Hawaii Health Insurance: Everything You Need to Know

Living in Hawaii offers many perks, such as the beautiful beaches and warm weather. However, like anywhere else, staying healthy is a top priority. This is where health insurance comes in. In this article, we will discuss everything you need to know about Hawaii health insurance.

What is Hawaii Health Insurance?

Health insurance is a type of insurance that covers the cost of medical and surgical expenses. In Hawaii, there are several health insurance options available, including:

Health Insurance Provider
Website
HMSA
www.hmsa.com
Kaiser Permanente
www.kp.org
HMAA
www.hmaa.com

Each provider offers different plans and coverage options. It is important to research and compare each provider to find the best plan for your needs and budget.

Why is Health Insurance Important in Hawaii?

While Hawaii offers many natural remedies and treatments, such as traditional Hawaiian medicine and acupuncture, sometimes medical emergencies require advanced medical treatment. Without health insurance, these treatments can be extremely expensive and lead to financial strain.

Additionally, Hawaii has a high cost of living and healthcare is no exception. Health insurance can help alleviate some of these costs and provide peace of mind in case of unexpected medical expenses.

What are the Different Types of Health Insurance Plans in Hawaii?

In Hawaii, there are several types of health insurance plans available:

Preferred Provider Organization (PPO)

A PPO plan allows you to see any doctor or specialist without a referral. However, out-of-network providers may result in higher out-of-pocket costs.

Health Maintenance Organization (HMO)

An HMO plan requires a primary care physician and referrals to see specialists. However, premiums and out-of-pocket costs are typically lower than PPO plans.

Exclusive Provider Organization (EPO)

An EPO plan is similar to a PPO plan but with more limited options for providers. Out-of-network providers are not covered.

Point of Service (POS)

A POS plan is a combination of HMO and PPO plans. It requires a primary care physician and referrals to see specialists but also allows for out-of-network providers for a higher cost.

How Much Does Health Insurance Cost in Hawaii?

The cost of health insurance in Hawaii varies depending on the provider, plan, and coverage options. According to the Kaiser Family Foundation, the average monthly premium for a single individual in Hawaii in 2019 was $529.

It is important to note that premiums are not the only cost associated with health insurance. Out-of-pocket costs, such as deductibles, co-pays, and co-insurance, also play a role in the overall cost of healthcare.

Who is Eligible for Hawaii Health Insurance?

Most individuals and families are eligible for health insurance in Hawaii. This includes:

  • Legal residents of Hawaii
  • United States citizens
  • Individuals with a qualifying health event, such as losing employer-sponsored coverage or having a baby

It is important to note that some health insurance plans may have specific eligibility requirements, such as age or income.

How to Apply for Hawaii Health Insurance?

There are several ways to apply for health insurance in Hawaii:

  1. Visit the Hawaii Health Connector website at www.hawaiihealthconnector.com and create an account to apply for coverage
  2. Contact a health insurance provider directly to apply for coverage
  3. Work with a licensed insurance agent to find and apply for coverage

It is important to note that the open enrollment period for health insurance in Hawaii typically runs from November to January. Outside of this period, individuals may still be able to qualify for coverage through a qualifying health event.

FAQ about Hawaii Health Insurance

What is the Hawaii Prepaid Health Care Act?

The Hawaii Prepaid Health Care Act requires most employers to provide health insurance to their employees working 20 or more hours per week. The employer must pay at least 50% of the premium and the employee is responsible for the remaining 50%. This law has been in effect since 1974 and helps ensure that all Hawaii residents have access to health insurance coverage.

What is the State Premium Tax Credit (SPTC)?

The State Premium Tax Credit (SPTC) is a tax credit offered to individuals and families who purchase health insurance through the Hawaii Health Connector. This tax credit helps lower the overall cost of health insurance premiums for those who qualify.

What is the Medicaid program in Hawaii?

The Medicaid program in Hawaii, also known as Medicaid QUEST Integration, provides health insurance coverage to low-income individuals and families who meet certain eligibility requirements. This program is funded by both the federal and state government and covers a variety of healthcare services, such as doctor visits, hospital stays, and prescription drugs.

What is the Children’s Health Insurance Program (CHIP)?

The Children’s Health Insurance Program (CHIP) provides health insurance coverage to children from low-income families who do not qualify for Medicaid. In Hawaii, this program is known as Hawaii’s QUEST Integration for Kids and is provided by the Department of Human Services.

What is the Hawaii Employer-Union Health Benefits Trust Fund (EUTF)?

The Hawaii Employer-Union Health Benefits Trust Fund (EUTF) provides health insurance coverage to state and county employees and retirees, as well as their dependents. The EUTF offers several health insurance plans and coverage options, as well as a wellness program to help employees and retirees stay healthy.

Conclusion

Health insurance is an important aspect of staying healthy and financially secure in Hawaii. By researching and comparing health insurance providers and plans, individuals and families can find the best coverage options for their needs and budget. It is important to prioritize health insurance and make it a part of your overall healthcare plan.