Frequently Asked Questions

Medicare:

  • Administered by the Center for Medicare and Medicaid Services (CMS)
  • Health care coverage for those age 65+ years
  • Available to those under age 65 with a disability
  • Available to those diagnosed with End Stage Renal Disease (ESRD)
  • Enrollment is done through the Social Security Administration

Hawaii SHIP can help with Medicare enrollment or visit medicare.gov or ssa.gov.

Medicaid:

  • Administered by the State of Hawaii Medicaid Office
  • Health care coverage for those who meet low income criteria
  • Enrollment is done through the local Medicaid Office

Hawaii SHIP can help Medicare beneficiaries with application assistance.

Complete an application to find out if you are eligible. The Medicaid Office will determine if you are eligible and notify you.

Hawaii SHIP can help Medicare beneficiaries with application assistance.

Complete an online application:

Apply over the phone with a Medicaid representative:

  • 1-800-316-8005 (Customer Service)
  • 1-808-524-3370 (Oahu Customer Service Branch)

Submit application by fax:

  • 587-3543 (Oahu Branch)
  • 692-7379 (Kapolei Branch)

Submit application by mail:

  • Oahu Branch: 801 Dillingham, Honolulu HI 96817
  • Kapolei Branch: 601 Kamokila Boulevard Kapolei HI 96707
  • Social Security number
  • Date of birth
  • Last year’s federal income tax form (1040 or 1040EZ) or your households current gross monthly income

If you are a non-citizen, please be prepared to provide the following:

  • Certification of citizenship
  • Naturalization certificate
  • Refugee travel documents
  • Arrival/ departure record

This refers to beneficiaries who qualify for both Medicare and Medicaid.

Changes are allowed but check with Medicaid on how often changes are allowed.

Aloha Care:
866-973-6395
www.AlohaCare.org

HMSA:
800-693-4672
www.hmsa.com/advantage

Kaiser Permanente:
877-408-3494
www.kp.org/medicare

Ohana Health Plan:
800-265-8171
www.wellcare.com/medicare

United Health Plan:
888-834-3721
www.UHCMedicareSolutions.com

(As listed in the 2018 Medicare and You Booklet, Pg. 133A&B)

  • You have a question about your eligibility
  • You start working
  • You change from one job to another
  • Your income or asset levels change
  • You move and change addresses
  • You change your name
  • The number of people living in your household changes
  • You have a question about a benefit or service
  • You need to find a doctor
  • You need a new member card
  • You change your name or address
  • You have a question about your medical statement

When you complete a Medicaid application, you will be notified if you qualify for an MSP. This low-income subsidy program can help pay for Medicare plan premiums, copays, and deductibles. If you require assistance, call Hawaii SHIP.

When you complete an application for Extra Help with the Social Security Administration, you may qualify for this low-income subsidy program that can help pay for prescription drug plan premiums, copays, and deductibles. If you require more information or application assistance, contact Hawaii SHIP.

It depends. The primary and secondary payor will be determined by the Coordination of Benefits rules. Make sure that your doctor has a copy of all of your current health plan member cards. If you think there was an error on your billing statement, contact your health plan to help resolve your issue. If you suspect fraudulent activity, contact Hawaii SHIP and ask to be referred to the Hawaii Senior Medicare Patrol program.

This document is very helpful to understand the terminology: Definitions

   

This project was supported, in part by grant number 90SAPG0005, from the U.S. Administration for Community Living, Department of Health and Human Services. Grantees undertaking projects under government sponsorships are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.

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