Hawaii Health Insurance Guide and Information

Health Insurance in Hawaii

This was created for the Hawaii resident. It explains important health plan features and information about health insurance in Hawaii. It will not answer all questions for all situations and it is not a substitute for legal advice. Should you have questions see the last page for contact information.

Health Plans Must Provide

• Complete descriptions of coverage, benefits, services, and copayments
• An explanation of the referral process, if any
• Information on where services or benefits may be obtained
• Information on complaints and appeals procedures
• The telephone number of the Hawaii Insurance Division
• A list of participating providers (updated regularly)
• Dependent coverage continuation for adult mentally retarded and handicapped children
• Family plan coverage of newborn children from birth for necessary care and treatment of medically diagnosed congenital defects and birth abnormalities (including adopted children with written notice)
• Family plan coverage for child health supervision services from birth to age five
• Annual mammography after 40
• Medical services without face-to-face contact with the provider
• One-time (per plan) in vitro fertilization
• Contraceptive services and supplies
• Hospice care
• Treatment of inborn error of metabolism (medical foods and low-protein modified food products)
• Coverage for diabetes
• Dependent Enrollment Regardless Of Enrollment Season With Child Support Order
• Reciprocal Beneficiary Coverage If Family Coverage Is Offered
• Adopted Children The Same Treatment As Dependent Children
• Alcohol And Drug Dependence Treatment Services
• Mental Illness Treatment Services

Health Insurers Cannot

• Cancel your insurance because you get sick
• Penalize you in any way for filing a complaint against them
• Discriminate against victims of domestic abuse
• Require you to disclose genetic information or discriminate with regard to genetic information
• Take Medicaid status into account
• Deny children coverage for being born out of wedlock
• Deny children coverage for not being claimed on tax return
• Deny children coverage for not living with the parent
• Deny children coverage for not living in the service area