Coverage Limitations, Costs and More Information on Hawaii Health Insurance

What Consumers Should Know About Health Insurance

Coverage limitations. Health insurance does not cover everything. For example there is an exclusion for investigational or experimental procedures. This means that the health plan may not pay for something your doctor recommends for you if the scientific evidence supporting its effectiveness is not fully developed. If you have an individual policy, there may be an exclusion for pre-existing conditions. These are just examples; the number of limitations on coverage are too numerous to be described here. You must read your summary plan description carefully to determine exactly what is covered and what is not. Coverage limitations can result in your being out of pocket a substantial sum of money because you may have to pay the full cost of treatment yourself. People are often surprised at how expensive medical treatment is. In an ideal world, we would all maintain a sizable cash reserve for these unexpected contingencies. Before undergoing treatment, consult with your healthcare provider to make sure that coverage will be available.

Premiums and medical costs. Health insurance premiums are rising in Hawaii and nationwide because the underlying medical costs are rising. This is a problem not only for individuals, but also for businesses which provide the majority of health insurance coverage. To put it in perspective, national health care costs were 4% of GDP in 1950, 15% of GDP in 2003, and are projected to be 19% of GDP in 2014.

A trend to be aware of. Because of rising costs, there is a trend in health plan design towards increased cost-sharing to shift costs away from businesses, deter unnecessary utilization, and to cause people to take greater responsibility for the impact of their lifestyle choices on their health. Although getting sick or injured is not always completely within our control, lifestyle choices are. Eating right, exercising, and avoiding consumption of unhealthy substances are steps in the right direction.

Coverage by Region:

Resources:

Articles:

Hawaii Health Guide Pages:

Links: