider who accepts Medicare nationwide, typically at a higher monthly premium. Medicare Advantage means trading some of that flexibility for a plan network and often a lower upfront cost. For a side-by-side comparison, see our guide to Original Medicare vs. Medicare Advantage.
Help Paying for Medicare in Hawaii
If you have limited income and resources, two programs can cut your Medicare costs significantly.
Medicare Savings Programs
Hawaii administers the Medicare Savings Programs through Med-QUEST, the state's Medicaid division. Hawaii's income limits are higher than the standard 48-state figures because Hawaii's Federal Poverty Level is set higher than the contiguous-state FPL.
| Program | Individual | Couple | What it pays |
|---|---|---|---|
| QMB | Up to about $1,563 | Up to about $2,106 | Part A and B premiums, deductibles, coinsurance |
| SLMB | Higher than standard | Higher than standard | Part B premium |
| QI | Higher than standard | Higher than standard | Part B premium |
The figures above are approximate, based on Hawaii's FPL differential. QMB is the most generous tier: it pays your Part B premium plus your deductibles and coinsurance, and federal law bars providers from billing a QMB enrollee for that cost-sharing. The 2026 resource limit for all three programs is $9,950 for one person and $14,910 for a couple (the standard federal limit, which does not vary by state). Confirm current income limits with Med-QUEST, since the FPL figures update each April. Enrolling in any MSP automatically qualifies you for Extra Help with Part D.
To apply, contact Med-QUEST directly or ask a Hawaii SHIP counselor to help you through the process.
Extra Help for Part D
Extra Help (also called the Low-Income Subsidy) pays Part D premiums, deductibles, and copays for people with limited income and resources. Since 2024 the partial-subsidy tier is gone; everyone who qualifies now gets the full subsidy.
- Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple
- Resource limits: $16,590 for an individual, $33,100 for a couple
- Enrollment in QMB, SLMB, or QI qualifies you for Extra Help automatically
Apply through Social Security at ssa.gov or call 1-800-772-1213.
Medicare Enrollment Periods
These deadlines are federal and the same in Hawaii as everywhere else. Miss one and you may face a coverage gap or a permanent penalty.
| Period | Dates | What you can do |
|---|---|---|
| Initial Enrollment | 7 months around your 65th birthday | Sign up for Parts A, B, and D; pick MA or Medigap |
| Annual Open Enrollment | Oct 15 - Dec 7 | Switch MA plans, move between MA and Original Medicare, change Part D |
| MA Open Enrollment | Jan 1 - Mar 31 | Switch MA plans or drop MA for Original Medicare (if already in MA) |
| General Enrollment | Jan 1 - Mar 31 | Sign up for Part B if you missed your initial window |
| Medigap Open Enrollment | 6 months from age 65 + Part B | Buy any Medigap plan at the standard rate, no health screening |
Changes during Annual Open Enrollment take effect January 1. If you're already receiving Social Security before 65, you're enrolled in Parts A and B automatically. If not, sign up through Social Security. The General Enrollment Period runs January through March; under the BENES Act, coverage now starts the first of the month after you sign up. If you delayed Part B because you had employer coverage, you get an 8-month Special Enrollment Period after that coverage ends (COBRA and retiree coverage do not count).
Free Medicare Help: Hawaii SHIP
The Hawaii SHIP (State Health Insurance Assistance Program) is run by the Executive Office on Aging, part of the Hawaii Department of Health. Counselors are trained volunteers who provide free, unbiased one-on-one Medicare guidance. They do not sell insurance.
Hawaii SHIP counselors can help you:
- Understand what Original Medicare, Medicare Advantage, and Medigap cover
- Compare Part D drug plans side by side
- Apply for the Medicare Savings Programs and Extra Help
- Sort out billing questions, denials, and appeals
- Understand your enrollment windows and avoid late penalties
Phone numbers:
- Oahu: 808-586-7299
- Neighbor islands (toll-free): 1-888-875-9229
Visit health.hawaii.gov/eoa/home/hawaiiship/ for local counselor locations on each island.
Frequently Asked Questions
Most people pay $0 for Part A. The standard Part B premium is $202.90 a month with a $283 annual deductible. Part D premiums vary by plan (the average is about $46.50 a month), and many Medicare Advantage plans charge no additional premium. Your total out-of-pocket depends on the plan you choose and the care you use.
No. Hawaii does not have a birthday rule or other state-added Medigap guaranteed-issue protections. The only guaranteed window is the standard federal six-month Medigap Open Enrollment Period that begins when you turn 65 and enroll in Part B. After that window closes, insurers may apply medical underwriting.
Hawaii uses higher limits than the 48-state standard because Hawaii's FPL is higher. For 2026, the QMB limit is approximately $1,563 a month for one person and $2,106 for a couple. The resource limit is $9,950 per individual and $14,910 per couple for all three programs. Confirm current figures with Med-QUEST.
Honolulu and Oahu generally have the widest plan selection. Maui, the Big Island, Kauai, and Molokai typically have fewer options. Use the Medicare Plan Finder at medicare.gov to check what's available in your specific county before enrolling.
The Hawaii SHIP, through the Executive Office on Aging. Counselors are free, unbiased, and available on all islands. Call 808-586-7299 on Oahu or 1-888-875-9229 from the neighbor islands.
Learn More
- Medicare: The National Guide
- Original Medicare vs. Medicare Advantage
- How Medigap Works
- Medicare Part D Drug Coverage
- Medicare Enrollment Periods
Find personalized help with Medicare in Hawaii at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.