Hawaii Individual Health Insurance Plans
In Hawaii, it has been a requirement since the year 1974 that every employer must provide Hawaii health insurance plans to his employees. This is the reason why Hawaii has the most number of health insured residents. However, those who cannot gain access to employer-sponsored group health plan can go apply for Hawaii individual insurance plans. Although they are both health plans, Hawaii individual health insurance plans are quite different from group health plans. There are limitations and rules that only exist in Hawaii individual health insurance companies. Group health plans, on the other hand, have different terms and conditions from Hawaii individual health plans. An example of this is pre-existing condition and its exclusion periods.
Still, Hawaii Health Insurance Law has required certain services to be covered by both kinds of Hawaii health plans. These are mammograms for adult women above forty years of age, care for diabetes, mental health parity and treatment for both alcohol and drugs. Any Hawaii health insurance company cannot terminate or decline a consumers insurance claim because he got sick or injured, nor can the insurance company reject the coverage renewal of a person. This is because of a protection called guaranteed renewability. However, this protection can be forfeited only if the person does not pay his premiums regularly or he defrauds the company.
Individuals who used to be enrolled in group health plans can still apply for Hawaii individual health insurance. Before Hawaii individual health insurance policy can be granted to a person, the insurer has to examine and interview the person first. This is apparently regarding the applicants health status because the granting of Hawaii health insurance depends upon the health condition of a person. If the applicant is proven healthy then it is most certain that his application will be approved. Otherwise, if he has recent health problems, then it is possible that his application for Hawaii health insurance plans will be rejected.
However, if he is HIPAA eligible, then the company cannot reject him and must offer him at least two Hawaii health plans. Another protection that a HIPAA eligible individual has is being free from pre-existing condition exclusion periods. However, the protection ends once he joins a Hawaii individual health insurance plan. To regain the protection and be a HIPAA eligible again, it is required that the individual rejoins a group health plan.
If you wonder what a HIPAA is, it is a federal law which protects individuals who were formerly enrolled in a group health plan and are looking for new Hawaii health insurance plans. As aforementioned, the individual who is a HIPAA eligible is exempted from exclusion periods of pre-existing conditions or elimination rider. One of the considered pre-existing condition is pregnancy.
There is no standard rate for Hawaii individual insurance premiums, nor is there a standardized policy. Each insurance company can design his own policy and rate. Individuals who have expensive health conditions can expect higher premiums than the usual. As they age or the health worsens, the premiums also increase inevitably.