Your Rights under Hawaii Health Insurance Law
(Copyright 2005 All Rights Reserved)
Individual Health Insurance:
In Hawaii, your health insurance options are somewhat dependent on your health status. Your health insurance cannot be canceled because of you getting sick. Most health insurance is guaranteed renewable.
In general, companies that sell individual health insurance in Hawaii are free to turn you down because of your health status and other factors.
If you are HIPAA (Health Insurance Portability and Accountability) eligible, you are guaranteed the right to buy any individual health policy from any individual health insurer that sells in Hawaii.
If you believe you may be at risk for cancer but are uninsured or underinsured, you may be eligible for screening and treatment. The Hawaii Breast and Cervical Cancer Control Program provides free cancer screening for qualified residents. Some women diagnosed with breast or cervical cancer through this program may be eligible for medical care through Medicaid.
If you are buying individual health insurance as a HIPAA eligible individual, the law does not limit what you can be charged for that individual health policy.
If you are not HIPAA eligible, individual health insurers in Hawaii are free to turn you down because of your health status and other factors. If you are offered an individual health insurance policy, you may have to satisfy a new pre-existing condition exclusion period.
Insurers offering individual health insurance are generally limited to a three-year period for pre-existing condition exclusions. In Hawaii, pregnancy can be considered a pre-existing condition by individual health insurers, but genetic information cannot be considered a pre-existing condition in the absence of a diagnosis.
Help is available to certain low-income residents of Hawaii who cannot afford to buy health insurance. Medicaid, Hawaii QUEST, the Breast and Cervical Cancer Control Program and other programs either offer free or subsidized health insurance coverage, direct medical services or other help. In addition, the Federal Health Coverage tax Credit Program (HCTC) provides tax credits to early retirees and some workers who lose their jobs or whose work hours and wages are reduced as a result of increased imports.
Hawaii QUEST also subsidizes health coverage to low-income Hawaiians who are not eligible for Medicaid and who have no health insurance.
The Hawaii Breast and Cervical Cancer Control Program provides qualified women with free screenings for breast and cervical cancer. In order to be eligible, you must be a resident of Hawaii, between the ages of 40 and 64, have no or limited health coverage, ineligible for Medicaid or Medicare, and have an income below 250% of federal poverty level.
For more information, please visit the Hawaii Insurance Division at
Group Health Insurance:
Hawaii requires all employers to provide health insurance coverage to employees who meet certain requirements.
You must work for your employer at least 20 hours per week for 4 consecutive weeks.
Employers are not required to provide health benefits to seasonal workers. Employer sponsored health coverage must be through an approved "prepaid group health care plan".
Your employer must pay at least one-half of your health plan premium.
In Hawaii, an employer who is otherwise exempt from offering an employee coverage, because that employee has other coverage through another employer, spouse or government program, is required to offer coverage to that employee if the employee loses their other coverage.
Under Hawaii law, newborns, adopted children, and children placed for adoption are automatically covered under the parents’ fully insured health plan for the first 31 days.
In Hawaii, adult dependents who are physically disabled or mentally retarded are able to stay on their parents’ fully insured group health plan after they have reached the age at which the health plan usually cancels dependent coverage.
In general, you can be charged higher premiums based on the health, risk, and demographic characteristics of your group.
help you find the best health insurance company
check out the complaint ratio. Click here for
the instruction sheet on
How to find an insurance company complaint
ARTICLES about INSURANCE
National Health Care- A Poison Pill