Hawaii Individual Health Insurance

Medical insurance is an essential safety net that guards individuals against illnesses and injuries and the huge costs associated with them. If you do not get group health insurance through your employer, then you should look into purchasing Hawaii individual health insurance from a private insurer. Finding out more about the rules and regulations regarding these individual health insurance plans in Hawaii is your first step to deciding if this option is right for you.

Eligibility: How Am I Evaluated?

Generally, health insurance applications are not regulated by the state and applicants can be denied for any reason. Insurers in Hawaii have the flexibility to evaluate each applicant based on factors defined by their own rules and regulations. These factors may include gender, age, number of people seeking coverage under the policy, and past medical history.

Hawaii does not have a high risk pool for its medically-uninsurable residents. In accordance with HIPPA Group-to-Individual Portability Coverage regulations, Hawaii guarantees issuance of health insurance via private health insurers who sell policies in the state. This means that if you are HIPPA eligible, an insurer cannot deny you coverage for any reason.

Hawaii Guaranteed Benefits & Pre-Existing Conditions

Hawaii law does not require insurers to carry standardized policies for consumers to choose from, but they do require the coverage of certain benefits by all insurers under all plans. These benefits include services such as mammograms for women over 40 years old, care for mental health conditions, diabetes care and alcohol and drug treatment services. For pre-existing conditions, HIPPA eligible consumers cannot have exclusion periods and elimination riders imposed on their policy. Pre-existing conditions can be included in an elimination rider attached to your policy, which will exclude them from coverage under the policy forever. Pre-existing conditions can also be included in an exclusionary period of up to 3 years. To determine what is a pre-existing condition, insurers can look back in your medical files for any condition that you did or should have sought medical advice or treatment for.

Hawaii Individual Health Insurance Premiums

Premiums for Hawaii individual health insurance are determined based on many factors, including your age, health status, gender, type of plan, health history and lifestyle habits. There are no restrictions or limits on what you can be charged and those with a health condition will likely be charged much more than healthy customers. When it is time to renew your policy, your premium can be raised due to increasing age and/or declining health. Your policy can be cancelled if your insurer decides to discontinue your plan; however, your policy cannot be cancelled because of a change in your health status, even when it is time to renew. This is known as guaranteed renewability and helps protect current health insurance customers who suddenly find themselves in poor health.

Before you buy a health insurance policy, you must read the policy details very carefully. You need to know exactly what is and isn't covered by your policy and how much you will end up paying in your premiums. Contacting a qualified Hawaiian broker or agent can help you in selecting the perfect health plan coverage.

* Please refer to our legal terms and conditions for disclaimers pertaining to the content on this page.