Welcome to the fastest way to find out about Obamacare in Hawaii.
Here, you'll find clear and accurate information about Obamacare, including:
whether or not you must get health insurance
what the available plans cover
how much coverage will cost, and
how to sign up for a plan.
To begin, keep in mind these three key points about Obamacare in Hawaii:
1. You must have health insurance, unless you qualify for an exemption.
Beginning March 31, 2014, to avoid paying a tax penalty, you must be enrolled in a health insurance plan or qualify for an exemption from the law. (The March 31 deadline has been extended for some people who have made a good faith effort to sign up by that date. For more information, see our Obamacare Blog.) You will report whether you have coverage -- or whether you are exempt -- when you file your taxes in 2015.
All health plans purchased through the Hawaii Health Connector, the health insurance marketplace for Hawaii, must include the following benefits. These are known under Obamacare as “essential health benefits”:
Ambulatory patient services (meaning outpatient care you receive without being admitted to a hospital)
Hospitalization (including surgery)
Maternity and newborn care
Mental health and substance use disorder services (including counseling and psychotherapy)
Rehabilitative and habilitative services and devices (for people with injuries, disabilities, or chronic conditions, to strengthen their mental and physical skills)
Preventive and wellness services and chronic disease management
Pediatric services (including oral and vision care)
Companies that offer plans through a state exchange will compete on price and quality of service in delivering these benefits.
Am I exempt from Obamacare?
Under Obamacare, most people who don't have health insurance will be required to pay a tax penalty. But you may not have to pay if you qualify for one or more of the following exemptions:
You are uninsured for fewer than three months of the year.
You prove that you can’t afford coverage -- that is, premiums for the least-expensive policy cost more than 8% of your earnings.
You don’t have to file a federal income tax return because your income is too low.
You are a member of a federally recognized Indian tribe.
You are a member of a health care sharing ministry.
You are a member of a recognized religion that objects to health insurance.
You are in the United States illegally.
You are incarcerated.
You may be eligible for an exemption under other circumstances, as well -- for example, if you can show that obtaining coverage would subject you to serious financial hardship.
If you have an individual insurance plan, you may keep it or use Hawaii Health Connector to compare plans and replace it. If you keep your current plan, you won't be eligible for the cost-saving subsidies available for plans purchased through the exchange.
Be sure to check with your current insurance provider before canceling a health insurance policy; you may have to wait until the end of your current policy year to make a change.
If you have insurance through an employer and you're happy with your plan, you can keep it. You're considered covered under Obamacare. On the other hand, if you're not satisfied with the coverage you have, you may be able to switch to an individual plan through Hawaii Health Connector.
Keep in mind that if you buy a plan through the exchange:
Your employer will not have to pay a portion of your monthly premiums.
You may not qualify for cost-saving subsidies, even if your income falls within the eligible range. If your employer offers coverage that is considered affordable and sufficient under the law, you won't qualify to save on premiums or out-of-pocket costs for plans purchased through Hawaii Health Connector.
What is the health insurance marketplace?
The health insurance marketplace (sometimes called an "exchange") is the new way to find health insurance under the Affordable Care Act. The marketplace for Hawaii is Hawaii Health Connector. You can use the marketplace to compare plans, learn whether you qualify for cost-saving subsidies, and sign up for the plan that works best for you.
Where can I get in-person help with my application?
In Hawaii, if you need help understanding your options for coverage under Obamacare or signing up for a plan, you can get free assistance from a certified Marketplace Assister or from a certified agent or broker.
Assisters can explain your options, answer your questions, and help you apply for the plan you choose -- but they can't recommend a specific plan for you. Private insurance agents or brokers are allowed to offer suggestions about particular plans.
"Open enrollment" is the period of time, once a year, when you can choose or change your insurance provider or what kind of plan options you want -- for example, monthly premium and annual deductible amounts -- for the upcoming calendar year.
For the first year of Obamacare, the open enrollment period begins on October 1, 2013 and closes on March 31, 2014. For the second year, open enrollment begins on November 15, 2014 and closes on December 7, 2014. Thereafter, open enrollment is expected to run from October 15 to December 7 of any given year.
Choose carefully, because after you make your choices, you must live with them until the next open enrollment period.
"Special enrollment" is an exception to the enrollment rules available for job-based insurance. If you qualify for special enrollment, you can sign up during a time period outside of the open enrollment period.
You should purchase a plan from the marketplace in the state you consider your primary residence -- where you vote, pay taxes, and so on. But snowbirds need to be sure they choose an appropriate “multistate” plan.
Some multistate plans may be restricted to a certain region – for example, a metropolitan area that straddles state boundaries. Others will be more appropriate for someone who migrates longer distances, spending, say, summers in Alaska and winters in Arizona.
Ask the insurance provider for details, and don’t sign up for a plan until you’re sure it will cover you where and when you need it.
What if I travel frequently?
Traveling shouldn't present any problem under a marketplace insurance plan. Simply sign up for a plan in the state of your primary residence. The plan will cover you in case of emergencies that happen out of state.
For more information about Obamacare in any state, including a link to the state’s health insurance exchange, choose the state from this list.
Information & Documents to Have on Hand
Here's a checklist of information to gather before you apply for health coverage at Hawaii Health Connector.
Social Security numbers for you and other members of your household who will be covered by your insurance plan
Policy numbers for any current health insurance plans
Documents to help you calculate your annual income. Include all sources, such as employment, pensions, alimony, rental property, or other income. If you have a job, gather together pay stubs or W-2 forms. If you’re self-employed, have last year’s tax return handy, as well other records that can help you estimate your yearly income.
If you or anyone in your household is eligible for job-based health insurance, a completed Employer Coverage Tool for each available plan
A good idea of your budget for health insurance, so you know how much you can afford to spend each month. This will help you choose the best plan from among those offered to you.
Finally, keep a list of any questions you want answered before you sign up for a health insurance plan. To get answers to your questions, or for information on signing up for a plan, see How Do I Sign Up for Obamacare in Hawaii?
Glossary of Obamacare Terms
The health care and insurance industries have their own lingo, which can be confusing.
To learn more about the new terms you encounter, see the glossary from HealthCare.gov, below. If your state has its own glossary, we link to that, too.
Press Release: New Website Provides Local Obamacare Information
September 23, 2013
A new website, ObamacareByZipCode.com, gives people the answers they need about the Affordable Care Act (Obamacare). In plain English, it guides consumers to reliable, local information about their new health insurance options.
When users choose their state or enter their zip code, they will quickly find:
whether or not they’re required to get health insurance
what the available plans cover
how much coverage will cost, and
how to sign up in each state.
For consumers concerned about cost, the site shows how to determine whether they qualify for subsidies. It also explains the new rules about expanded Medicaid eligibility.
The new site was created by Albin Renauer, founder of LegalConsumer.com, and is coauthored by Renauer and legal editor and writer Shae Irving. LegalConsumer, which until now has concentrated on consumer bankruptcy, began in 2005, when Congress overhauled federal bankruptcy laws.
“When politicians tried to make it harder to file bankruptcy, I vowed to make it easier. When I read about politicians making it hard to get information about Obamacare, it got my blood boiling -- and I realized I could help folks find that information the same way I do with bankruptcy.”
Some states, says Renauer, are hiding the ball when it comes to the new options for healthcare coverage under Obamacare. Missouri, for example, has not created an insurance marketplace (exchange), forbids state officials from cooperating with the federal government, and provides no information. “It is being run like a covert operation, with no marketing or detailed information about its products or their prices,” wrote the New York Times. (Missouri Citizens Face Obstacles to Coverage, Aug. 2, 2013.)
On ObamacareByZipCode.com, all consumers need to do, says Renauer, is start with a zip code. The site will guide them to all the official local resources they need to make sure they get the maximum benefits under the law.
Another reason for expanding a bankruptcy website to cover health care reform? It’s obvious to Renauer: “Huge medical bills are a major reason that people are forced into bankruptcy.”
LegalConsumer.com has helped more than a million consumers navigate the bankruptcy process by providing a free online “means test calculator,” which shows people whether or not they’re eligible to file for bankruptcy.
After receiving his J.D. from the University of Michigan Law School in 1985, Albin Renauer worked for various public-interest law firms in the Bay Area and as a staff attorney for Chief Justice Rose Bird of the California Supreme Court. He spent 17 years as an editor at leading do-it-yourself legal publisher Nolo, where he helped create numerous books and software programs, including the bestselling Quicken WillMaker. He also edited Law on the Net, the first online directory of legal resources, and was the architect of Nolo's Webby Award winning website.
Despite what you may have heard, you can’t be arrested or thrown in jail if you don’t have health insurance in Hawaii. You may, however, be forced to pay a tax penalty if you aren't enrolled in a health insurance plan by March 31, 2014.
To avoid the penalty, you must either obtain qualified health coverage or prove your eligibility for an exception.
What Qualifies as Coverage?
If you have any of the following types of health coverage, you won’t have to pay a penalty:
This article explains the costs of health care plans offered under Obamacare (the Affordable Care Act of 2014) for individuals or families who are currently uninsured or not covered by a job-based health plan.
What you'll pay for an Obamacare plan depends on five things:
The easiest way to sign up for a health plan under the Affordable Care Act is to go to the online health insurance marketplace for Hawaii. If you're not ready to enroll right now, you can get more information online, over the phone, or in person.
Where's the Hawaii Health Care Exchange?
You can find the health insurance exchange for Hawaii at Hawaii Health Connector. This is where you can learn about the various health insurance options available to you under Obamacare. If you see a plan you like, you'll be guided through the enrollment process online. If you prefer to apply with a paper application, call the Hawaii Health Connector customer service center or contact an assister using the information just below.
Since the launch of Obamacare on October 1, the federal and state health insurance marketplaces (also called “exchanges”) have been plagued by technical troubles. Many, perhaps most, people who have tried to sign up for new health insurance plans online have been unable to complete their applications.
Because of these difficulties, some individuals and application assistants are turning to the old-fashioned way of getting health insurance -- paper applications.
Applying on Paper May Not Be Better or Faster
When facing a slow or broken online health insurance exchange, using a paper application may seem tempting -- at least it would provide the feeling of getting something done. However, paper forms may not speed up the process at all. On the contrary, they could slow down your application even more.
The worker who reviews your paper application must manually enter the information from your forms into the same system you would use online at your state’s exchange. It won’t work any faster for them than it does for you. Plus, using a paper application opens up more opportunity for error by putting more people between you and your goal of getting insurance.
One way to satisfy Obamacare’s health insurance requirement is to obtain coverage under Medicaid. If you qualify for Medicaid and enroll in Hawaii's Medicaid program, you do not have to sign up for another insurance plan.
It’s Now Easier to Qualify for Medicaid in Hawaii
The Affordable Care Act expanded Medicaid eligibility to cover more people who can’t afford health insurance. The U.S. Supreme Court later decided that it was up to individual states to decide whether or not to expand Medicaid.
Because Hawaii did decide to expand its Medicaid program, you can qualify for Medicaid if you earn up to 138% of the federal poverty level. In 2014, that’s about $18,520 for a single person, or $37,850 for a family of four.
If you received a notice from your health insurance company saying your insurance plan has been cancelled, you’re not alone. Millions of Americans have learned they may not be able keep their existing health coverage under Obamacare. Cancellation is primarily affecting those who purchase individual insurance plans, such as the self-employed, but some people employed by small businesses are losing their existing coverage, too.
The Obama administration, Congress, and insurance providers have engaged in a strenuous debate over whether the cancellations will stand or whether some individuals will be allowed to continue coverage under their cancelled plans for another year or more. On March 5, 2014 the Obama administration announced that you can keep your cancelled policy through 2016. The catch is that state insurance officials must agree to this extension. So far, about half states have decided to allow renewals, while the rest have decided against them.
To learn whether you may have the option of keeping your existing plan, contact your insurance provider.
Many self-employed people will be quick to tell you that getting and paying for health insurance is one of the biggest hassles they face. But this may change for the better under Obamacare, which provides new coverage options for the self-employed.
Are You Self-Employed or an Employer?
Before you start evaluating your new options for health coverage, you need understand whether you are in fact considered self-employed under Obamacare.
The law says you are self-employed if you are an independent contractor or a sole proprietor without employees. (If you hire other independent contractors to do some work for you, you probably still qualify as self-employed.) Self-employed people can use the new health care marketplace to purchase individual health insurance plans.
The difficulties of unemployment are often compounded by the lack or loss of health insurance. But millions of Americans who are currently without both a job and health coverage may find relief under Obamacare. That's because new coverage options are now available through Hawaii Health Connector, the health insurance marketplace serving Hawaii.
All plans available through the marketplace offer essential medical benefits, including preventive care, emergency services, and prescription drug coverage. You can't be turned away if you have a pre-existing medical condition and, as an unemployed person, you probably qualify for significant cost-saving subsidies.
When you sign up for a marketplace health plan, your coverage can start within a few weeks. Usually, you must sign up during an open enrollment period. (For 2014, open enrollment closed on March 31. The next open enrollment period begins on November 15.) But leaving your job and losing job-based health insurance makes you eligible for a special enrollment period. That means you'll have 60 days to sign up for a new health plan.
When it comes to Obamacare, Hawaii business owners are in a unique position. That’s because an existing state law, the Hawaii Prepaid Health Care Act, already requires most employers to provide health coverage to employees who work at least 20 hours per week.
Hawaii’s law goes well beyond Obamacare’s employer mandate, which requires employers to offer health insurance only if they have 50 or more full-time equivalent employees. (For a definition of FTE, see the end of this article.)
Here’s a summary of key points about Obamacare for Hawaii small business owners:
You must comply with Hawaii’s more stringent health insurance rules. As mentioned above, Hawaii law requires you to offer health insurance to most employees who work at least 20 hours per week. You must meet these requirements, even though the federal law is not as strict.
Under Hawaii law, employers may refuse health care coverage to only the following types of employees:
those who work less than 20 hours per week
federal, state, and county employees
agricultural seasonal workers
insurance or real estate salespeople paid only by commission
people working for a spouse or child, and
people under the age of 21 working for their parents. more...
As a business owner, you may have heard the buzz about Obamacare’s “employer mandate.” Maybe you’re still wondering what it is and whether it applies to you. The short answer is that most Hawaii business owners won't have to worry about the Affordable Care Act's employer mandate, because state law already has you covered.
What Is Obamacare's Employer Mandate?
Soon, the federal Affordable Care Act (ACA) will require businesses employing 50 or more full-time-equivalent (FTE) workers to offer insurance coverage or face a tax penalty. This law will apply to businesses in which even one employee would qualify for cost-saving health insurance subsidies through Hawaii Health Connector, the health insurance marketplace for Hawaii.
You can learn more about the employer mandate here.
Why Obamacare's Employer Mandate Won't Affect Most Hawaii Business Owners
The new law is likely to have little effect on owners of large businesses in Hawaii, because existing state law includes a mandate that is much stricter than the ACA's. The Hawaii Prepaid Health Care Act (PHCA), passed in 1974, requires employers with even one employee to provide health coverage to those who work at least 20 hours per week.
If you’re stymied by your health care choices under Obamacare -- or if you’re having a difficult time completing an application -- there are many ways to get help. For example, you can call the Hawaii health insurance exchange for telephone support or obtain free, in-person guidance from trained assisters or “navigators.” You can also seek help from a licensed insurance agent or broker.
Given the flawed and confusing rollout of the new health care marketplaces, getting help from an agent or broker is turning out to be an attractive option for many people. Agents and brokers, while grappling with most of the same delays and technical troubles faced by individuals, can make the process easier in several important ways, including:
When registered domestic partners or civil union partners apply for coverage in the new health insurance marketplace, there’s one question that almost always arises: Do we apply based on our separate incomes, or must we include all the income we make as a couple?
The answer depends on the state where you live.
States other than California, Nevada, or Washington. In almost all states, registered domestic partners or civil union partners who apply for insurance via the state’s health insurance exchange must do so separately. Each partner includes only his or her separate income, and this amount determines health plan costs and eligibility for cost-saving subsidies. It works this way because domestic partners are not considered married for federal tax purposes. (If you registered first and got legally married later, this article doesn't apply to you. You must apply as a married person and report your combined income.)