Healthcare in Hawaii

Hawaii has maintained a system of near universal health coverage for more than three decades. You will be happy to hear that Hawaii was ranked fourth among the nation’s healthiest states last year, due in large part to this long-standing commitment to public health by the state’s public and private sectors.

With the high costs of medical care these days, we all know how important it is to have comprehensive health insurance. It will be important to know your options before you arrive. Hawaii residents have three basic options for obtaining health insurance:

• Coverage through your employer (ESI);
• Coverage through Income Eligible Programs;
• Private individual coverage.

Hawaii’s dedication to comprehensive health coverage began in 1974 when it passed the Hawaii Prepaid Healthcare Act. With this law, Hawaii became the first state to set minimum standards of health care benefits for its workers. Hawaii companies must provide health care coverage to employees who:

• Work at least 20 hours per week
• Earn at least $628 per month (this amount is based on the state minimum wage).

Providing these requirements are met, employers must commence coverage after four (4) consecutive weeks of employment or the earliest time thereafter at which coverage can be provided by the health care plan contractor (usually the first of the month).

Additionally, to ensure employers provide their employees with adequate coverage, available plans must meet or exceed the standards of the prevalent Service and Reimbursement plans throughout the state, as defined by the Hawaii Prepaid Health Care Advisory Council.

Click here to see an up-to-date list of approved ESI plans in Hawaii.

Low income Hawaii residents have access to various healthcare options, including:

• The Hawaii QUEST program provides comprehensive health and dental coverage through managed care plans for eligible low income Hawaii residents.
• Medicaid Fee-for-Service is the traditional Medicaid Program that has provided medical coverage to low-income Hawaii residents for almost 50 years. The program provides coverage for individuals who are age 65 and over, or under age 65 who are blind or disabled. All other individuals are covered by QUEST.
• The QUEST-Net program provides medical coverage for former QUEST or Medicaid Fee-for-Service recipients who became ineligible because their assets or income exceeded allowable limits. QUEST-Net coverage is typically not as comprehensive as coverage in the QUEST or the Medicaid FFS programs.
• Through the Prevent Adult Dental Decay (PADD) program, recipients of Medicaid – including the QUEST and FFS programs – can receive $500 in yearly benefits for a variety of dental services. The program also provides $1,000 in annual benefits for recipients who require full or partial dentures.

If you do not have access to ESI or Income Eligible Programs, you may want to buy private individual health insurance coverage. The Federal Health Insurance Portability and Accountability Act (HIPAA) provides limited guaranteed access to individual health insurance. Keep in mind that there are some alternatives to individual health insurance, such as COBRA.