Open Enrollment (Healthcare Coverage)

The Affordable Care Act (ACA) signed into law in 2010 requires every American to have minimum essential healthcare coverage. Most people in Hawaii are already covered due to the Prepaid Health Care Act, which mandates that all employers with one or more employees, whether full-time or part-time, provide coverage for them. Information on the Hawaii Prepaid Health Care Act is available here.

If you live in Hawaii and do not have healthcare coverage through your employer, or you are self-employed or need to buy your own insurance, you can purchase health insurance through the Health Insurance Marketplace online at healthcare.gov. Open enrollment for 2018 health plans runs from November 1, 2017 to December 15, 2017. As of 2015, Hawaii no longer operates a state-based exchange.

The following information may be helpful to currently uninsured individuals as well as Hawaii residents who enrolled in a 2017 Marketplace plan and are looking to continue coverage.

Current Customers
For consumers who purchased 2017 health insurance through healthcare.gov, your coverage will end on December 31, 2017. If you take no action, you will be automatically re-enrolled in your current plan, or - if it is no longer offered - something similar.

There are several important reasons that you should still visit healthcare.gov during open enrollment:

  • Your income and employment information may be out of date. Updating this information will ensure that any financial assistance you receive is calculated accurately - and help keep things simple for you during income tax season.

  • Your insurance company may have made changes to your coverage. Insurers sometimes change things like hospital networks and co-payment rates. Log in to make sure your plan still meets your needs and your budget.

  • New plans may be available that better suit your needs. Even if you were satisfied with your 2017 plan, it's still a good idea to review any new options for 2018 coverage on the marketplace.

New Customers

If you live in Hawaii and do not have health insurance, you may use www.HealthCare.gov to access health coverage for 2018. Open enrollment is an opportunity to compare the various health plans available to you and find out if you qualify for financial assistance. During last year's open enrollment period, over 13,000 Hawaii residents were eligible for some form of financial assistance made available through the Affordable Care Act. Every plan available on www.HealthCare.Gov is required to cover certain essential benefits, such as prescription drug coverage, doctor’s visits, hospital stays, primary care, and more.

FREQUENTLY ASKED QUESTIONS

Am I eligible for healthcare.gov?
To be eligible to enroll in health coverage through the Marketplace, you:

  • Must live in the United States

  • Must be a U.S. citizen or national (or be lawfully present). Learn about eligible immigration statuses.

  • Can't be incarcerated

If you have Medicare coverage, you’re not eligible to use the Marketplace to buy a health or dental plan. Learn more about Medicare and the Marketplace.

 

What are the important dates for enrolling in 2018 health coverage?

  • November 1, 2017: Open Enrollment begins.

  • December 15, 2017: Open Enrollment ends. After December 15, you can still buy a health plan if you qualify for a Special Enrollment Period.

  • January 1, 2018: Plans that were sold during Open Enrollment start.

 

Is Healthcare.gov be available 24/7?
No. This year, healthcare.gov will not be accessible on Sundays from 12am to 12pm EST, except on Dec. 10, 2017. Also, please anticipate outages on opening night, Nov. 1, 2017. Be sure to mark your calendars accordingly to ensure you meet the requirements of the open enrollment period

What Qualifies as Special Enrollment?
Certain life events may qualify you to obtain coverage through a special enrollment period beyond the Dec. 15, 2017 open enrollment deadline. If you do not qualify for a special enrollment period, please make sure you have secured a plan by the open enrollment deadline.

Special Enrollment periods are available for many reasons, such as loss of coverage, changes in household size, and changes in residence, among others. A detailed list of qualifying changes is available here.

What is Auto-Enrollment?
If you have a plan from 2017 and do not update your information or double-check on your plan status, you may be auto-enrolled in a plan on December 15, 2017, the last day for open enrollment. Even if you suspect you will be auto-enrolled, it is always better to log in to your account and verify your plan before it becomes too late to make any changes.

For some, auto-enrollment may be an issue, since the open enrollment dates are shorter than in previous years. For example, if your plan premiums rose a lot for 2018 and you did not double check your plan’s auto-renewal before the December 15, 2017 deadline, you may be stuck with an unaffordable plan for the entire year.

More information on auto-enrollment is available here.

Where can I find 2018 plans and prices?
Hawaii residents can view 2018 plans and prices here: https://www.healthcare.gov/see-plans/

What If I Need to Renew, Change, Update, or Cancel My Plan?
If you had a marketplace plan in 2017, you can make changes during open enrollment. Additional information is available here.

If I have trouble with my application, is there anyone to help me?

Live representatives with www.HealthCare.Gov are available at 1-800-318-2596.

Which Insurers are Available in Hawaii?

Both Kaiser and Hawaii Medical Service Association (HMSA) will participate in Hawaii’s market in 2018. Both insurers have filed proposed rate changes, though some rates may not be finalized so make sure to double-check your premiums and out-of-pocket costs, especially if you had coverage in 2017 and will be auto-renewing your plan

What If I Have a Pre-Existing Condition?

The ACA still guarantees coverage despite any pre-existing health conditions you may have.

What if I have health insurance through my job?

The Marketplace is designed for people whose jobs do not provide health care benefits, or individuals who are self-employed and need to buy their own insurance. If you have job-based health insurance you like, you can keep it. You're considered to have what the Affordable Care Act qualifies as minimum essential coverage. You don't need to change to a Marketplace plan in order to avoid the individual mandate penalty.

What if I have Medicare or Medicaid?
If you receive coverage through Medicare or Medicaid, you do not need to apply for health insurance through the Marketplace.

Where can I get local advice about my health care options?
Authorized navigators can help you enroll in the Marketplace. For a list of authorized navigators, click here

Will I Be Eligible for Premium Tax Credits?
Premium Tax Credits, or “premium subsidies,” still are available in the exchange for individuals with income up to 400% of the federal poverty level (FPL). As an estimate, for 2018, a single person can earn up to $48,240, and a family of four can earn up to $98,400, in order to be eligible for tax credits through the exchange. These figures still are subject to change. It’s important to note that premium tax credits only are available if you sign up for coverage through the exchange

How Can I Estimate My Savings?
In order to receive subsidies or tax credits, coverage must be purchased on the exchange. A tool that helps you estimate your savings is available here.

 

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