Jane Dotson
If you're looking to get medical insurance in Hawaii, there are a few things you should know. Firstly, Hawaii residents can expect to pay around $224.30 per person for a major medical individual health insurance plan, although prices will vary depending on factors like age, gender, and health status. The state has strict rules regarding short-term health plans, with a 2018 law prohibiting the sale of such plans to those eligible for an ACA-compliant plan in the previous year. Hawaii also has strong employee protections, with employers required to provide health insurance to employees working at least 20 hours per week. To find the right plan for you, consider using HealthCare.gov's Plan Finder to compare options in your area, and don't forget to check if you're eligible for financial assistance or Medicaid coverage. Legal Aid Hawaii and UHA are also great resources for finding affordable coverage and answering any questions you may have.
| Characteristics | Values |
|---|---|
| Health Insurance | A contract that requires your health insurer to pay some or all of your healthcare costs and medical expenses in exchange for a premium |
| Medicaid | Federal health insurance for people aged 65 and older or those on Social Security Disability Income |
| Medicare | For people aged 65 and older or those on Social Security Disability Income |
| MCO Health Plans | AlohaCare, HMSA, Kaiser Permanente, 'Ohana Health Plan, and UnitedHealthcare Community Plan |
| FFS Model | The state pays providers directly for each covered service received by a Medicaid beneficiary |
| UHA Health | Largest network of physicians, specialists, and healthcare providers in the state |
| UnitedHealthcare | Low-cost or no-cost health insurance plans for those with limited incomes |
| Golden Rule Insurance Company | Underwrites Health ProtectorGuard fixed indemnity insurance, critical illness insurance, vision insurance, and dental insurance |
| Teladoc Health | Provides unlimited online mental health care without insurance for $59.99 per month |
| Hawaii Medical Service Association (HMSA) | Blue Cross Blue Shield of Hawaii |
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What You'll Learn
Hawaii Medical Service Association (HMSA)
HMSA also offers Medicare plans and provides information and guidance on the different parts of Medicare (A, B, C, and D), eligibility, and making informed decisions. Additionally, HMSA representatives have appeared on the radio show "Hawaii Matters" to discuss Medicare during the open enrollment period.
Furthermore, HMSA is one of the five Managed Care Organization (MCO) health plans in Hawaii that provides medical and Long-Term Services and Support (LTSS) benefits. Under the MCO model, the state pays a capitation fee to the MCO health plan for each beneficiary enrolled, and the health plan, in turn, pays providers for eligible Medicaid services.
To learn more about HMSA's specific plans, benefits, and enrollment processes, you can visit their website at hmsa.com or contact their customer service and membership services departments using the phone numbers provided on their website.
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Medicaid
In Hawaii, Medicaid is a federal-state partnership that provides health coverage for very low-income children and adults. The program is administered by the Department of Human Services' Med-QUEST Division and is jointly financed by the state and the Federal Centers for Medicare and Medicaid Services.
To be eligible for Medicaid in Hawaii, there is no required residency period, but applicants must intend to reside in the state. An individual's or family's income must not exceed the applicable Medicaid income standard, which is based on the federal poverty limit and the size of your family. For example, if you have a family of four, your income cannot be higher than $3,208 per month to qualify for Medicaid. Additionally, assets (such as savings, checking accounts, stocks, bonds, and IRAs) are not counted when determining financial eligibility for children, pregnant women, parents or caretaker relatives, and adult groups. However, assets are considered when evaluating individuals for elderly, blind, or disabled programs.
If you are eligible and missing only a Social Security number on your application, you may still be covered by Medicaid. In an emergency, you may be eligible for coverage of that specific service.
There are three ways to apply for Medicaid in Hawaii:
- Download and complete a Medicaid application from the Department of Human Services (DHS) website and submit it by mail or fax to the Med-QUEST offices.
- Submit an online application at www.mybenefits.hawaii.gov.
- Contact the Hawaii Connector Call Center at 1-877-628-5076 (TTY/TDD users call 1-855-585-8604) to receive assistance over the phone. The application process is estimated to take 30-40 minutes to complete.
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Low-cost health insurance
Health insurance in Hawaii is available through employers, the Marketplace (HealthCare.gov), or Med-QUEST (Medicaid/CHIP). If you don't have health insurance through an employer, you can buy an individual health plan during the annual Open Enrollment period (between November 1 and January 15 each year) or see if you are eligible for a Special Enrollment Period through HealthCare.gov.
If you don't qualify for an employer's health plan or Medicare, you can still get cheap health insurance in Hawaii. The cost of health insurance depends on the type of plan you choose and your income. Catastrophic plans, for example, have the cheapest monthly rates but cover the lowest share of your medical bills. They are only a good option if you cannot afford anything else and do not qualify for Medicaid. In Hawaii, Catastrophic plans cost an average of $256 per month, with the HMSA Catastrophic Plan from Blue Cross Blue Shield costing $170 per month.
If you are looking for a balance between affordability and high quality, Silver plans are the most common choice, with moderate premiums and copays. Silver plans cost $523 per month, on average, in Hawaii. If you earn less than $24,000 per year as a single person or $50,000 per year as a family of four, you may qualify for Medicaid and receive free coverage. If you earn between $17,310 and $43,275 per year as a single person, or between $35,880 and $89,700 as a family of four, you can buy a Silver plan and use discounts to make your rate and medical care cheaper.
Additionally, if your income is no more than 250% of the federal poverty level, you may qualify for cost-sharing reductions (CSRs) to reduce your deductibles and out-of-pocket expenses, as long as you select a Silver plan through the Marketplace. The most cost-effective Silver plan in Hawaii is the KP HI Standard Silver 5900/40 offered by Kaiser Permanente, with a monthly cost of $457.
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Dental insurance
If you are looking for dental insurance in Hawaii, there are a few options to consider. Firstly, it is important to understand the different ways to obtain dental coverage. You can either get dental insurance through your employer or purchase it individually. If you don't have dental coverage through your job, you can explore alternative options.
One option for dental insurance in Hawaii is Hawaii Dental Service (HDS). HDS offers dental plans for individuals, families, small businesses, and large corporations. Their plans include access to a large network of dentists across the state and local customer service. HDS also provides 24/7 virtual dental care, which can be convenient for emergencies or quick oral health advice. Additionally, HDS has a blog with oral health resources and recipes to promote dental health.
Another option for dental insurance is through Hawaii Medical Service Association (HMSA) - Blue Cross Blue Shield of Hawaii. HMSA offers dental plans and provides convenient online access to plan information through their "My Account" feature. They also offer teledentistry, allowing members to connect with participating dentists for emergency dental assistance by phone.
It is worth noting that if you are a Medicaid beneficiary, there are specific Managed Care Organization (MCO) health plans available in Hawaii, such as AlohaCare, HMSA, Kaiser Permanente, 'Ohana Health Plan, and UnitedHealthcare Community Plan. These plans may include dental coverage, so it is worth exploring to see if dental care is included in their benefits package.
Additionally, if you are over the age of 65 or meet certain other criteria, you may be eligible for Medicare, which is federal health insurance administered by the Centers for Medicare and Medicaid Services. This option could provide dental coverage, depending on the specific plan and your individual circumstances.
Finally, UHA Health offers medical insurance plans in Hawaii, and they may also provide dental insurance options. They have a large network of physicians, specialists, and healthcare providers across the state, so it is worth inquiring about their dental coverage offerings.
Remember to carefully review the terms, conditions, and coverage details of any dental insurance plan before making a decision to ensure it meets your specific needs and budget.
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Vision insurance
If you don't have health insurance through an employer, you can buy an individual health plan during the annual Open Enrollment period or see if you are eligible for a Special Enrollment Period through HealthCare.gov. One such company offering health insurance plans in Hawaii is UHA Health, which offers business plans for all company sizes, dependent eligibility for coverage, and a large network of physicians, specialists, and healthcare providers across the state.
One option for vision insurance in Hawaii is VSP Individual Vision Insurance, offered through Hawaii Dental Service (HDS). VSP provides access to a network of over 34,000 doctors and offers exclusive discounts on everyday goods and services such as car rentals, online shopping, and UPS Express delivery services. HDS members can also save money on eye care and eyewear by taking advantage of VSP's extensive doctor network and personalized care.
Another option for vision insurance in Hawaii may be UHA Health, as they offer both medical and routine eye care and accept a number of insurance plans. They also have a low annual deductible and a $12 co-pay for most physician services.
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Frequently asked questions
Some options for medical insurance in Hawaii are UHA Health, Hawaii Medical Service Association (HMSA), and UnitedHealthcare.
In Hawaii, most Medicaid services are delivered through Managed Care Organization (MCO) health plans. There are five MCO health plans: AlohaCare, HMSA, Kaiser Permanente, 'Ohana Health Plan, and UnitedHealthcare Community Plan.
If you don't have health insurance through an employer, you can buy an individual health plan during the annual Open Enrollment period or see if you are eligible for a Special Enrollment Period through HealthCare.gov.
