For many Hawai‘i residents, managing health care expenses can be overwhelming—especially for kupuna (seniors) and people with disabilities. If you qualify for both Medicare and Medicaid, you could unlock dual coverage, a powerful way to get more benefits while paying less out-of-pocket.
This guide explains how dual coverage works, why it matters, and how to find support right here in Hawai‘i.
Medicare is a federal health insurance program that covers:
People age 65 and older
Individuals receiving Social Security Disability Insurance (SSDI) for 24 months
People living with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS)
Medicare includes several parts:
Part A: Covers hospital stays and inpatient care
Part B: Covers doctor visits and outpatient services
Part D: Covers prescription drugs
Part C (Medicare Advantage): Combines Parts A and B, often includes Part D, and may offer extra benefits like dental, vision, or hearing services
Medicaid is a joint federal and state program that helps low-income individuals and families afford health care. In Hawai‘i, the Aged, Blind, and Disabled (ABD) Medicaid program is specifically designed for residents 65+ or living with disabilities.
To qualify, your income and assets must fall below certain limits. The good news: not everything you own counts toward these limits. For example, the following are typically excluded:
Your primary home (if you live in it)
One vehicle
Household items
Life insurance up to $1,500
Burial plot or fund up to $1,500
Yes! If you meet the requirements for both programs, you’re considered dual-eligible. Medicaid can work with either:
Original Medicare (Parts A, B, and D)
Medicare Advantage (Part C)
When you’re dual-eligible:
Medicare pays first, usually covering about 80% of your health care costs.
Medicaid pays second, helping with what Medicare doesn’t cover—such as copayments, deductibles, and coinsurance.
👉 If you have other private insurance, Medicaid is always the last payer.
Dual coverage can significantly improve both affordability and access to care. Here’s why it’s so valuable:
Medicaid helps cover premiums, deductibles, copays, and coinsurance—reducing your medical bills.
You’ll receive the combined benefits of both programs, including:
Hospital and doctor visits
Prescription drug coverage
Long-term care
Home health services
Medicaid often covers additional benefits not included in Medicare, such as:
Dental, vision, and hearing care
Transportation to doctor appointments
Personal care services at home
If you’re dual-eligible, you may qualify for D-SNPs (Dual-Eligible Special Needs Plans)—special Medicare Advantage plans designed to coordinate your Medicare and Medicaid benefits.
Tip: We’ll cover D-SNP plans in detail in an upcoming article.
You don’t have to figure this out alone. Hawai‘i residents can get free, unbiased guidance from local resources:
📞 State Health Insurance Assistance Program (SHIP): Call 877-839-2675 (say “Medicare” when prompted) to speak with a certified counselor.
👥 Senior Medicare Patrol (SMP): For questions about Medicare fraud, errors, or abuse, call 877-808-2468.
Dual coverage allows Hawai‘i’s seniors and residents with disabilities to get more benefits with fewer costs. By understanding how Medicare and Medicaid work together—and by connecting with trusted local organizations—you can make informed decisions that protect both your health and your finances.
