Hawaii Individual Health Insurance
Medical insurance is an essential safety net that every person should consider for themselves and their family. 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 age, number of people seeking coverage under the policy, and past medical history.
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.
The following regulations apply to 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 and health status. 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.
Lastly, when it is time to renew your policy, your premium can be raised based on any reason, including 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.