Medicare serves more than 60 million people nationwide. Hawai‘i has 268,000 Medicare beneficiaries in 2019 — nearly 19 percent of the state’s total population. About 45 percent of Hawai‘i’s beneficiaries select Medicare Advantage plans. The remaining 55 percent are covered under Original Medicare.
Every year during Medicare’s Annual Election Period (AEP) — Oct. 15 to Dec. 7 — Medicare beneficiaries can add, drop or switch plans. Medicare health plans and prescription drug plans can change in cost, coverage and services every year, so look at your plan’s coverage for 2020 and compare it with other plans.
Hawai‘i residents can chose from between six and 19 Medicare Advantage plans in 2019, depend- ing on their county. Fourteen insurers offer Medigap plans in Hawai‘i.
When looking at other plans, check the provider’s network and formulary. Unless you are willing to find a new doctor, make sure your doctor is in that network. Every plan has a different formulary — a list of prescription drugs covered by a prescription drug plan. Make sure the drugs you are taking are in that plan’s formulary or else you will need an exception or another drug. Check the cost; prices vary between plans.
Other Medicare options are Medicare Supplement Insurance policies, also known as Medigap policies. Original Medicare pays for much, but not all of the cost of covered healthcare services and supplies. Medicare Supplement Insurance policies sold by private companies can help pay some of the remaining costs.
The 2020 “Medicare & You” book that comes in the mail in early October lists all the Medicare health plans and their costs. It also compares service areas, monthly premiums, out-of-pocket limits, primary care visits, specialist visits and so forth.
Medicare beneficiaries can also compare plans using the Medicare plan finder at www.medicare.gov. Compare up to three plans at a time by sorting by lowest estimated annual costs.
Medicare rates all health and prescription drug plans each year based on quality and performance. Use these ratings to compare plans.
If you have limited income and resources, you may qualify for help to pay for some healthcare and Medicare prescription drug costs. If you qualify for Extra Help and join a Medicare drug plan, you will get help paying your Medicare drug plan’s costs, have no coverage gap and have no late enrollment penalty.
Start researching now to see if you have all the benefits and services you deserve.