Medicare guidance for Hawaii

Understanding EUTF Retiree Medicare Benefits in Hawaii

For retired Hawaii state and county workers, the Hawaii Employer-Union Health Benefits Trust Fund (EUTF) provides vital health coverage. When you turn 65, enrolling in Medicare Part B is required to remain eligible for coverage under your EUTF retiree medical and prescription drug plans.

One of the most valuable benefits available to eligible EUTF retirees is Medicare Part B premium reimbursement. For 2026, the standard Medicare Part B monthly premium is $202.90, confirmed by the Centers for Medicare & Medicaid Services (CMS). EUTF reimburses eligible retirees for this monthly cost, though the exact eligibility and reimbursement rules depend on your hire date and coverage type:

• Retirees hired before July 1, 2023: you and an eligible spouse or domestic partner/civil union partner can both be reimbursed for your Medicare Part B premiums, including any income-related monthly adjustment amount (IRMAA), excluding
• Retirees hired on or after July 1, 2023: you can be reimbursed for your own standard Medicare Part B premium, excluding IRMAA and Spouses and domestic partners/civil union partners are not eligible for their own reimbursement under this rule.

To receive proper reimbursement, EUTF requires you to submit a copy of your Medicare card showing Part B enrollment, a completed Direct Deposit Agreement Form, and a Social Security Administration (SSA) letter or CMS invoice showing your Part B premium amount. New retirees generally have 60 days from becoming Medicare-eligible to submit this proof, and retirees who pay a higher, income-adjusted premium must resubmit updated SSA documentation each year to keep their reimbursement current.

Jai Cusack, your NW Senior Insurance Solutions Licensed Medicare Enrollment Agent, helps local retirees walk through this exact documentation process so reimbursements start, and continue without a missed payment. Call Jai at 808-633-6245 to review your specific EUTF situation.

Inter-Island Healthcare Access and Network Strategies

Living on a neighbor island brings unique medical considerations that mainland insurance companies rarely understand. If you live on Maui, Kauai, or the Big Island, you know that specialized medical treatments or surgical consultations often require traveling to major medical centers in Honolulu on Oahu.

Choosing the wrong Medicare plan can create unexpected obstacles when you need care on another island. Many Medicare Advantage HMO and PPO plans rely on regional provider networks that require prior authorizations or specialist referrals before approving out-of-island care.

For seniors who travel frequently between islands or want complete freedom to see any doctor, pairing Original Medicare with a Medicare Supplement policy eliminates network boundaries entirely. With a Supplement plan, you can visit any doctor or hospital in Hawaii, or anywhere across the United States that accepts Medicare, without needing a referral. As your NW Senior Insurance Solutions Licensed Medicare Enrollment Specialist, Jai works with you to evaluate your doctors and travel habits to ensure your plan keeps up with your life.

Essential 2026 Medicare Baseline Highlights

Understanding the baseline costs of Medicare helps you plan your retirement budget with confidence. These figures are confirmed by CMS for 2026:

• Medicare Part B Premium: The standard monthly premium for Medicare Part B is $202.90.
• Annual Part B Deductible: The annual deductible for outpatient services is $283. Once met, Medicare generally pays 80 percent of approved medical
• Prescription Drug Protection: Federal rules cap out-of-pocket costs for covered Part D prescription drugs at $2,100 per Once you reach this cap, covered medications are paid at 100 percent for the remainder of the calendar year.
• Medicare Prescription Payment Plan: Hawaii beneficiaries can opt to spread high pharmacy copays into manageable monthly payments throughout the year rather than paying large amounts at the pharmacy

Have a question about how these numbers apply to your specific plan? Jai Cusack, your NW Senior Insurance Solutions Licensed Medicare Enrollment Specialist, can walk through your budget in one call — 808.633.6245

Local Island Medicare Coverage Across Hawaii

Whether you live in urban Honolulu or a rural island community, local plan options and hospital networks vary. Jai Cusack, your NW Senior Insurance Solutions Licensed Medicare Enrollment Agent, provides localized assistance across all Hawaiian Islands:

• Oahu: Guidance for Honolulu, Pearl City, Kaneohe, Kapolei, and the North
• Maui: Local plan reviews for Kahului, Wailuku, Lahaina, and
• Big Island: Dedicated support across Hilo, Kona, Waimea, and
• Kauai: Personalized insurance help for Lihue, Kapaa, Hanapepe, and

No matter which island you call home, reach Jai directly at 808.633.6245 or the NW Senior Insurance Solutions office at (360) 326-0850.

Frequently Asked Questions About Hawaii Medicare

You'll need to submit a copy of your Medicare card showing Part B enrollment, a completed Direct Deposit Agreement Form, and a copy of your Social Security Administration letter or CMS invoice stating your premium amount to the EUTF office. Exact eligibility depends on your hire date and whether a spouse or partner is also covered. Jai Cusack, your NW Senior Insurance Solutions Licensed Medicare Enrollment Agent, can help you confirm which rules apply to you and organize the paperwork correctly.

Yes, but your coverage depends on your plan type. Original Medicare paired with a Medigap policy allows you to see any specialist on Oahu without referrals. Medicare Advantage plans may require prior authorization for out-of-network or off-island visits.

Federal regulations cap out-of-pocket expenses for covered Part D prescription drugs at $2,100 per year, confirmed by CMS.

The standard Medicare Part B premium is $202.90 per month, and the annual deductible is $283 — both confirmed by CMS for 2026.

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