20 Medicare Part D Drug Plans in Hawaii for 2023

All Medicare has 20 Medicare Part D prescription drug plans available in Hawaii for you to compare.   See Plans

Medicare Part D Cost-Sharing Phases

Medicare Part D plans are optional coverage you can buy in Hawaii to add prescription drug coverage to your Original Medicare (Part A and Part B) or a Medicare Advantage plan that does not include Part D benefits. If you are new to Medicare, the Medicare Part D plan cost-sharing concepts may be confusing. Let's start with an overview.

Phase 1: The Plan's Deductible

Before a Part D plan will pay any of your prescription costs, you must first pay full cost of your prescriptions until the annual deductible is met. So, for instance, if you enroll in a Hawaii plan with a $400 deductible, you will pay $400 out-of-pocket to pick up your prescriptions before the plan kicks in to pay its share.

IMPORTANT: Here's a cost-savings tip. A few plans in Hawaii exclude Tier 1 drugs from the annual deductible. If you use mostly Tier 1 generic drugs, this can add up to a significant cost savings.

Phase 2: Initial Coverage Limit (ICL)

After the deductible phase, the Initial Coverage Limit (ICL) phase goes into effect. This year, the ICL amount is $4,660. You and your plan will share all costs during this phase until your prescription's total retail expenditure reaches $4,660. When this happens is based on the cost of your prescriptions and the formulary tier of each medication.

CRITICAL: When the total cost of your prescriptions exceeds $4,660, you will be in the Coverage Gap phase (aka, "donut hole").

Phase 3: The Coverage Gap

You'll pay 25% of the full retail price for brand-name medications while you're in the Coverage Gap phase (aka, "donut hole"). The manufacturer is required to give you a discount of 70%, and your Medicare Part D plan will pick up the remaining 5%. The 25% payment plus the 70% discount will be added to your True Out Of Pocket Costs (TrOOP). Once your spending reaches $7,400, you move into the catastrophic phase.

TIP: Some Hawaii plans offer additional gap coverage, so look for it on the plan information pages.

Generic drugs are different. Your Medicare Part D plan covers 75% and you pay 25%. But, only the 25% that you pay yourself is counted towards your TrOOP to get you out of the donut hole.

Phase 4: Catastrophic Coverage

Once you've spent $7,400 out-of-pocket in 2023 you are out of the coverage gap phase and will receive catastrophic coverage. This happens automatically and ensures that you only pay a small amount for all covered drugs for the remainder of the year. This is a feature that's built into every Medicare prescription drug plans sold in Hawaii.

Costs That Help You Get Catastrophic Coverage

1. Your plan's deductible;
2. What you paid during the initial coverage limit period;
3. Most of the full cost of brand-name drugs (and the manufacturer’s discount) purchased in the coverage gap;
4. The amount paid by others, including family members, most charities, and other persons on your behalf; and
5. The amount paid by State Pharmaceutical Assistance Programs (SPAPs), AIDS Drug Assistance Programs, and the Indian Health Service.

Medicare Part D is Bundled with Most Hawaii Medicare Advantage Plans

There's more than one way to get prescription drug coverage with your Medicare benefits. The first way is by enrolling in one of the Medicare prescription drug plans available in Hawaii. The second way is to get prescription coverage through one of the many Hawaii Medicare Advantage Plans or Hawaii Medicare Special Needs Plans that include Part D benefits. Most Medicare Advantage plans available in Hawaii include Part D as an additional benefit.

Medicare Part D and Medicare Supplement Insurance Work Together

Just like Medicare Advantage, Original Medicare does not cover all of your hospitalization and medical bills. In fact, it only covers about 80 percent of your major medical costs, and there isn't an annual cap like there is with Medicare Advantage. That's why All Medicare maintains an up-to-date directory of Hawaii Medigap plans, also called Medicare supplements, with a free quoting tool that lets you get rates from all carriers in your area. Best of all, Medicare Part D plans are fully compatible with Hawaii Medigap plans.

Medicare Part D for Dual Eligible Hawaii Residents

If you are dual-eligible and qualify for both Medicare and Medicaid in Hawaii, you will automatically receive a pre-selected Medicare Part D, as well as Extra Help from Social Security. For dual-eligible people, the Extra Help program covers most prescription costs. Call your local Medicaid office for assistance with your dual-eligible benefits.

The 2023 Medicare Part D Plan information for Hawaii was last updated by the All Medicare team on January 9, 2023