Hawaii’s New High Risk Pool

November 8, 2010, 9:30 AM HST · Updated November 8, 9:30 AM
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For Hawaiian residents with pre-existing conditions, finding affordable health insurance can be very challenging. However, insurance prospects improved significantly in July of this year, thanks to a new high risk pool that the state is now offering. This pool is a part of the federal healthcare reform and provides insurance coverage to individuals who were previously unable to find affordable health insurance through other means. This article will explain the details of the high risk pool to help Hawaiians know if this insurance option is the best one for them.

Who is Eligible?

To qualify for health insurance coverage through Hawaii’s high risk pool, you must:

  • Be a citizen of the United States or in the country legally
  • Have been previous uninsured for six months or more before you can apply
  • Have been rejected for insurance coverage in the past, due to your pre-existing condition

If you meet the above criteria, you may be able to purchase affordable medical insurance through Hawaii’s high risk pool set up specifically for people like you.

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What is the Cost?

Most people with pre-existing conditions know that finding health insurance at an affordable price is nearly impossible. Even if you find a company willing to provide you with coverage, the premiums charged for the insurance may be way out of your budget range. However, the Hawaii high risk pool offers much more affordable coverage than you may have found in the past, with the following monthly rate guidelines:

  • Ages 0 -34: $215
  • Ages 35 – 44: $258
  • Ages 45 – 54: $330
  • Ages 55+: $459

While these rates may seem somewhat steep, they are typically much less than what many private insurance companies charge for members with pre-existing conditions. However, all of your medical care will be included in the coverage, even care for your pre-existing condition. This is very different from many insurance policies that refuse to cover any medications or doctor’s visits that might be associated with your pre-existing condition.

What is Covered?

Under the high risk insurance plan, primary and specialty care will be covered, as well as hospitalizations and prescription drugs. The plan comes with a $2,500 deductible that will need to be paid in full before coverage can begin. This deductible does not apply to any type of preventative services, under the healthcare reform act. Once the deductible is covered, you will be responsible for $25 co-pays for doctor’s visits and 20% of other medical care. Prescriptions may cost anywhere from $4 to $30, depending on the type of medicine used.

Health insurance is now available to Hawaii residents with pre-existing conditions for a reasonable price. With the high risk pool in full swing, everyone in Hawaii who needs health coverage will now be able to get it.

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