Regardless of whether you are part of the 4% of Hawaii residents who don't have health insurance or not, I am sure you can agree that finding cheap health insurance in Hawaii can be complicated.
But, it doesn’t have to be, we have taken some complicated concepts and broken them down in "plain English".
This blog post will cover the average cost of health insurance in HI and how it's broken down into tiers.
We will also list the most affordable health insurance companies in Hawaii so you can get personal health insurance and find the best coverage for your needs and budget!
More Of The Best And Cheapest Health Insurance Companies In Hawaii:
How Much Does Health Insurance In Hawaii Cost Per Month?
The average cost of individual health insurance in Hawaii is $490 per month or $5,880 per year for an adult in their 40s. However, this cost will change significantly depending on the metal tier of coverage you select and your age. Like most insurance products, the older you are when you take out the policy, the more expensive it will be.
What Factors Influence The Cost Of Hawaii Individual Health Insurance?
Under the new health care law, insurance companies are only allowed to consider five factors when determining rates: for Hawaii residents, your location, age, tobacco use, plan type, and whether the policy covers dependents.
Where You Live - Yes, health insurance premiums vary from one state to the next and even neighborhood to neighborhood. The cost of living and the typical wage are two elements that influence how much you will pay for a health plan.
Your Age - Your age will impact your premiums, just like most insurance. When you get health insurance, the younger you are, the lower your rates will be.
Tobacco Use - The use of tobacco is very likely the one thing on this list that will cause you to pay more for insurance. Regarding health insurance, premiums can rise by upwards of 60% per month.
What Factors Can’t Affect Health Insurance Premiums?
Insurers may not charge women and men different rates for the same policy. When determining prices, they cannot consider your present health status or past medical history. All health plans must cover treatment for pre-existing conditions from the day coverage begins.
Health Insurance Rate Changes In Hawaii (2021 vs. 2022)
Health insurance costs, deductibles, and out-of-pocket maximums are updated yearly by health insurance carriers. The plans are then submitted to the federal exchange for approval for the following plan year. From 2021 to 2022, health insurance premiums in Hawaii rose an average of 1.66%.
Is Health Insurance Required By Law In Hawaii?
Technically, the Affordable Care Act - or Obamacare - still states that everyone must have health insurance. However, the federal tax penalty for not having health insurance was eliminated in 2019. So, on your federal taxes, you'll need to indicate whether or not you had coverage.
Will I Be Penalized If I Don't Have Health Insurance?
You won't be fined by the IRS for not having health coverage in 2022—but there are several disadvantages to being uninsured. The tax penalty under Obamacare vanished in 2019, so if you don't have health insurance, you won't be penalized.
However, some states have passed their own health insurance requirements, resulting in a state-level tax fine if you go without coverage.
Massachusetts, New Jersey, Vermont, California, Rhode Island, and Washington D.C are among the states that have enacted their own health insurance rules.
What Type Of Health Insurance Marketplace Does Hawaii Have?
Hawaii uses the federally run marketplace Healthcare.gov, so individuals and families who need to buy their own health coverage can go online to enroll. Like the Hawaii health insurance marketplace, regardless of the state you live in, there is some sort of Marketplace for you to buy coverage.
When Is The Open Enrollment Period For Obamacare?
Hawaii's health insurance marketplace has an open enrollment period that generally runs from November 1st to December 15th of each year. This is when enrollees may join a new plan or modify their existing coverage.
When Does The Open Enrollment Period (OEP) For Hawaii Health Insurance Start In 2022?
Unfortunately, Open Enrollment for the ACA Marketplace ended on January 15, 2022. This implies you'll have to qualify for the special enrollment period or purchase short-term health insurance if you want coverage right now.
What Are The Hawaii Open Enrollment Dates For Health Insurance In 2023?
Open Enrollment begins on Thursday, December 15th, 2022. Open Enrollment will end on Sunday, January 1st, 2023, when any plans purchased during Open Enrollment will begin.
Types of Affordable Health Insurance Plans In Hawaii?
There are five distinct kinds of health insurance to select from, including HMOs, PPOs, POS plans, EPO plans, and HSA plans.
A Health Maintenance Organization (HMO) is one of the major medical plans that limit your access to specialists to local hospitals and frequently necessitates the use of a referral. If you have an HMO plan, make sure you stay in-network, which may cost you money.
A Preferred Provider Organization (PPO) is a health plan that allows you to utilize any doctor, hospital, or treatment facility. You'll pay less if you use "in-network" physicians, however. Because of their size, these networks provide an extensive choice of doctors.
A Point of Service Plan (POS) has a smaller network than a PPO plan, and its costs for in-network care are often lower (like the cost of an HMO.) You must pick a primary care physician and any other provider from the network of doctors. You also need to obtain a referral to see a specialist.
An EPO, or Exclusive Provider Organization, will only pay if you go to an in-network doctor. You don't need a referral to see a specialist; however, if you visit a non-network doctor, you will be responsible for the total cost. Depending on the company, this plan may or may not require you to pick a primary care physician.
An HSA, often known as a Health Savings Account, is a kind of insurance that allows you to pay for medical expenses using pre-tax money. The account is held and controlled by the individual, allowing it to pay for current and future health care expenditures.
What Are The Different Health Insurance Tiers In Hawaii?
According to the Affordable Care Act, there are now, also, five tiers of health insurance in Hawaii. These tiers are catastrophic, bronze, silver, gold, and platinum. The more valuable the metal, the greater the coverage's benefits and cost. We have listed them below with a brief description of each plan:
Catastrophic plans will typically have the lowest monthly premiums compared to the other metal tiers. To be eligible for a Catastrophic plan, you must be under the age of 30 or qualify for a "hardship exemption" A Catastrophic Plan must satisfy similar Qualified Health Plan (QHP) criteria and usually doesn't cover any other services than three primary care visits each year.
Deductibles for Bronze plans (the amount of medical expenses you pay yourself before your insurance plan starts to reimburse you) can be thousands of dollars a year. It's a decent alternative if you want a low-cost option for protecting yourself against severe sickness or injury. Your monthly payment will be modest, but you'll have to pay for most routine care alone.
The Silver plan's monthly premium is reasonable, and the expenses incurred when you need care are moderate. Deductibles on the Silver plan are usually smaller than those on the Bronze plan. If you qualify for "additional savings," or if you're willing to pay a little more each month in premiums to have more of your routine care covered, the Silver plan is an excellent choice.
The Platinum plan will have the highest monthly premium and lowest cost when seeking treatment. Your deductible is relatively low, which means your policy kicks in sooner than other categories of plans. It's a great choice if you require a lot of care. However, you should be prepared to pay a significant monthly premium.
The gold plan will have a high monthly premium, but Low costs when you need care, and the deductibles are usually low. It's a good choice if you're willing to pay more each month to cover more costs when you get medical treatment. If you use a lot of care, a Gold plan could be a good value.
What Does Health Insurance Cover In HI?
Most hospital and doctor visits, mental health services, preventative care, prescriptions, and medical devices are covered by your health insurance. Each of these items is addressed in your policy under various sections that we go through below:
Your deductible is the amount you must pay out of pocket before your insurance coverage kicks in (co-insurance). Deductibles can range from $0 to $10,000 per year, and the smaller the deductible, the higher the monthly premium.
Your co-insurance will come into play to help you cover medical expenditures when your annual deductible has been exhausted. Typically, this is expressed as 80/20 or 70/30. The insurance company pays the first amount (80%), while you pay the second (20%).
A co-pay is the amount you will pay to see your doctor. They can differ depending on whether you are seeing your primary or specialist physician. This amount is not covered by your co-insurance and must be paid individually on each visit.
Out Of Pocket Maximum
An out-of-pocket annual maximum will be included in each plan. This is the most you can spend out of your pocket in a year without going completely uninsured. These amounts are determined by your deductible, co-insurance, and prescription costs.
Prescription medicines are covered based on formulary tiers. Formularies come in multiple levels, such as Tier 1, Tier 2, and so forth. The price of prescription medicine is determined by the tier. You may have an additional prescription drug deductible on top of your primary plan's deductible.
Most policies include a free annual examination when you purchase them, and then a free check-up once per year. Some insurance businesses are placing more emphasis on preventative care in the early stages to help clients live longer.
What Does Health Insurance Not Cover In Hawaii?
Cosmetic surgical treatments, fertility treatments, off-label therapies, and new technologies and goods are all excluded from health care coverage.
Because cosmetic operations and fertility treatments are typically considered elective by insurance companies.
And because prescribed medications are investigated and authorized for particular illnesses, if your condition isn't listed on the "label," your provider will not reimburse your prescription costs.
How To Get Hawaii Health Insurance Quotes Online?
There is no reason to go without health insurance coverage in Hawaii, especially when it's so easy to find a plan that suits your needs and budget!
The best approach to finding affordable health insurance rates in Hawaii is to compare numerous quotes from multiple companies online.
All you have to do is click here or on one of the above buttons to get free private health insurance quotes. Best of all, you can get covered in less than ten minutes.
Frequently Asked Questions About Cheap Health Insurance Hawaii
How much is health insurance a month for one person in Hawaii?
The average cost of health insurance in Hawaii is $490 per month or $5,880 per year for one person in their 40s. However, this cost will change significantly depending on the metal tier of coverage you select and your age.
Is there any free healthcare in Hawaii?
Medicaid offers free and inexpensive healthcare to eligible people in Hawaii. However, not everyone will qualify for Medicaid services, and many people do not know they are eligible. It is best to check with your state's Department of Health website to see if you qualify.
What is the cheapest health insurance plan in Hawaii?
The cheapest health insurance plan in Hawaii would be a catastrophic plan with a high deductible and high maximum out-of-pocket expenses. This policy does not cover preventive care or prescription drugs and is only meant for emergency situations.
Does Hawaii have low-income health insurance?
Yes, Medicaid is a federal government-sponsored insurance program that provides medical coverage to low-income people and families. The cost of the Medicaid program is split between the state and federal governments.