What Uninsured Need to Know
Don’t have health insurance? Health care reform will affect you. Health care reform was created to help you get health insurance and protect you from serious health and financial problems. We’ll help you choose a plan that’s right for you.
Get health insurance – it’s the law
By March 31, 2014, you must buy health insurance or pay a federal government fine:
- 2014: $95 or 1 percent of your income, whichever is greater
- 2015: $325 or 2 percent of your income, whichever is greater
- 2016: $695 or 2.5 percent of your income, whichever is greater
Is anyone excluded from paying a fine?
There are a few exceptions to the penalty, including:
- Religious reasons
- Not present in the United States
- In prison
- Not able to pay for coverage that is more than 8 percent of the household income
- An income that is below 100 percent of the poverty level
- Having a hardship waiver
- Not covered for less than three months during the year
Learn more at healthcare.gov.
Easier to get coverage
Starting January 1, 2014, you can’t be denied coverage even if you have a serious health condition.
Options for buying a health plan
Starting in October, you can buy health insurance directly from HMSA for personal service or through the Hawai‘i Health Connector, which is an online marketplace that will offer health insurance, including HMSA health plans.
More affordable than you think
Depending on your income, you may qualify for financial help to pay for health insurance premiums and out-of-pocket costs by going through the Hawai‘i Health Connector. Or you could qualify for QUEST, the state Medicaid program, which cost nothing.
How much will it cost?
Starting in 2014, the cost of your health plan will depend on your age and rates may be adjusted based on tobacco use. Health plans for older people may cost more than plans for younger people.
What do I get with my health plan?
Starting in 2014, your health plan will offer these 10 essential health benefits:
- Prescription drugs
- Ambulance service
- Emergency care
- Laboratory services
- Maternity and newborn care
- Mental health and substance use services
- Pediatric oral and vision services
- Rehabilitation and habilitative services
- Services for preventive care, wellness, and chronic disease management
Why do I need health insurance?
Health coverage could save you money in the long run. Without health insurance, you and your family’s health and finances are at risk from high medical costs. Accidents, surgeries, treatments, medications, and specialty care can easily cost you hundreds of thousands of dollars without insurance. And preventive care, such as screenings for cancers, diabetes, and heart disease, will protect your health.
I work part-time and don’t have coverage
If you work part time (less than 20 hours a week) and don’t have health insurance, you’ll need coverage by March 31, 2014, or pay a fine to the Internal Revenue Service. Because of health care reform, you won’t be denied health insurance, even if you couldn’t get coverage in the past because of a serious health condition.
You can buy an HMSA individual plan directly from us or in the Hawai‘i Health Connector, the state’s online health insurance marketplace. Depending on your income, you could be eligible for financial help to pay for health insurance if you buy it from the Connector.
This information is based on HMSA’s review of the Affordable Care Act (ACA). This overview is intended for educational purposes only and should not be used as tax, legal, or compliance advice.