Medicare Part A in Hawaii — hospital insurance
Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most Hawaii residents qualify for premium-free Part A.
What Part A covers
- Inpatient hospital care — semi-private room, meals, general nursing, drugs administered, and other hospital services and supplies
- Skilled nursing facility (SNF) care — up to 100 days following a qualifying inpatient stay (3 nights minimum)
- Home health care — limited skilled services if you're homebound and need part-time care
- Hospice care — for terminally ill beneficiaries with a prognosis of 6 months or less
- Inpatient psychiatric care — up to 190 lifetime days in a psychiatric hospital
2026 Part A costs
| Service | 2026 cost |
|---|---|
| Hospital deductible (per benefit period) | $1,736 |
| Hospital days 1–60 | $0 after deductible |
| Hospital days 61–90 | $434/day |
| Hospital days 91+ (lifetime reserve) | $868/day (60 days lifetime) |
| SNF days 1–20 | $0 |
| SNF days 21–100 | $217/day |
| SNF days 101+ | All costs |
Premium-free Part A: If you or your spouse paid Medicare taxes for at least 40 quarters (10 years), Part A is free. Otherwise, premiums in 2026 are $311–$565/month depending on work history.
Understanding "benefit periods"
A Part A benefit period begins the day you're admitted as an inpatient and ends when you've been out of the hospital (and not received SNF care) for 60 consecutive days. You can have multiple benefit periods in one year, each with its own $1,736 deductible.
Hawaii-specific considerations
If you're a neighbor-island resident hospitalized on Oahu (e.g., transferred for specialty care), the same Part A rules apply. Inter-island air-ambulance transport may be covered under Part B as a medically necessary ambulance service when ground transport is not feasible — common for inter-island medical transfers.
For Native Hawaiian beneficiaries, services received through Indian Health Service-eligible providers (including Native Hawaiian Health Care Systems facilities) may have additional coordination considerations. Learn more.
Frequently asked questions
Most Hawaii residents qualify for premium-free Part A based on Medicare taxes paid by them or their spouse. If you don't qualify, the 2026 premium is $311 or $565/month based on work history.
No. Part A covers up to 100 days of skilled nursing facility care after a qualifying hospital stay — this is short-term rehabilitation, not long-term custodial care. For long-term care, look into Med-QUEST, long-term care insurance, or veterans' benefits.
Inter-island medical transport is common in Hawaii. Part A covers your inpatient stays at both facilities. Medically necessary air-ambulance transport between islands typically falls under Part B as ambulance services.