Medicare in Hawaii

Aloha state has the lowest standardized per-capita Medicare spending

Resources for Hawaii beneficiaries

State Health Insurance Assistance Programs (SHIPs) provide free, in-depth, one-on-one insurance counseling and assistance to Medicare beneficiaries, their families, friends, and caregivers. SHIPs operate in all 50 states.

In Hawaii you can reach SHIP at 1-888-875-9229 or online here.

Snapshot of Medicare in Hawaii

Total Medicare enrollment in Hawaii

In 2015 there were 244,364 Medicare beneficiaries in Hawaii, which is 17 percent of its total population. That’s the same percentage of the population nationwide enrolled in Medicare.

The states with the highest percentage of beneficiaries are West Virginia and Maine with about 23 percent each. Those with the lowest percentage are Alaska (11 percent) and Utah (12 percent). In raw numbers, Alaska has the least recipients at 83,863 and California (which has about an eighth of the country’s population within its borders) has the most at 5.6 million (14 percent of its population). This doesn’t count the US Territories, which mostly have low total enrollment in Medicare (Northern Mariana Islands had just 2,075 Medicare enrollees in 2015).

Read about Medicare’s open enrollment period and other important enrollment deadlines.

Breakdown of the aged vs. disabled

Individuals who qualify by virtue of their age alone make up 90 percent of Hawaii Medicare enrollees. The balance — 10 percent — are on Medicare as the result of a disability, which is the lowest percentage in the country.

Kentucky has the highest percent of Medicare recipients listed as disabled (25 percent), followed by Alabama, Mississippi, West Virginia and Arkansas.

After Hawaii New Jersey, and North and South Dakota have the lowest percentage of disabled (as opposed to elderly) Medicare beneficiaries, at 13 percent each.

Medicare spending per recipient

In 2014, Medicare’s per-enrollee spending in Hawaii was $5,967, which was the lowest in the country. The fact that Hawaii has the lowest percentage of Medicare enrollees who qualify based on a disability (as opposed to age) plays a role in the low per-capita spending.

That data is based on a standardized spending report from CMS, which eliminates spending differences that stem from strictly geographic differences in costs (eg, higher labor costs or overhead expenses in higher cost-of-living areas like Alaska and Hawaii). The report only considers spending in Original Medicare, as opposed to Medicare Advantage.

Louisiana had the highest per-capita Medicare spending, at $10,754.

Medicare spending overall

Total Medicare spending in Hawaii was $1.53 billion in 2009 (latest available data). With the largest and smallest numbers of recipients, itʼs no surprise that California accounts for $50.6 billion of overall Medicare spending while Alaska spends only $553 million. Total Medicare spending for all states and the District of Columbia was $471 billion in 2009.

Medicare Advantage in Hawaii

Medicare Advantage offers health benefits for Medicare beneficiaries through private plans instead of through Original — or traditional — Medicare (the federal government’s fee-for-service program). These plans are one option for consumers who desire additional benefits beyond what Original Medicare offers, but are not considered a wise option by some consumers who are concerned that government spends more per enrollee on the private plans than it does on Original Medicare. Medicare Advantage plans are available with no premium other than the cost of Part B, but they also have provider networks that are more limited than Original Medicare, and total out-of-pocket costs can be considerably higher than enrollees would pay if they had Original Medicare plus a Part D plan plus Medigap.

There were 106,670 people in Hawaii enrolled in Medicare Advantage plans in 2015. That’s 46 percent of the state’s total Medicare population – the second highest percentage in the country, trailing only Minnesota. Nationwide, 31 percent of Medicare beneficiaries are enrolled in a Medicare Advantage program.

Minnesota is the only state where more than half (53 percent) of Medicare eligibles enrolled in a Medicare Advantage plan. Alaska is the only state to have zero percent enrolled in Medicare Advantage, although five states have Medicare Advantage enrollment (as a percentage of the state’s Medicare enrollees) in the single digits: Wyoming with 3 percent, New Hampshire and Vermont with 7 percent, and Maryland and Delaware with 8 percent.

Stand-alone Medicare Prescription Drug plans

Hawaii had 61,546 Medicare beneficiaries – about a quarter of the state’s total Medicare population – enrolled in stand-alone prescription drug plans in 2015. Hawaii has 21 plans with premiums ranging from about $18 to $80 per month.

Medicare prescription drug coverage — called Medicare Part D — was the result of legislation passed in 2003 and signed into law by President George W. Bush in 2006. It is a bit of a controversial program because it was an unfunded liability — meaning that the vast majority of costs fell on taxpayers — and the law also barred Medicare from negotiating lower drug prices with drug makers.

But by the end of its first decade, Medicare Part D was providing coverage for almost three quarters of all eligible Medicare beneficiaries nationwide, including those who have Part D coverage as part of their Medicare Advantage plan.

For those under 65 in Hawaii

Are you under 65 years of age? We have information on Hawaii health insurance and the Hawaii health insurance marketplace at our health insurance site.