Best Health Insurance Plans in Hawaii

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Not only are Hawaii residents surrounded by stunning scenery, they’re also spoiled when it comes to health care. According to a study by US News, HI has the best health care in the country. That study looks at access, quality, and overall public health. Congratulations, Hawaii!

Health Care Choices in Hawaii

According to HI’s insurance department, there are several ways for state residents to access health care:

  1. Employer-provided
    1. From your employer
    2. Through your spouse's employer
    3. Through COBRA
  2. Individual or family plans
    1. Through HealthCare.gov
    2. Directly from a health insurance company
  3. Government-assisted
    1. Medicare
    2. Medicaid (Med-QUEST)

Where do most Hawaii residents get their health insurance coverage?

Hawaii Health Insurance Sources
Sources Percent
Employer-Provided 55%
Individual or family 3%
Medicaid 15%
Medicare 15%
Other Public Care 6%
Uninsured 5%
Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population

Five percent of HI residents are uninsured, less than the national average. That’s great for policyholders. A low rate of uninsured people helps lower insurance premiums.

Hawaii Health Insurance Costs and Rate Factors

Hawaiians spend an average of $7,299 per year on health care, less than the national average. So, what influences your health care costs in the Aloha State? Prices vary person to person, based primarily on these factors:

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Body Mass Index

According to the CDC, a high body mass often leads to several serious health conditions. That’s why insurance companies will look at your BMI to determine your risk-level. A higher BMI means higher insurance rates.

In 2016, HI had a 23.8 percent obesity rate, the third lowest rate in the country. Of the Hawaiians who used QuoteWizard to compare health insurance plans, 25 percent have a BMI in the obese range.

Tobacco Use

Smokers pay more for health care because of the high risk from tobacco use. About 13.1 percent of HI residents are smokers, the third lowest rate in the country.

Age

According to HealthCare.gov, older people pay up to three times more for health care than younger people. HI residents who used QuoteWizard to shop for health insurance plans are, on average, 33 years old.

Plan Type

The more health care coverage you want, the more you’ll have to pay. Marketplace plans come in metal tiers: bronze, silver, gold, and platinum.

What should you expect to pay in Hawaii? These are the average monthly rates for a middle-aged HI resident in 2018:

Hawaii Martketplace Plan Rates
Bronze Silver Gold
$336 $437 $449
Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier

Gold plans cost about 34 percent more than bronze plans. That’s because gold plans cover 80 percent of medical costs, whereas bronze plans cover 60 percent of costs.

You may also qualify for a catastrophic plan, the lowest level of coverage available. Catastrophic plans have low monthly premiums but a high yearly deductible of $7,150. That deductible may mean you’ll save money with a gold or silver plan when you need to use your insurance.

Location

You zip code plays a big role in your rates. That’s because every state has different rules, regulations, and providers surrounding their health insurance marketplace.

Insurance companies also use community-rating to determine your prices. Rates are based in part on the combined claims that everyone files. If your neighbors file an unusually high number of claims, your rates will jump.

That means your state’s overall health level plays a role. Aloha State residents are in luck. According to America’s Health Rankings, HI is the second healthiest state in the country.

Hawaii Health Insurance Companies

These companies offer both individual and family health insurance plans in Hawaii:

Hawaii Health Insurance Laws

The Affordable Care Act limits how insurance companies price your policies:

There’s a limit to how much you’ll pay out-of-pocket for a marketplace plan. In 2018, the out-of-pocket maximum is $7,350 for an individual plan and $14,700 for a family plan.

State law requires health insurance companies to offer at least some coverage for the following services:

  • Autism
  • Cancer treatment
  • Contraceptive services
  • Hospice care
  • Child health supervision services
  • Chemotherapy
  • Mental health and alcohol and drug abuse treatment
  • Telehealth
  • In-vitro fertilization procedure

There are additional services that providers need to offer coverage for. Find the whole list on cms.gov.

Medicare and Medicaid in Hawaii

Medicare and Medicaid are both federal-funded health care programs. Medicare aids seniors, whereas Medicaid covers low-income families and children.

Medicare

Seniors over 65 qualify for Medicare. There are several coverage options including Medicare parts A, B, C, D, and supplemental coverage plans. HI residents may also qualify for one of these Medicare Savings Program:

Qualified Medicare Beneficiary (QMB):

  • Single person with a monthly income lower than $1,164 and assets less than $7,560.
  • Couple with a monthly income lower than $1,578 and assets less than $11,340.

Specified Low-Income Medicare Beneficiary (SLMB):

  • Single person with a monthly income lower than $1,396 and assets less than $7,560.
  • Couple with a monthly income lower than $1,893 and assets less than $11,340.

Qualifying Individual (QI):

  • Single person with a monthly income lower than $1,571 and assets less than $7,560.
  • Couple with a monthly income lower than $2,130 and assets less than $11,340.

Qualified Disabled Working Individual (QDWI):

  • Single person with a monthly income lower than $4,739 and assets less than $4,000.
  • Couple with a monthly income lower than $6,395 and assets less than $6,000.

Medicaid

Medicaid aids low-income families and children. These are the state’s Medicaid financial requirements:

Hawaii Medicaid Financial Requirements
Household Size Maximum Yearly Income
1 $13,860
2 $18,860
3 $23,480
4 $28,290
5 $33,100
6 $37,910
7 $42,720
8 $47,530

Hawaii Department of Commerce and Consumer Affairs - Insurance

Website:
Homepage
Insurance Commissioner:
Gordon I. Ito
Insurance Hotline:
(808) 586 – 2790
Office Hours:
Monday - Friday
7:45 am to 4:30 pm
File a Consumer Insurance Complaint
Complaint Page

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