Private Individual and Family Health Plans in Hawaii

Affordable Individual Health Insurance Hawaii

Self-employed or uninsured individuals of Hawaii, who are looking for individual or family health insurance plans will find a wide range of ACA-compliant health plans available in the state. Hawaii uninsured population are showing great interest in enrolling in health insurance plan and the exchange enrollment in the state has grown every year from the year 2014 with only a slight decrease in 2020 but grew again to a record high in the year 2021. In 2017 Hawaii switched to a completely federally run exchange after two years of using a technologically troubled state-based enrollment system, though the state oversees the health plans that are sold in the exchange. Now the uninsured residents of the state use to enroll in health plans and more than 20,000 Hawaii residents have enrolled for private individual market coverage.

Normally residents of the state are allowed to enroll in a health plan during the annual open enrollment period that runs from November 1 to December 15 or during a special enrollment period triggered by a qualifying event but due to the Covid pandemic, there is a COVID-related enrollment period in 2021 that continues through August 15. The residents of the state can make use of this window to enroll in coverage for the first time, switch from one plan to another, and can even switch from a non-ACA-compliant plan. Individuals can make these changes to take advantage of the premium subsidy enhancements made by the American Rescue Plan.

Vital Statistics Related to Hawaii Health Insurance

  • 1.4 million residents of the state have multiple options to purchase or replace health insurance for themselves and their families.
  • 55% of the state residents receive health coverage through their jobs, and the remaining population can obtain a qualified health plan through the exchange.
  • KP HI Silver 4000/45 from Kaiser Foundation is the cheapest Silver health plan in every county.
  • All the health plans available through the marketplace in the state adhere to the ACA requirements.
  • 4% of the Hawaii residents are uninsured that is less than the national average. This is good for policyholders as a lower rate of uninsured people keeps the health insurance premiums low in the state.
  • While applying for the ACA plan, individuals will automatically get to know about subsidies and other benefits if they are eligible.
  • Two health insurance carriers are offering health plan plans in the state in 2021.

Types of Health Plans available in Hawaii

The individual health insurance plans offered on and off the health insurance exchange of Hawaii are organized into different metal-tiers like Catastrophic, Expanded Bronze, Bronze, Silver, Gold, and Platinum. Health plans of higher metal tiers like Platinum and Gold provide better health coverage but these plans are expensive compared to the lower metal tier of plans. Plans in all the metal categories are required to cover the ten essential health benefits as per the requirement of the ACA. Bronze and Catastrophic metal-tier health plans are best for young and healthy people, as Catastrophic plans are offered to people under 30 or people who qualify for an exemption. Bronze and Catastrophic health plans are the least expensive plans providing less coverage and are recommended to individuals who are financially sound to cover a large part of their health care expenses in case of a medical emergency.

Silver metal-tier plan is a mid-range health plan that allows lower-income individuals to qualify for cost-sharing reduction subsidies that lower their out-of-pocket expenses. The Silver metal-tier plans cover about 70% of an individual’s healthcare costs while the insured are required to pay the remaining 30% of their healthcare costs. Gold and Platinum higher metal-tier plans are recommended to individuals who expect high medical costs, as these plans cover the greatest share of out-of-pocket costs like copays, deductibles, and coinsurance. Though these benefits come at the cost of a higher monthly premium. Individuals who expect to incur high medical expenses for chronic health conditions, or who have costly prescriptions should generally opt for Gold and Platinum health insurance plans.

Average Cost of Health Insurance by Metal-Tier in Hawaii

Type of Plan Monthly Premium for 21 Year Monthly Premium for 40 Year
Catastrophic $154 $197
Bronze $246 $314
Expanded Bronze $279 $356
Silver $377 $482
Gold $373 $476
Platinum $435 $555

Private Health Insurance Options in Hawaii

Hawaii residents who are uninsured due to any reason should enroll in a health plan because a part of their healthcare costs will be paid by their carrier, thereby easing their financial burden at the time of medical emergency. Though the residents of the Hawaii don’t need to have health insurance, but still, it is not a good idea to remain uninsured for a long time, as they will be responsible for 100% of their medical bills that can quickly turn into thousands of dollars. People looking for a private individual or family plans can purchase it either through or directly from a health insurance company available in the state. People looking for private individual and family health plans will find health plans offered by two health insurance carriers of Hawaii, Hawaii Medical Service Association and Kaiser Foundation Health Plan Inc. Though both these carriers offer health plans in each of the five counties of Hawaii but Kaiser does not offer any Catastrophic or Bronze health plan in the state.

Health Insurance Carriers in Hawaii

Two health insurance companies, Hawaii Medicare Service Association and Kaiser Permanente Health Plan of Hawaii are offering individual and family health plans through the Hawaii Marketplace in 2021. Though people have the option to purchase a plan directly from the carriers, but while direct purchasing they will not have access to any subsidies available on the marketplace.

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