General information, not insurance advice or medical advice. This page explains how health insurance works in Hawaii using published figures. It is not a quote and not advice about what coverage you should buy. Confirm your coverage with a licensed insurance agent or the official sources listed below.
Last verified: 12 November 2026.
The short answer
Hawaii is different from every other state when it comes to health insurance. Almost every employer must offer health coverage by law, and a 40-year-old buying on the federal marketplace pays about $541 a month for the benchmark Silver plan before subsidies. Only two insurers sell individual coverage in Hawaii — HMSA and Kaiser. Uninsured residents are only about 3–4% of the population, among the lowest rates of any state.
Most people in Hawaii get covered in one of three ways: through a job, through the federal marketplace (HealthCare.gov), or through a government program — Med-QUEST (Hawaii’s Medicaid program) or Medicare (people 65 and older, and some younger people with disabilities).
The big picture — at a glance
Hawaii is the only state with a universal employer health-insurance mandate. The Prepaid Health Care Act (1974) requires most employers to offer health coverage to employees who work 20 or more hours a week and earn at least $1,386.72 a month (2026). The employer must pay at least half the premium, and the worker’s share cannot be more than 1.5% of their wages. The result: 97% of Hawaii employers offer health coverage — the highest rate of any state.
HMSA holds about two-thirds — about 66% — of Hawaii’s commercial (employer and individual) health insurance market, according to the AMA’s 2026 report (2024 data), “10 states with the least competitive health insurance markets.” Kaiser Permanente Hawaii holds about 25% of the commercial market. Together, HMSA and Kaiser hold roughly 90% of the commercial book.
On the marketplace, a 40-year-old in Hawaii pays about $541 a month for the benchmark Silver plan and about $414 a month for Bronze, before premium tax credits. Med-QUEST covers about 390,000 residents — roughly 27% of the state’s population. Medicare’s standard Part B premium in 2026 is $202.90 a month, with a $283-a-year Part B deductible.
Guides in this section
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Medicare in Hawaii: Parts A, B, C, D and Medigap
Medicare covers people 65 and older, and some younger people with disabilities. In 2026 the standard Part B premium is $202.90 a month and the Part B deductible is $283 a year.
Medicare Advantage in Hawaii
Medicare Advantage (Part C) is a private plan that replaces Original Medicare and usually includes drug coverage. In Honolulu County there are 28 Medicare Advantage plans from 8 insurers in 2026, led by HMSA Akamai Advantage ($0–$75 a month) and Kaiser Senior Advantage ($0–$60 a month).
HMSA vs Kaiser in Hawaii
HMSA holds about 66% of Hawaii’s commercial market and has the widest network; Kaiser holds about 25% and usually costs about $25–$40 a month less. This guide compares their premiums, networks and how care works.
Hawaii ACA Marketplace Guide
HMSA and Kaiser are the only two insurers on Hawaii’s marketplace. A 40-year-old pays about $541 a month for the benchmark Silver plan and about $414 for Bronze, before tax credits, and open enrollment runs November 1 to January 15.
Med-QUEST (Hawaii Medicaid)
Med-QUEST covers about 390,000 residents — roughly 27% of Hawaii’s population — with no premiums for most adults. Adults may qualify with income up to 138% of the federal poverty level, about $2,112 a month for a single adult, and can apply any time.
Hawaii’s Prepaid Health Care Act
Hawaii’s 1974 Prepaid Health Care Act requires most employers to offer coverage to employees working 20 or more hours a week. Employers must pay at least half the premium, workers pay no more than 1.5% of wages, and 97% of Hawaii employers offer coverage.
Sources
- Hawaii Department of Labor and Industrial Relations, Prepaid Health Care Act (HRS Chapter 393)
- AHIP, July 20, 2026 analysis (97% employer offer rate) — via liveinsurancenews.com
- KFF, 2026 Average Marketplace Premiums by Metal Tier (benchmark Silver Hawaii $541)
- CMS, “2026 Medicare Parts A & B Premiums and Deductibles,” Nov 14, 2025 (updated Mar 3, 2026)
- Hawaii Med-QUEST Division, 2026 MAGI Income Standards Chart (effective Jan 13, 2026)
- AMA, “10 states with the least competitive health insurance markets” (2026 report, 2024 data)
Health insurance rules and prices change often. Verify current premiums and eligibility with the official sources above before you enroll.