HMSA Silver PPO
Silver · PPO · HMSA · Hawaii
At age 40 it costs $695.10 a month before any subsidy.
What this Silver plan costs if your income qualifies
Below certain incomes the marketplace improves a Silver plan's cost sharing automatically — you do not apply for it, and it happens on Silver and on no other metal level. The premium does not change; the deductible and what you pay at the doctor do.
| If your income is | Deductible | Most you could pay in a year | Primary care | Generic drugs |
|---|---|---|---|---|
| Above 250%, or not applied for | $6,000 | $8,900 | $40 | $20 |
| up to 150% of the federal poverty level | $0 | $2,200 | No Charge | No Charge |
| 150% to 200% | $700 | $3,300 | $20 | $10 |
| 200% to 250% | $3,000 | $7,400 | $40 | $20 |
CMS calls these cost-sharing reductions. The percentages are actuarial values, not discounts. HealthCare.gov works out which one you get from the income you report when you apply.
What CMS publishes about it
| Plan ID | 18350HI0880017 |
|---|---|
| Insurer | HMSA |
| Metal level | Silver |
| Plan type | PPO |
| Standardised design | Design 1 — a plan CMS defined the benefits of, so it can be compared like for like |
| Deductible (individual) | $6,000 |
| Deductible (family) | $12,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $8,900 |
| Family maximum | $17,800 |
| Primary care visit | $40 |
| Specialist visit | $80 |
| Emergency room | 40% Coinsurance after deductible |
| Inpatient stay | 40% Coinsurance after deductible |
| Generic drugs | $20 |
| Preferred brand drugs | $40 |
| Specialty drugs | $350 Copay after deductible |
| Adult dental included | No |
| Child dental included | No |
| Share of premium buying essential health benefits | 98.97% |
| Network directory | Who is in network |
| Summary of benefits | Summary of benefits and coverage |
| Drug list | Formulary |
| Customer service | 1-800-620-4672 · TTY 1-877-447-5990 |
Where it is sold, and what it costs there
5 counties. The premium is the price before any tax credit; what you pay depends on your income.
| County | At 21 | At 30 | At 40 | At 50 | At 60 |
|---|---|---|---|---|---|
| Hawaii County | $543.90 | $617.33 | $695.10 | $971.41 | $1,476.14 |
| Honolulu County | $543.90 | $617.33 | $695.10 | $971.41 | $1,476.14 |
| Kalawao County | $543.90 | $617.33 | $695.10 | $971.41 | $1,476.14 |
| Kauai County | $543.90 | $617.33 | $695.10 | $971.41 | $1,476.14 |
| Maui County | $543.90 | $617.33 | $695.10 | $971.41 | $1,476.14 |
Open enrollment for 2026 coverage runs 1 November 2025 to 15 January 2026 in most states. Outside that window you need a qualifying life event — losing other coverage, moving, marrying, having a child — to enrol.
Get told when this changes
When this plan’s price or benefits change.
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Premiums, deductibles, out-of-pocket maximums and cost sharing are reproduced from the HealthCare.gov Qualified Health Plan landscape file published by the Centers for Medicare & Medicaid Services for plan year 2026. Nothing on this page is calculated by us. This is not a complete list of your options and it is not advice: to see every plan and to enrol, use HealthCare.gov or call 1-800-318-2596.