Hawaii Health Insurance Consumer Guide

Virtually all residents of Hawaii are eligible to buy Marketplace health insurance with the following exceptions:⁵ 

• People who are not legally in the U.S.
• People already enrolled in Medicare
• People who are incarcerated

Hawaii’s open enrollment period for individual and family health coverage is from November 1 to January 15. This is set by the federal government since Hawaii uses the federal exchange.

Here are some key dates to remember:⁶

• November 1: Open enrollment starts! This is when you can first sign up for or change plans for the following year. If you enroll by December 15, your coverage will begin on January 1.
• December 15: Last day to change plans or enroll for coverage to begin on January 1. After this date, any changes or new plans will start on February 1.
• January 15: Open enrollment ends. 

After open enrollment, you can sign up for or make changes to an ACA Marketplace health through a special enrollment period (SEP). To be eligible for a SEP, you’ll need a qualifying life event.

Some SEPs don’t depend on a qualifying life event. For example:

• If you’re a Native American, you can enroll whenever necessary.⁷
• If you’re eligible for premium tax credits and your income is not more than 150% of the poverty level, you can enroll anytime until at least 2025.⁸
• People eligible for Medicaid/CHIP (Med-QUEST in Hawaii) can enroll anytime.

If you qualify for an ACA Marketplace plan, you have three sign-up options:

1. Enroll online via HealthCare.gov.
2. Enroll by phone at (800) 318-2596.

Enroll in person with the help of agents, Navigators, certified application counselors or an approved enhanced direct enrollment entity.⁹

Here are two options to find affordable health coverage in Hawaii:

ACA Marketplace plans (on HealthCare.gov)

• About 83% of eligible enrollees in Hawaii receive 2023 subsidies through the exchange.
• Subsidies – or Advance Premium Tax Credits (APTC) – help reduce premiums.
• The average premium subsidy for eligible enrollees is $545/month, meaning those subsidized enrollees pay an average of $140/month in premiums.¹⁰
  
• If your income is below 250% of the federal poverty level, you may qualify for cost-sharing reductions (CSR) to reduce your deductibles and out-of-pocket expenses.¹¹

Source: CMS.gov¹²

Medicaid 

Hawaiians may find affordable coverage through Medicaid (Med-QUEST) if eligible.

Hawaii’s health insurance Marketplace features two insurers providing 2023 individual and family health plans:¹³ 

• Hawaii Medical Service Association (HMSA)
• Kaiser

In 2023, for the third consecutive year, there were minimal changes in average premiums in Hawaii. Both HMSA and Kaiser proposed and received approval for a 2% average rate increase for the year.¹³

The federal rate review site indicates that both insurers have proposed raising average rates for the year 2024 as follows:¹³ 

Source: HealthCare.gov¹³

During the 2023 enrollment period, 21,645 people enrolled in private plans through Hawaii’s exchange.¹⁰ This represents a 3% decline compared to the previous year’s enrollment of 22,327.¹⁴

Source: 2014,¹⁵ 2015, ¹⁶ 2016,¹⁷ 2017,¹⁸ 2018,¹⁹ 2019,²⁰ 2020,²¹ 2021,²² 2022,¹⁴ 2023,²³ 2024²⁴

HealthCare.gov
This is the ACA Marketplace, where you can enroll in a health insurance plan online. You may also get help by calling (800) 318-2596. 

Hawaii’s Insurance Division of the Department of Commerce and Consumer Affairs
Licenses and regulates health insurers, agents, and brokers. They also handle consumer questions and complaints about insurance.

Legal Aid Society of Hawaii
The Navigator organization funded by the federal government in Hawaii.

Hawaii Medicaid (Med-QUEST)
This program provides health coverage for eligible residents.

Hawaii Prepaid Health Care Law information
This law helps ensure that many workers in Hawaii have access to health coverage through their jobs.