Jeffrey Wade
If you're looking for free medical insurance in Hawaii, you may be eligible for Medicaid (Med-QUEST) or Medicare. To qualify for Medicaid, you must be a resident of Hawaii and meet certain income and asset requirements. You can apply for Medicaid through the ACA Marketplace at HealthCare.gov or by calling (800) 318-2596. If you're over 65, retiring soon, or meet other criteria, you may be eligible for Medicare, for which you can get free counselling and information from Hawaii SHIP. Hawaii also has the nation's strongest employee protections in terms of employer-sponsored health coverage, so getting a job with benefits could be a good option. Additionally, if you're a college student, you may be able to get health insurance through your school.
| Characteristics | Values |
|---|---|
| Eligibility | Virtually all residents of Hawaii are eligible to buy Marketplace health insurance. |
| The only people who aren't eligible to purchase a plan are undocumented immigrants, incarcerated individuals, and people who are eligible for premium-free Medicare Part A. | |
| People with limited income and/or assets may be eligible for the Hawaii State Health Insurance Assistance Program (Hawaii SHIP). | |
| College/university students can usually pay for health insurance through an insurance company that works with their college. | |
| People with no income can get Medicaid-Quest. | |
| Types of Insurance | Individual and family health coverage are offered by two private insurance companies through Hawaii's health insurance Marketplace. |
| Supplemental plans for dental, vision, accident insurance, etc. are available. | |
| Medicare Supplement plans are insured by UnitedHealthcare Insurance Company. | |
| Accident, Critical Illness, Dental, Fixed Indemnity, Hospital Indemnity, Short Term, Term Life, and Vision insurance plans are underwritten by Golden Rule Insurance Company. | |
| Hawaii Medical Service Association (HMSA) and Kaiser are two popular insurance providers. | |
| Hawaii has the nation's strongest employee protections in terms of employer-sponsored health coverage. | |
| Non-ACA-compliant health coverage options include fixed indemnity plans and health care sharing ministry plans. | |
| Enrollment | Hawaii's open enrollment period for individual and family health coverage is from November 1 to January 15. |
| Residents enroll through HealthCare.gov. | |
| The Hawaii Insurance Division of the Department of Commerce and Consumer Affairs licenses and regulates health insurers, agents, and brokers. | |
| The Legal Aid Society of Hawaii is a federally funded Navigator organization. | |
| Hawaii SHIP provides free, local, one-on-one sessions and presentations to help people understand their Medicare options. |
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What You'll Learn
Eligibility for free insurance
- Income: Free or subsidised insurance is typically available for individuals with limited incomes. The specific criteria for determining eligibility based on income may vary, and it is important to refer to the guidelines provided by official sources.
- Citizenship: Individuals who are not legally in the United States are generally not eligible for free medical insurance in Hawaii. Undocumented immigrants are specifically mentioned as being ineligible to purchase plans in the exchange.
- Age: Medicare eligibility usually starts at 65 years of age. However, individuals under 65 who have been receiving SSDI for 2 years or have certain medical conditions may also qualify.
- Employment: Hawaii's Prepaid Health Care Act mandates that employers provide health insurance to employees working at least 20 hours per week. This rule applies regardless of the business size, and the cost to the employee cannot exceed 1.5% of their wages for self-only coverage.
- Existing Coverage: Eligibility for financial assistance or subsidies may depend on whether an individual already has coverage through an employer's plan, Medicare, or Medicaid.
- Student Status: College and university students can often access health insurance through their educational institution or pay for it through an insurance company that works with the school. Some student fees may also contribute to covering health services on campus.
It is important to note that the availability of free insurance or subsidies may change over time. Therefore, it is advisable to refer to the most up-to-date information from official sources, such as the Hawaii State Health Insurance Assistance Program (Hawaii SHIP) and the Hawaii Insurance Division of the Department of Commerce and Consumer Affairs.
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Short-term insurance options
Short-term health insurance is not an option in Hawaii. In 2018, the state enacted legislation that prohibits the sale or renewal of short-term plans to anyone who was eligible to purchase an ACA-compliant plan in the exchange during the previous calendar year. This law also limits the duration of short-term plans to no more than 90 days. As a result, insurers have stopped offering short-term health insurance in the state.
However, there are other ways to obtain affordable health insurance in Hawaii. One option is to take advantage of the state's strong employee protections. Under the Prepaid Health Care Act, employers are required to provide health insurance to employees who work at least 20 hours per week, regardless of the size of the business. The plan can cost the employee no more than 1.5% of their wages for self-only coverage.
Another option is to explore Medicaid (Med-QUEST) or CHIP, which provide health coverage for eligible residents. Most enrollees in these programs qualify for premium subsidies, which are designed to keep pace with the cost of the benchmark plan in each area. As of early 2024, subsidies were being paid on behalf of 84% of Hawaii Marketplace enrollees. To be eligible for subsidies, you must not qualify for an employer's plan that is considered affordable and comprehensive.
You can also purchase health insurance through Hawaii's health insurance Marketplace, where two private insurers offer individual and family health plans. The Hawaii Insurance Division oversees the plans sold in the exchange, and most enrollees receive subsidies that offset a significant portion of their premiums. The subsidy amounts change each year to keep pace with the cost of the benchmark Silver plan.
Additionally, college and university students can usually pay for health insurance through an insurance company that works with their school. Some health services on campus may already be covered by student fees.
Finally, if you are looking for short-term coverage until you find long-term insurance, you may want to consider a telehealth membership, which provides access to medical doctors and mental health professionals. However, it is important to note that these products are not insurance.
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Employer-provided insurance
If you are employed, your employer may provide you with health insurance. In Hawaii, state law requires private employers to provide health insurance for their employees who work at least 20 hours per week for four consecutive weeks. This is known as the Hawaii Prepaid Health Care Act.
Employers may purchase a DLIR-approved health care plan or a Qualified Health Plan from HealthCare.gov. They may also adopt an approved self-insured plan, but this requires audit information and bonding. Employers have the option to pay the entire cost of the health insurance premium or share it with their employees. However, except for certain union agreements, employers must contribute at least half of the premium cost for single coverage. The employee will then be responsible for the remainder, provided their share is not more than 1.5% of their wages.
For example, if an employee earns $1,733 per month and their health insurance costs $500 per month, the employer will pay $250, and the employee will pay $250 minus 1.5% of their net salary (which, in this case, works out to $26).
If an employee is hospitalized or unable to work due to illness, the employer will continue to pay the same amount toward their premium. To find out how long employers will pay premiums in these circumstances, contact HDLIR.
It is also worth noting that if you are a student, you may be able to pay for health insurance through an insurance company that works with your college or university. Some health services on campus might already be covered by your student fees.
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Student insurance plans
The University of Hawaiʻi has selected the Hawaiʻi Medical Service Association (HMSA), Blue Cross-Blue Shield of Hawaii, to provide student health insurance for UH students for the current academic year (Fall 2024 - Summer 2025). The UH Student Plan is available to certain non-student individuals affiliated with the University, such as visiting scholars (post-docs).
There are four plan options for the UH Student Plan, all of which provide medical and prescription drug coverage, as well as laboratory, radiology, mental health, family planning, medical evacuation, and overseas travel benefits. Depending on your health insurance needs, you can also purchase dental and repatriation, life insurance, and accidental death and dismemberment benefits.
For international students, the benefit options that meet the University's insurance requirements are: Option #2 (Medical with Drug, Repatriation, Life and AD&D), and Option #4 (Medical with Drug, Dental, Repatriation, Life and AD&D).
If you have questions regarding the UH Student Plan or insurance requirements for F-1 international students, you can contact the Student Health Insurance Office (SHIO) at University Health Services Mānoa, University of Hawaiʻi, 1710 East West Road, Honolulu, HI 96822. Their phone number is (808) 956-5361, and their email is [email protected].
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Medicare and Medicaid
In Hawaii, Medicaid is called QUEST Integration and is managed by the Department of Human Services' Med-QUEST Division. It is jointly financed by the State of Hawaii and the Federal Centers for Medicare and Medicaid Services. Medicaid provides free or low-cost health coverage to low-income individuals and their families. The income limits are based on the federal poverty limit and the number of people in the family. For instance, a family of four must not have an income higher than $3,208 per month to qualify for Medicaid in Hawaii.
Medicaid in Hawaii covers children, pregnant women, parent and caretaker relatives, adults (including the elderly aged 65 and older), blind, and disabled individuals. The benefits include doctor visits, hospital care, immunizations, pregnancy-related services, physical and occupational therapy, radiology, imaging, screening, lab tests, physical exams, counseling, vaccines, chronic disease management, dental care, vision care, immunizations, and more.
To apply for Medicaid in Hawaii, individuals can download an application from the Department of Human Services (DHS) website, submit an online application at mybenefits.hawaii.gov, or contact the Hawaii Connector Call Center at 1-877-628-5076 for assistance over the phone.
Medicare, on the other hand, is a federal and state program that provides health insurance for people with limited income and/or assets who meet certain criteria. Individuals can explore Medicare options provided by private companies like UnitedHealthcare Insurance Company. Additionally, resources like Hawaii SHIP (State Health Insurance Assistance Program) offer free, unbiased Medicare counseling and information to help individuals make informed decisions about their healthcare.
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Frequently asked questions
The best option for free medical insurance in Hawaii is to qualify for Medicaid (Med-QUEST). This is a federal and state program that provides health insurance for people with limited income and/or assets.
To qualify for Medicaid in Hawaii, you must meet certain income and asset criteria. Eligibility for premium subsidies depends on how the cost of coverage in your area compares with your household income. You must not be eligible for an employer's insurance plan, premium-free Medicare Part A, or Medicare Part B.
If you are a college or university student, you can usually pay for health insurance through an insurance company that works with your college. Some health services on campus might already be paid for by student fees. If you are employed, your employer may be required to provide you with health insurance under the Prepaid Health Care Act if you work at least 20 hours per week.
