Affordable Health Insurance in Hawaii

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Best Hawaii Health Insurance Plans

Hawaii is composed entirely of islands and is renowned for its scenic beauty, amazing culture and adventure.

Earlier Hawaii Health Connector was the health insurance marketplace where residents of this state used enroll in a plan, compare plan prices, change plan and apply for cost assistance. Post 2016, residents are using HealthCare.Gov, which is the official Hawaii state marketplace to enroll and compare plans and to apply for health insurance under Obamacare. During the open enrollment period for 2019 coverage, 20,193 people enrolled in private plans through Hawaii exchange, which was 2% increase over the previous year. Hawaii has been one of the U.S. states that has seen upward trend in enrollment in the recent years and that use the federally-run exchange. In the year 2019, there are two insurers in Hawaii exchange that offer coverage for individual and family.

Top Health Insurance plan in Hawaii

  • HMSA

    HMSA Catastrophic Plan

    premium $160.53/mo

    Deductible $8150/yr

    Coinsurance0%
    Insurance Type PPO
    HSA Eligible No
  • HMSA

    HMSA Bronze HMO

    premium $297.54/mo

    Deductible $6000/yr

    Coinsurance2.2%
    Insurance Type HMO
    HSA Eligible No
  • HMSA

    HMSA Bronze PPO

    premium $299.64/mo

    Deductible $8150/yr

    Coinsurance0%
    Insurance Type PPO
    HSA Eligible No
  • Kaiser Permanente

    KP HI Bronze 6500/60

    premium $301.75/mo

    Deductible $7500/yr

    Coinsurance3.8%
    Insurance Type HMO
    HSA Eligible No
  • HMSA

    HMSA Bronze PPO HSA

    premium $303.19/mo

    Deductible $6500/yr

    Coinsurance0%
    Insurance Type PPO
    HSA Eligible Yes

Highlights and Updates

  • Hawaii has the federally run exchange at HealthCare.gov, which residents can use to enroll in plans and apply for coverage.
  • Open enrollment for 2020 coverage in Hawaii will end on December 15, however enrollment will be open for Hawaiians having qualifying events.
  • In 2019, two insurance carriers are offering coverage through the Hawaii exchange.
  • By the end of 2018 around 19,800 Hawaiians enrolled in coverage through Hawaii exchange.
  • The market for short-term plans was effectively eliminated from the Hawaii state.
  • In Hawaii the weighted average premium increase in 2019 was 5.3%.
  • Only 19% Hawaiians are enrolled in Medicare plans.
  • The ACA’s Medicaid expansion was implemented in Hawaii in 2014.

Individual and Family Health Insurance

All individual and family health insurance plans in Hawaii must comply with the ACA and should include coverage of the ten essential health benefits regardless of the area where they are sold. When Hawaiians residents enroll in ACA compliant individual and family health plans offered through the health insurance exchange, they have the option to apply for income-based financial assistance that allows them reduce their monthly health insurance premiums and out-of-pocket expenses for healthcare. Individual and family health insurance premium amounts are determined by the insurer’s age at the time of purchasing the plan and the number of members that will be covered. Hawaii’s exchange has two insurers that offer individual market coverage for 2019. Major Individual and Family

Individual Health Insurance Plans Available in Hawaii

Individuals seeking individual and family health plans in Hawaii can choose from any of the given plans:

Indemnity Plans

Indemnity plans typically have a deductible, which is the amount which insured has to pay before the insurance carrier starts paying benefits. It is only after their covered expenses exceed the deductible amount then the benefits are paid as a percentage of actual expenses. Indemnity plans offer the more flexibility to insured in terms of choosing the healthcare provider.

Preferred Provider Organization Plans

In these plans insurance companies make a contract with a network of doctors and hospitals who agree to render healthcare services at a discounted rate. All the member of the PPO plan will be able to access healthcare services from the network doctors and hospitals and also from a doctor or hospital from out-of-the-network, but they will have to pay a higher deductible or co-payment.

Health Maintenance Organization Plans

In these plans insured have to choose a primary care physician from a list of network providers, who is responsible for managing the insured healthcare. If one requires care from any physician other than primary care physician then one has to get a referral from the primary care physician. In order to receive their claim through the HMO insured need to receive care from a network provider.

Point of Service Plans

POS plans are the mix of the PPO and HMO plans. POS plans are flexible than HMO plans but require insured to select a primary care physician. Insured can also avail health care from an out-of-network provider but need to pay more of the cost. However, if the primary care physician refer to an out-of-network doctor then the cost will be paid by the plan carrier.

Short-term Health Insurance Plans in Hawaii

Due to the legislation enactment in 2018 in Hawaii the sale of short-term plans has been prohibited and insurers have stopped offering these plans in the state. As per this law anyone eligible to buy an ACA compliant health plan in the state’s exchange during the previous year is not allowed to purchase a short-term plan. The short-term plans can be offered for a duration of not more than 90 days and even renewals are prohibited. Thereby, this law has effectively eliminated the short-term plans market in Hawaii.

Dental Plans in Hawaii

In Hawaii dental coverage is included in some of the individual and family health insurance plans but still one can get a stand-alone dental plan by paying a separate premium. In the Hawaii health insurance marketplace, one can get dental coverage either as a part of a health plan or as a stand-alone dental plan. There are two categories of dental plan in Hawaii, High and Low. The high coverage dental plan has higher premiums but lower co payments and deductibles. This means that one needs to pay higher premium amount every month but pay less for the dental care services availed. The low coverage dental plan has lower premiums but co payments and deductibles are higher, which means that one will pay less premium every month but need to pay more when availing dental care services.

Vision Insurance

A vision insurance policy is not the same as health insurance. Regular health insurance plans protect you against financial losses due to unexpected eye injuries or disease. Vision insurance, on the other hand, is a wellness benefit designed to provide routine eye care, prescription eye wear and other vision-related services at a reduced cost.

FAQ on Hawaii Health Insurance

The Hawaii state does not have any specific law according to which its residents need to have health insurance coverage. Though, the state has always promoted health insurance programs and encourage its residents to have proper coverage for sudden medical emergencies. To promote health insurance within its residents, the state has come out with the Hawaii Prepaid Health Care Act. This law requires most employers to offer their employees’ group health insurance plans. The state also supports the federal Affordable Care Act that requires all citizens of the U.S. to have health insurance.

The open enrollment period for enrolling in 2021 health plans will run from November 1, 2020, and will end on December 15, 2020. However, only residents with qualifying events are eligible to enroll or make changes to their health plan coverage for 2020.

In Hawaii there are six different metal-tiers of plans, choosing among which can be difficult for the people. Thus, to help people out find below the cheapest health plan in each metal tier offered in Hawaii:

  • The cheapest Catastrophic health plan in Hawaii is the HMSA Catastrophic plan having a monthly premium of $196 for a 40-year old.
  • The cheapest Bronze health plan is the HMSA Bronze PPO plan having a monthly premium of $365 for a 40-year old.
  • The cheapest expanded Bronze plan is the HMSA Bronze HMO plan having a monthly premium of $363 for a 40-year old.
  • The cheapest Silver plan is the KP HI Silver 4000/45 plan having a monthly premium of $460 for a 40-year old.
  • The cheapest Gold plan is the HMSA Gold PPO 1000 plan having a monthly premium of $455 for a 40-year old.
  • The cheapest Platinum health plan is HMSA Platinum PPO plan having a monthly premium of $539 for a 40-year old.
  • After researching all the health insurance plans available in the state it was found that the KP HI Silver 4000/45 offered by Kaiser Foundation is the cheapest health plan in almost every county of Hawaii. However, the metal tier and age are the two vital factors based on which the actual cost of the health insurance plan is determined. So the best health plan may vary from one person to another. On average the Hawaiian pays around $300 monthly for health insurance premiums.

    Residents of Hawaii have a variety of health insurance options, as it was the first state where employers were required to offer health insurance to their employees who work more than 20 hours per week under the Hawaii Prepaid Health Care Act. However, the law does not require to provide coverage for employees’ dependents, but they may do so voluntarily. Besides, employer-sponsored plans, residents also have several other health insurance options such as ACA-compliant plans, short-term health plans, accident & critical illness insurance, fixed indemnity plans, along with government-funded plans like Medicare and Medicaid.  

    As a resident of the Hawaii state, you can enroll in health insurance plans using the HealthCare.gov enrollment platform because Hawaii has fully-federally-run exchange. Though, the state still oversees the plans that are sold in the exchange.  

    Hawaii in the year 2020 has only two health insurance carriers operating in the state, Hawaii Medical Service Association offering some of the best health insurance plans in the state with plenty of options to choose from, and the other carrier present in the state is Kaiser Permanente, which is the largest and highly-rated health insurance provider in Hawaii.

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