Get Mybenefits Hawaii

This guide provides clear, step-by-step instructions on completing the Mybenefits Hawaii application for health coverage and assistance with paying costs. It is designed to support individuals and families in understanding the process and gathering necessary information.

Follow the steps to successfully complete your application.

1. Click the ‘Get Form’ button to access the Mybenefits Hawaii application and open it for editing.
2. Begin by providing personal information for an adult contact. Fill in your first name, middle name, last name, address, city, state, and ZIP code. Include a phone number and an alternative contact number if available. Optionally, provide an email address if you prefer to receive updates electronically.
3. Continuing with your application, list all family members who will be included. Remember to include yourself, your spouse or partner, and any children under the age of 21 who live with you. Additional details about tax dependents can also be provided.
4. For each family member listed, complete a section detailing their personal information, including date of birth, sex, Social Security Number (if applicable), and health coverage needs. Ensure to indicate if the family member has a disability or if they live in a medical facility.
5. Next, provide income information. For employed individuals, include employer details, wages, hours worked, and any additional income sources. If self-employed, indicate monthly net income. Do not report certain income types such as child support unless necessary.
6. After completing income information, review any existing health coverage your family members may have and indicate if they are enrolled in programs such as Medicaid or Medicare, providing policy details as needed.
7. Sign the application to confirm the accuracy of the provided information. Remember to indicate if you consent to automatic renewal for future years and provide your date of signature.
8. Lastly, mail your signed application to the appropriate address listed for Mybenefits Hawaii. Make sure to keep a copy of your application for your records.

Begin your application online today to secure your health coverage options.