The Cheapest Hawaii Health Insurance for Individuals and Families
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While health insurance is often obtained from employment or the government, such as Medicaid Medicare for seniors, individuals who don’t have these options can instead get private plans through Hawaii’s insurance exchange.
Cheaper plans are not always the best option because they tend to come with higher deductibles and lead to lower medical costs covered monthly. This is why policyholders should aim to find a balance between an affordable plan with all the right coverages and reasonable out-of-pocket expenses.
MoneyGeek examined affordable health insurance in Hawaii for individuals of varying ages seeking different plan types to help you find the right coverage for your needs. Our analysis is for plans purchased through Hawaii’s insurance marketplace.
The Cheapest Health Insurance in Hawaii by Metal Tier
The cost of health insurance in Hawaii for an individual looking in the private market depends on the metal tier chosen. The different tiers allow you to have higher deductibles to lower your monthly costs or lower your deductibles for a higher monthly cost.
There are six metal tiers in Hawaii, including Catastrophic, Bronze, Expanded Bronze, Silver, Gold and Platinum. The average costs of each metal tier in Hawaii are:
- Catastrophic: $197 per month
- Bronze: $314 per month
- Expanded Bronze: $356 per month
- Silver: $482 per month
- Gold: $476 per month
- Platinum: $555 per month
In certain markets, like Hawaii, a lower tier may cost more than the level above it, such as with Silver and Gold. Those who often have to visit the hospital should consider paying for higher levels such as Gold or Platinum. This can help them save on medical costs in the long run since you’ll pay less out of pocket.
The table below showcases the most affordable health insurance in Hawaii for each metal tier. Note that the premiums, deductibles and out-of-pocket max expenses vary by tier.
For people with a low income, health insurance in Hawaii is still attainable. Low income individuals may be qualified for cost-sharing reductions (CSR), which can reduce deductibles, copays and coinsurance. While this is only allowed for individuals getting a Silver plan, taking advantage of the cost-sharing subsidy can make it easier to get and more cost-effective.
MoneyGeek collected rates based on a sample profile of a 40-year-old male for all types of plans available in the state of Hawaii. It covered all types of plans, including HMO and PPO plans, in the state.
Cheapest Health Insurance in Hawaii by Metal Tier
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- Metal TierPlanCompanyMonthly CostOOP Max
- CatastrophicHMSA Catastrophic PlanHMSA$197$8,550
- BronzeKP HI Bronze 7000/30%Kaiser Permanente$314$8,550
- Expanded BronzeHMSA Bronze PPOHMSA$348$8,550
- SilverKP HI Silver 4000/45Kaiser Permanente$467$8,500
- GoldHMSA Gold PPO 1000HMSA$440$8,550
The Cheapest Health Insurance in Hawaii by Age and Metal Tier
The cost of health insurance in Hawaii is affected by a number of factors. Aside from location and metal tier, a policyholder’s age can influence rates as well. Case in point, the difference between a Silver HMO plan for a 26-year-old and a 60-year-old can average around $637 per month, with the former paying a monthly average of $386 and the latter paying roughly $1,023.
Health Insurance Costs in Hawaii by Age and Metal Tier
As you age, the rate of health insurance goes up due to the likelihood of you needing more medical care. While low-deductible plans have smaller monthly premiums, you may have to pay more out-of-pocket in case your medical bills are high.
Prices gathered by MoneyGeek are based on sample ages and do not take into account your unique situation, such as your income or age. For instance, senior Hawaiians may find themselves eligible for cheaper plan options due to tax premiums or other regulations. However, you won’t get a precise quote until you apply for a plan.
The following table shows how costs can change between metal tiers and ages. To better understand what metal tier is best for you, check out our extensive guide on how to get health insurance in Hawaii.
Cheapest Health Insurance in Hawaii by Age And Metal Tier
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- PlanCompanyMonthly Rate
- CatastrophicPPOHMSA$141
- BronzeHMOKaiser Permanente$224
- Expanded BronzePPOHMSA$249
- Expanded BronzePPOHMSA$253
- Expanded BronzeHMOKaiser Permanente$255
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The Cheapest Health Insurance in Hawaii by County
The cost of health insurance in Hawaii can vary based on where a policyholder lives. Places in the state are divided into rating areas, which can consist of counties, metropolitan statistical areas or postal codes. These are then used by insurers to calculate premiums.
The state has five counties and one rating area, which means rates will not change by county but instead will be based on other factors like age and income. The most populous county in Hawaii is Honolulu, with the cheapest Silver plan being the KP HI Silver 4000/45 offered by Kaiser Permanente at an average of $467 per month.
Check out the table below to find the cheapest plan in your county based on the metal tier that suits your needs.
The rates above are based on a sample profile of a 40-year-old male residing in Hawaii purchasing a health plan in each respective county.
Cheapest Health Insurance Plans in Hawaii by County
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- Metal TierCompanyCheapest PlanMonthly Premium
- HonoluluCatastrophicHMSAHMSA Catastrophic Plan$197
- HawaiiCatastrophicHMSAHMSA Catastrophic Plan$197
- MauiCatastrophicHMSAHMSA Catastrophic Plan$197
- KalawaoCatastrophicHMSAHMSA Catastrophic Plan$197
- KauaiCatastrophicHMSAHMSA Catastrophic Plan$197
The Cheapest Health Insurance in Hawaii With High Out-of-Pocket Maxes
Young professionals or individuals who are less likely to have high medical costs may want to get low-cost plans to stay covered. While this does mean higher out-of-pocket expenses in case of a medical situation, it can still help lower the overall cost.
The most affordable health insurance in Hawaii with the highest out-of-pocket expense is the HMSA Catastrophic Plan offered by HMSA, costing an average of $158 per month for a 26-year-old.
MoneyGeek defines a high out-of-pocket max as a plan with overhead expenses costing $8,250 or higher.
HMSA
The best health insurance in Hawaii for an individual looking for a low-cost plan regardless of high out-of-pocket expenses is offered by HMSA. As their plan is in the Catastrophic tier, only individuals under the age of 30 or who qualify for hardship or affordability can get this plan.
The Cheapest Health Insurance in Hawaii With Low Out-of-Pocket Maximums
Individuals in Hawaii who often have expensive medical costs will benefit from getting a higher plan with a low out-of-pocket max. Frequent visits to the doctor or needing expensive prescription drugs will help reach the out-of-pocket maximum quickly, letting insurance coverage kick in sooner.
The most affordable health insurance in Hawaii with low out-of-pocket maximums is the KP HI Platinum 0/10 offered by Kaiser Permanente at an average of $586 per month for a 40-year-old.
Plans with an out-of-pocket maximum below $4,250 are considered to be low. However, the state of Hawaii does not have a plan with out-of-pocket maximums below this threshold. Despite this, Kaiser Permanente’s KP HI Platinum 0/10 plan has the cheapest premiums in the state with the lowest out-of-pocket max.
Kaiser Permanente
Kaiser Permanente’s KP HI Platinum 0/10 plan falls under the Platinum tier, which is the highest in the state. Metal tiers such as Platinum and Gold often come with higher premiums, but being able to reach the low out-of-pocket max means medical costs will be covered sooner. This is beneficial for those who frequent the doctor.
Cheapest PPO/HMO Health Insurance Plan in Hawaii
The healthcare plan that suits you best will depend entirely on your medical care needs and preferences. Health Maintenance Organization (HMO) plans are common in Hawaii, but Preferred Provider Organization (PPO) plans are also offered.
An HMO plan is the cheapest and most common option across states, but policyholders must stay within the provider network to have services covered. This does not apply in emergencies. PPO plans, on the other hand, cost more but typically have wider networks. They are also more flexible and require no referral to see a specialist.
The cheapest Silver options for both plans are:
- HMO: KP HI Silver 4000/45 by Kaiser Permanente, costing an average of $467 per month for a 40-year-old.
- PPO: HMSA Silver PPO 3500 by HMSA, costing an average of $478 per month for a 40-year-old.
Cheapest Plan in Hawaii With an HSA
Hawaiian residents who are in good health and don’t plan on visiting the doctor often may opt to get a Health Savings Account (HSA) instead. This plan is cheaper and essentially acts as a savings account specifically for future medical expenses. Money contributed here is not taxed, and contributions are completely under your control, which helps you build a good nest egg should you decide not to use it on medical costs.
MoneyGeek found that the most affordable health insurance in Hawaii for an individual with a Health Savings Account is:
- Expanded Bronze: The HMSA Bronze PPO HSA offered by HMSA, offered at an average of $355 per month for 40-year-olds.
Note that these plans often come with high deductibles, which means any major and unexpected medical costs can affect your savings greatly.
What to Know About Health Insurance in Hawaii
While prices gathered and used in MoneyGeek’s analysis were taken from private plan data in Hawaii’s marketplace, you might be able to find cheaper plans since rates depend on your unique situation. For qualified residents with low incomes, health insurance in Hawaii can be attainable through Medicaid or Medicare, which is cheaper than any other marketplace plan.
Private Health Insurance on the Hawaii Marketplace
Private health insurance plans in Hawaii are divided into six metal tiers, which determine the split of costs between an insurer and policyholder.
All tiers meet the minimum federal and state requirements, but each come with their own pros and cons:
- Catastrophic: Catastrophic plans have the lowest premiums, highest deductibles and the least amount of benefits. Additionally, only those under the age of 30 or who face economic hardship are eligible for this tier. While this tier does not offer much in terms of covering medical costs, it can still help avoid thousands of dollars of debt in the event of a medical emergency.
- Bronze: Similar to Catastrophic plans, Bronze plans have low premiums and high deductibles. However, it offers more in terms of benefits. It is another low-cost option for individuals who don’t go to the doctor frequently but still want protection in case of an emergency. Note that this tier comes with high out-of-pocket maximums, so it may take awhile before insurance coverage kicks in.
- Expanded Bronze: The Expanded Bronze plan is the middle ground between Bronze and Silver. It offers coverage close to that of the Silver plan at a similar price to the Bronze plan. There are still high deductibles and out-of-pocket maximums, but they are still lower than Bronze or Catastrophic.
- Silver: The tier that offers the most balance between premiums and out-of-pocket costs is the Silver tier. This tier is suitable for those who want more of their routine care covered. It is also best for those who qualify for cost-sharing reductions, as they can save hundreds or thousands of dollars per year.
- Gold: The Gold tier is where premiums start to significantly rise, but the out-of-pocket costs required when you need care are lower compared to tiers Silver and below. This is best for individuals who frequently visit the doctor or have expensive prescription drugs.
- Platinum: The highest of the tiers, Platinum plans have the most expensive premiums and the lowest out-of-pocket costs. This means that those who have a lot of medical needs will get their costs covered much sooner as the plan kicks in earlier compared to other tiers.
It’s still possible to get lower rates and increased coverage than what’s cited in MoneyGeek’s analysis, as most insurers still have to factor in your income level and unique situation. If your income is between 100% and 400% of the federal poverty level, it’s possible for you to get premium tax credits. This applies to a two-person household in Hawaii making anywhere between $20,040 to $80,160 annually. To find out how much you can roughly save based on your income level, check out Healthcare.gov’s calculator.
Open enrollment is a period of time within a given year where you can enroll for a new plan. This typically falls between the months of November and December, but the COVID-19 pandemic has expanded these dates to offer policyholders more flexibility.
For those with an income level between 138% and 250%, or $27,655 and $50,100, for a two-person household in Hawaii, you can get cost-sharing reductions if you buy a Silver plan. This offers the most favorable deal, as it can help lower deductibles, copayments or coinsurance and out-of-pocket maximums. You may even get Gold plan coverage at the cost of a Silver plan if you qualify for cost-sharing reductions.
Medicaid in Hawaii
Medicaid is an assistance option that helps those eligible pay little to nothing for their medical costs. As Medicaid in Hawaii is expanded, individuals can qualify based on income alone if their income is below 138% of the poverty level. For instance, if there are four people in your family, your income cannot be higher than $3,208 per month. This amount changes based on the number of people in your family.
Medicare in Hawaii
Hawaii residents who have qualifying disabilities or illnesses or are age 65 and older may be eligible for Medicare. This is a federal government program that helps assist the nation's elderly in meeting their medical needs. It is different from Medicaid since it requires payment for coverage. However, Medicare can still give individuals more health care choices, letting them pick a plan that best suits their needs and their budget.
There are three different Medicare parts:
- Part A: This involves any in-hospital expenses, like in-patient hospital care, home health care or hospice care.
- Part B: This covers any medical-related expenses like medical supplies, doctors’ services or preventative services.
- Part D: This pays for prescription drugs or vaccines.
Methodology
MoneyGeek's research is based on estimates, and the cheapest plan for you will depend on your individual needs and characteristics. This analysis is intended to serve as a guide and no single plan is guaranteed to be the cheapest in Hawaii for you
MoneyGeek collected plans and premiums for health insurance in Hawaii from the Health Insurance Exchange Public Use Files (Exchange PUFs) for all available metal tiers and across several age groups.
Health insurance premiums on this page are an estimate and exclude potential premium tax credits and cost-sharing subsidies that users may be eligible for.
About Mark Fitzpatrick
sources
- Healthcare.gov. "Catastrophic health plans." Accessed June 13, 2021.
- Healthcare.gov. "How insurance companies set health premiums." Accessed June 13, 2021.
- State of Hawaii. "MEDICAID FAQS." Accessed June 13, 2021.