How do I apply for Medicare in Hawaii?

If you are drawing from your Social Security benefits before you turn 65 then you will automatically be enrolled into Medicare by Social Security when you turn 65. You should receive your Medicare insurance card three months before the month you turn 65. 

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If you are not already drawing from your Social Security benefits then you will need to manually apply for Medicare. You can apply online, over the phone, or in person at your local Social Security office. When applying online, you'll need to create a "my Social Security" account. Click here to view a checklist of information you'll need to have on hand when creating your account.

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Note: If you are currently receiving disability payments from Social Security then you will automatically be enrolled into Medicare in your 25th month of receiving Social Security Disability Insurance (SSDI). If you have been diagnosed with End Stage Renal disease, then you will qualify for Medicare after your 4th month of being on dialysis. 

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When do I need to first enroll in Medicare?

Your initial window to enroll is the seven-month period that begins three months before the month of your 65th birthday and ends three months after it. It is recommended to generally sign up on time to avoid penalties that could be quite costly over the course of retirement. 

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What if I'm still working when I turn 65?

Your requirement to enroll in Medicare will depend on your company's size. If your company has less than 20 employees, you will need to still enroll in Medicare Parts A & B during your 7-month window because that will be your primary insurance. If your company has 20 employees or more, then you don't have to enroll when you first turn 65. This is because your company's health care insurance will be your primary insurance. 

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My company has more than 20 employees, should I still enroll?

Yes. It is often advantageous to enroll in Medicare Part A on time even if you already have health insurance through your employer. It won't cost you anything to enroll in Part A, and this way your Medicare insurance will serve as secondary insurance and potentially pick up the tab for anything your primary insurance doesn't cover. 

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When do I enroll in Medicare if I retire after turning 65?

If your employer has 20 or more employees and you're still working and covered under your employer's health care plan when you turn 65, you can delay your enrollment in Medicare (specifically in Medicare Part B, which allows you to avoid the Part B monthly premium while you're covered under your employer's plan).

 

In this case, you'll actually get an eight-month special enrollment period to sign up for Medicare if and when you leave your job and/or your employer stops offering coverage. It will start the month after you separate from your employer (or the month after your group health coverage ends, whichever one happens sooner). This 8-month special enrollment period also applies to those who have signed up for Part A originally but delayed enrolling in Part B. Note, this only applies to those covered under a current employer. This does not apply to those on a COBRA or retiree plan. 

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What if I missed my sign-up period?

Or what if I want to change my Medicare insurance coverage?

You can make any changes to your Medicare insurance coverage once a year during the Medicare annual enrollment period: October 15 - December 7.

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What's the difference between Medicare and Medicaid? 

Medicare is a Federal Health insurance program for people 65 years of age or older, or for people under the age of 65 with certain disabilities like End Stage Renal Disease (ESRD) and Amyotrophic Lateral Sclerosis (ALS), commonly known as Lou Gehrig's disease.

• Medicare Part A (hospital coverage) is free if you (or your spouse) has worked and paid Medicare taxes (part of your FICA tax burden, taxed at 1.45% of your payroll) in the US for at least 10 years.

• Medicare Bart B (medical coverage) has a premium of $164.90/month for 2023 (this premium may change each year). 

• Prescription drug coverage under Medicare is offered through private health insurance companies. You can get drug coverage through either a Medicare Advantage plan that includes prescription drug coverage (Medicare Part C), or a standalone prescription drug plan (Medicare Part D).

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Medicaid is a State Health insurance program that provides health coverage and/or nursing home coverage to certain categories of individuals, including children, pregnant women, parents of eligible children, low income adults, former foster care children, aged, blind and disabled individuals. 

 

The Medicaid program in Hawaii is called Med-QUEST. To qualify for Med-QUEST you have to apply online or submit a paper application.

• If you are under the age of 65 and not receiving Medicare benefits, the Med-QUEST office will look at your income level to determine if you qualify for Med-QUEST coverage.

• Once you are eligible for Medicare, Med-QUEST looks at income and assets to see if you qualify. 

 

Click here for a full list of QUEST Eligibility requirements. 

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Individuals on Med-QUEST do not have to pay any co-payments or coinsurance for covered medical benefits and prescription medications. Med-QUEST contracts with HMSA, United Healthcare, Ohana Health Plan, Kaiser and Aloha Care to administer the Med-QUEST program in Hawaii.