How to Get Health Insurance

There are three main ways to get health insurance – through an employer, on your own, or from the government.

Through an Employer (or your Spouse's Employer)

Group Plans

Many people in Hawaii have health insurance through their job or their spouse's job. This is because Hawaii is the only state in the nation with a nifty law requiring employers to offer health insurance to employees who work more than 20 hours a week and earn at least $628 per month after four weeks on the job. (Learn more about the Hawaii Prepaid Health Care Act.) Lucky you live Hawaii!

If you have health insurance through your job, your employer chooses the coverage options available to you. They might also offer more than one type of plan or your choice of insurer. The amount that your employer will pay for your insurance will vary.

COBRA

Lost your job? COBRA lets you stay on your employer's health plan for a while.

COBRA lets you (and your dependents) stay insured, temporarily and at your own expense, after any of the following:

• Loss of job for reasons other than gross misconduct.
• Reduced work hours below the minimum required for coverage.
• The employee covered under the plan dies.
• Enrollment in Medicare.
• Divorce or legal separation.
• A child no longer meets the plan's eligibility rules.
• The employer sponsoring a retiree's plan goes bankrupt.

COBRA is only available at companies with 20 or more full-time employees, and can be used for up to 18 months. Contact your employer to find out how to enroll in COBRA.

Directly Through a Health Insurer

Individual Plans

Choose from a variety of HMSA health plan options that fit your health and budget needs.

Learn more

Not everyone has health insurance through their job or the government. Many people buy health insurance on their own.

Paying for an individual health plan can put a squeeze on your budget, especially if your family members also need coverage. That's because you pay for the monthly premiums on your own without anyone (like an employer) to share the cost.

But health insurance gives you a safety net to protect you from the total cost of health care. Let's say you fall off a bike and need to go to the emergency room because you broke your leg. The cost of the ER visit, seeing a doctor, X-rays, a cast and crutches, pain medication, and follow-up doctor visits could cost you $5,000. If you didn't have health insurance, you'd end up paying the entire $5,000. With health insurance, you might only have to pay $100 and your health plan would pay the remaining $4,900. That's big savings.

Through the Government

QUEST

On a limited income? You don't have to go without insurance.

QUEST is Hawaii's Medicaid program in which the state pays a health plan to provide medical and mental health coverage. Medicaid is a joint federal/state program that's available to low-income families and children, pregnant women, the elderly, and people with disabilities. If you qualify for QUEST, you pick a plan from a private health insurer.

To find out if you're eligible, call the Med-QUEST Division or visit their website for more info.

Medicare

Medicare is a federal program that provides basic health benefits to people 65 years or older and to certain disabled individuals. Medicare has four parts:

• Medicare Part A. Covers hospital stays and emergency care.
• Medicare Part B. Covers doctor's office visits. Together, Part A and Part B are often referred to as Original Medicare.
• Medicare Part C. Known as Medicare Advantage, it provides all the benefits of Part A and Part B and may include Part D prescription drug coverage. Medicare Advantage plans are offered by private health insurance companies.
• Medicare Part D. Prescription drug coverage.

Keep in mind that Medicare does not cover all of your medical costs. You will still have to pay a portion of expenses out of your own pocket, such as premiums, copayments, coinsurance, and deductibles.