Denied in Hawaii? Here is the phone number, then the date.
Put in the date on your notice and get both federal deadlines as calendar dates.
Free, for a denial in Hawaii, and it runs entirely in your browser. The date, the plan type and the state you pick are never sent to us and never stored.
It also tells you whether your external review goes to Hawaii or to the federal process, the part that is not the same in every state.
The Hawaii consumer service is open 7:45AM – 4:30PM (Hawaiʻi Standard Time), Monday to Friday, except state holidays., and it can tell you whether your external review goes to the state or to the federal process, and in some cases it will file for you. That call costs nothing and does not use up your 180 days. The complaint form is here.
Read from cca.hawaii.gov on September 9, 2026. If the number has changed, tell us and we will fix it the same day.Insurers in Hawaii denied 203,127 in-network claims in this release, 26.3% of everything submitted.
Further down this page, after the free steps: the paid next step.
Insurance company denied claim. What do we do?
Those are the plan-year 2027 release figures, from the federal Transparency in Coverage file issued October 22, 2026. Not one of them reached independent external review.
The deadlines are federal, so they are the same in every state. You have 180 days from the date on your denial notice to file the internal appeal, and then 4 months from the final internal denial to ask for an independent external review. If waiting would seriously jeopardize your health you can ask for both to be expedited, decided in about 72 hours. Both timeframes are federal, not your insurer's choice, 29 CFR 2560.503-1 (PDF) and 45 CFR 147.136 (PDF), in plain English at HealthCare.gov, and your own denial letter states the ones that govern your plan. The PDFs are the same sections on govinfo.gov, which serves them without a challenge page, so an automated reader can check these two dates as easily as you can.
You are not alone in this, and it can be measured: insurers in Hawaii denied 203,127 in-network claims in a single plan year across 2 reporting insurers. Not one of them reached the one stage whose decision the insurer has to obey.
- Among the 29 states in the federal file, Hawaii has the first highest denial rate at 26.3%, against a national 15.7%.
- For every 10,000 claims denied in Hawaii, about 7 came back as an internal appeal.
- Of 203,127 denials in Hawaii, not one reached independent external review in the reported year.
- The reason recorded most often in Hawaii is other reasons, 66.1% of its categorized denials against 32.4% nationally.
- Find the reason code on your denial letter. Whichever of the 2 insurers reporting in Hawaii sent it, the notice has to state the specific reason and the plan provision behind it. Copy both onto paper tonight.
- Ask your insurer for the clinical criteria they judged you against. Under 29 CFR 2560.503-1 they have to hand you the claim file and the policy they applied, free, on request, and you cannot argue with a checklist you have never read.
- Put both deadlines on your calendar before you go to bed. 180 days from the date on the letter for the internal appeal, 4 months from the final internal denial for external review. The free calculator on this page turns your date into the two calendar dates in about ten seconds. Not one external review was filed in Hawaii in the reported year. Missing the date is how that happens.
None of those three steps costs anything. Anyone charging you to do them is selling you something you can do yourself in twenty minutes.
What that Hawaii external-review count means for your own denial, and by when. Not one of the 203,127 denials recorded in Hawaii reached independent external review, the stage whose decision binds the plan, Hawaii's own rows in the plan-year 2027 release of the CMS Transparency in Coverage file, read November 4, 2026 (data.healthcare.gov). Whichever way that lands, nobody files the appeal for you, and the filing runs on a clock set by which plan you hold: an employer or Marketplace plan gives you at least 180 days from the denial notice to file the internal appeal (29 CFR 2560.503-1(h)(3)(i), carried onto individual-market coverage by 45 CFR 147.136(b)(3)(i)), while Medicare Advantage gives you 65 calendar days from the date of its notice (CMS, 42 CFR 422.582(b)) and Medicaid managed care 60 calendar days from the date on the notice (42 CFR 438.402(c)(2)(ii)), both stages free, and the three steps above are the whole of what to do tonight, and the Hawaii route at the end of them is on this page. The consumer line above, the letter and the deadline calculator are all free, and none of them asks for an email.
Insurers in Hawaii
| Insurer | Denial rate | Denied | External reviews |
|---|---|---|---|
| Hawaii Medical Service Association | 26.3% | 203,127 | 0 |
| Kaiser Foundation Health Plan, Inc. | not reported | 0 | 0 |
Put the date from your notice in and get the two calendar dates, with the days remaining.
Runs entirely in your browser, the date you type is never sent to us and never stored. Open the full calculator →
Questions about appealing in Hawaii
What percentage of health insurance claims are denied in Hawaii?
26.3%, insurers in Hawaii denied 203,127 of 773,728 in-network claims across 2 reporting insurers, in the plan-year 2027 release of the CMS Transparency in Coverage Public Use File. The national rate in the plan-year 2027 release is 15.7%.
Does Hawaii run its own external review, or does the federal process apply?
Hawaii runs its own external review process meeting the federal standards, so an independent review there is handled through the state program rather than the federal one. Source: the CCIIO state external review table, linked above and read August 3, 2026. One exception matters more than the rest: This route is the one for insured plans, Marketplace, individual, and employer plans where an insurance company carries the risk. If your coverage is through a job and the employer pays the claims itself (a self-funded or self-insured plan, which is 63% of covered workers), the state process does not apply to you whatever your state operates, and your external review goes through the federal process instead. Your denial letter names your route; if it does not, ask your plan in writing whether the plan is self-funded.
My plan is through my job, does this state route apply to me?
Only if an insurance company carries the risk. If your employer pays the claims itself, a self-funded or self-insured plan, which is 63% of covered workers, your plan is not insurance and is outside state insurance regulation, so Hawaii's process does not apply to you and your external review goes through the federal process instead. Filing with the state insurance department in that situation is one of the most common ways the external-review stage is lost without ever being heard. Three free ways to check which you have: your ID card and plan documents (self-funded plans usually name the insurer as "administrator" or "third-party administrator"), the Summary Plan Description your employer must give you on request, and your employer's Form 5500 at efast.dol.gov. Your denial letter names your actual route and is the authority.
How much does external review cost in Hawaii?
Nothing under the HHS-administered federal process. Where an insurer uses a contracted independent review organization or a state process, a filing fee may apply but it cannot exceed $25 per review. The internal appeal is free in every case. Anyone asking you for more than that cap to file an external review is not describing the federal scheme.
How many people in Hawaii reached independent external review, and how many won?
Not one. Zero external reviews were filed in Hawaii against 203,127 denials in the reported year. Nationally, 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) of external reviews are overturned and the decision is binding on the plan.
Which insurer in Hawaii denies the most?
By rate, Hawaii Medical Service Association at 26.3% of in-network claims (203,127 denied). 1 insurers in Hawaii report a denial rate; the lowest is Hawaii Medical Service Association at 26.3%. A denial rate describes the insurer's book of business, not the merits of an individual claim.
How long do I have to appeal a denial in Hawaii?
Appeal deadlines are federal, not state: generally 180 days from the denial notice for the internal appeal, then generally four months from the final internal denial to request external review. Expedited review is decided in about 72 hours where delay would seriously jeopardize your health. Your denial letter states the deadlines that govern your plan.
Hawaii has 2 insurers reporting into this file, that is the bit of this page we would not skip. The deadlines are federal, so they are the same wherever you live. What changes by state is who runs the independent review at the end, and getting that wrong is one of the most common ways people lose the last stage without ever being heard. That is why the route for this state is near the top of this page rather than in a footnote. If your plan is through a job, read the self-funded note carefully; it decides which door your review goes through.
Axion Labs · hello@getaxionlabs.comThe Appeal Kit is the clock, yours and your plan’s, dated from your letter: $29 once.
The Hawaii figures on this page, 26.3%, 203,127 denials and 0 external reviews across 2 insurers, are the state’s own rows in the plan-year 2027 release, issued October 22, 2026. From the plan-year 2024 release to the plan-year 2026 release, external reviews filed went from 2,336 to 5,881. Overturned reviews went from 32.8% in the plan-year 2026 release to 22.2% in plan-year 2027, or from 32.6% to 32.6% without SelectHealth. We do not compare filed or overturned counts across plan-years 2026 and 2027. Some issuers may have counted pre-service appeals in their 2026 cells. The external-review route above comes from the CCIIO state external review table, read August 3, 2026.
Counts: CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain. Rights and timeframes: 29 CFR 2560.503-1 (180 days, and your free right to the claim file) and 45 CFR 147.136 (4 months, and what qualifies), explained at HealthCare.gov. Expedited review is decided in about 72 hours under both sections.
Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at govinfo.gov (29 CFR 2560.503-1) and govinfo.gov (45 CFR 147.136).