Compare Your Medicare Options in Hawaii

Every Medicare beneficiary in Hawaii has a choice to make. Here's how the three paths compare, side by side.

Most Flexibility

Original Medicare + Medigap

Plan G or Plan N + standalone Part D

Lower Premiums

Medicare Advantage

All-in-one plan replaces Original Medicare

Highest Risk

Original Medicare Only

Parts A & B with no supplement

Feature	Original Medicare + Medigap	Medicare Advantage	Original Medicare Only
🏥 Doctor Choice	Any doctor or hospital that accepts Medicare, nationwide	Limited to plan's network. Out-of-network care may not be covered or costs significantly more	Any doctor or hospital that accepts Medicare, nationwide
✈️ Off-Island & Mainland Coverage	Full coverage anywhere in the U.S. See any Medicare provider on the mainland, neighbor islands, or while traveling	Limited or no coverage outside the plan's service area. Emergency-only in most cases when off-island	Covered anywhere Medicare is accepted, but you pay 20% coinsurance with no cap
📋 Referrals & Prior Authorization	None required. See any specialist directly	Often required. Plan may deny or delay services pending approval	None required
🛡️ Out-of-Pocket Maximum	Predictable costs. Plan G: you pay the annual Part B deductible, then Medigap covers the rest. No surprises	Required by CMS. Typically $3,000-$8,000/year depending on plan. You could owe up to this amount	No cap. Medicare has no out-of-pocket maximum. A serious illness could cost tens of thousands
💲 Monthly Premium	Part B premium + Medigap premium (varies by age, carrier, plan). Higher monthly cost, but lower risk	Part B premium + plan premium (often $0-$50/month). Lower monthly cost, but higher potential out-of-pocket	Part B premium only. Lowest monthly cost, but highest financial risk
💊 Prescription Drug Coverage	Separate standalone Part D plan required. You choose the plan that best covers your specific medications	Usually built in (MAPD). Convenient, but formulary is locked to that one plan	Must enroll in a standalone Part D plan or face a late enrollment penalty
📊 Cost Predictability	Highly predictable. You know your monthly cost and exposure is minimal beyond that	Variable. Copays, coinsurance, and deductibles vary by service. Costs depend on how much care you use	Unpredictable. You're responsible for 20% of all Part B services with no limit
🔄 Plan Stability	Standardized by federal law. Plan G is Plan G regardless of carrier. Benefits don't change year to year	Plans can change benefits, networks, formularies, and costs every year. Your plan this year may look different next year	Original Medicare benefits are set by CMS. Stable, but no supplemental protection

🏥 Doctor Choice

Medigap: Any doctor or hospital that accepts Medicare, nationwide

Medicare Advantage: Limited to plan's network. Out-of-network care may not be covered or costs significantly more

Original Only: Any doctor or hospital that accepts Medicare, nationwide

✈️ Off-Island & Mainland Coverage

Medigap: Full coverage anywhere in the U.S. See any Medicare provider on the mainland, neighbor islands, or while traveling

Medicare Advantage: Limited or no coverage outside the plan's service area. Emergency-only in most cases when off-island

Original Only: Covered anywhere Medicare is accepted, but you pay 20% coinsurance with no cap

📋 Referrals & Prior Authorization

Medigap: None required. See any specialist directly

Medicare Advantage: Often required. Plan may deny or delay services pending approval

Original Only: None required

🛡️ Out-of-Pocket Maximum

Medigap: Predictable costs. Plan G: you pay the annual Part B deductible, then Medigap covers the rest. No surprises

Medicare Advantage: Required by CMS. Typically $3,000-$8,000/year depending on plan. You could owe up to this amount

Original Only: No cap. Medicare has no out-of-pocket maximum. A serious illness could cost tens of thousands

💲 Monthly Premium

Medigap: Part B premium + Medigap premium (varies by age, carrier, plan). Higher monthly cost, but lower risk

Medicare Advantage: Part B premium + plan premium (often $0-$50/month). Lower monthly cost, but higher potential out-of-pocket

Original Only: Part B premium only. Lowest monthly cost, but highest financial risk

💊 Prescription Drug Coverage

Medigap: Separate standalone Part D plan required. You choose the plan that best covers your specific medications

Medicare Advantage: Usually built in (MAPD). Convenient, but formulary is locked to that one plan

Original Only: Must enroll in a standalone Part D plan or face a late enrollment penalty

📊 Cost Predictability

Medigap: Highly predictable. You know your monthly cost and exposure is minimal beyond that

Medicare Advantage: Variable. Copays, coinsurance, and deductibles vary by service. Costs depend on how much care you use

Original Only: Unpredictable. You're responsible for 20% of all Part B services with no limit

🔄 Plan Stability

Medigap: Standardized by federal law. Plan G is Plan G regardless of carrier. Benefits don't change year to year

Medicare Advantage: Plans can change benefits, networks, formularies, and costs every year. Your plan this year may look different next year

Original Only: Original Medicare benefits are set by CMS. Stable, but no supplemental protection

Medigap may be right for you if:

You want to see any doctor or specialist without restrictions
You travel to the mainland or neighbor islands regularly
You want predictable, low out-of-pocket costs
You prefer choosing your own Part D plan based on your medications
You value plan stability that doesn't change year to year

Talk to a Medigap Specialist

Medicare Advantage may work if:

You're comfortable staying within a provider network
You rarely travel off-island
You want the convenience of medical and drug coverage in one plan
You prefer a lower monthly premium and are willing to accept variable costs

Original Medicare alone is risky because:

There is no out-of-pocket maximum. One hospital stay could cost thousands
You're responsible for 20% of every Part B service, indefinitely
Most financial advisors and Medicare counselors recommend supplemental coverage

Medicare Advantage Plans Available in Hawaii

These are the major Medicare Advantage plans currently serving Hawaii. Plan details, networks, and costs change annually.

Plan	Carrier	Type	Network
HMSA Akamai Advantage	HMSA	PPO	HMSA network preferred, out-of-network at higher cost
Kaiser Senior Advantage	Kaiser Permanente	HMO	Kaiser facilities and providers only
Humana Honor (PPO)	Humana	PPO	Humana network (some out-of-network coverage)
UnitedHealthcare (AARP)	UnitedHealthcare	HMO/PPO	UHC network providers

No Matter Which Path You Choose, Part D Matters

Formularies change every year

The drugs covered by your Part D plan, and what you pay for them, can change every January 1st. A plan that was perfect last year might not cover your medications the same way this year.

The wrong plan costs real money

Choosing a Part D plan without analyzing your specific medications can mean paying hundreds or even thousands more per year than necessary.

Tier placement matters

The same drug can be Tier 2 (low cost) on one plan and Tier 4 (high cost) on another. A professional analysis compares your exact medications across every available plan.

The $2,100 cap changes the math

The Inflation Reduction Act capped Part D out-of-pocket costs. This is good news, but it also changes which plans make the most sense for different medication profiles.

Get a Professional Part D Analysis

Not Sure Which Path Is Right for You?

Book a free 15-minute discovery call. We'll look at your situation, your medications, and your priorities to help you figure out the best option.

Schedule a Free Discovery Call