Idaho Health Insurance
If you live in Idaho and either buy your own health insurance or are currently uninsured, this guide is for you. It will help you:
- Determine whether you may qualify for a credit to help you pay for health insurance under the Affordable Care Act (also known as Obamacare)
- Compare private health plans using U.S. News & World Report's health insurance ratings for Idaho
Do I Qualify for a Tax Break on Health Insurance?
Use the calculator below to determine whether you qualify to receive a tax credit (called a subsidy) that you can use to pay for health insurance. The calculator will also help steer you toward health insurance options that may be best for your needs.
What Plan Type is Right For Me?
You may qualify for Medicaid, a free, state-sponsored health insurance program. Call 855-944-3246 or go to the Your Health Idaho website to find out if you can enroll in Medicaid.
You qualify for a subsidy (tax credit) that will save you money if you buy a plan on Idaho's new insurance marketplace, called Your Health Idaho. Plans should be offered there starting October 1, 2013. While your subsidy will cover part of the monthly premium for any of the marketplace's plans, a plan that's in the "silver tier" probably offers the best deal. That's because you also qualify for a second subsidy that increases the value of benefits you'd get from any silver plan.
You qualify for a subsidy (tax credit) that will save you money if you buy a health plan on Idaho's new insurance marketplace, called Your Health Idaho. Plans should be offered there starting October 1, 2013. Your subsidy will cover part of the monthly premium for any of the marketplace's plans, known as Qualified Health Plans.
You don't qualify for a subsidy. You can either buy a plan on the Your Health Idaho website or click the button below to compare U.S. News-rated plans in your state's private insurance market. Plans on Your Health Idaho will generally offer more health coverage than plans in the private market, but they also tend to cost more in monthly premiums. The Your Health Idaho website should offer plans beginning October 1, 2013.
Any children in your household may be eligible for Medicaid. Call 855-944-3246 or go to the Your Health Idaho website to find out if your children are Medicaid-eligible.
If You Qualify: Plans That Cost Less
Under the Affordable Care Act, you might qualify for a subsidy to help pay for your health insurance. If you qualify, the subsidy can be used to reduce the cost of your monthly premium or can be taken as an annual tax credit. To take advantage of a subsidy, you must choose a health plan that has been approved by the federal government and the government of Idaho. These plans, known as Exchange Plans, meet a set of standards that aim to eliminate benefit loopholes to make sure that people with pre-existing conditions are not being denied coverage.
Note: you had until March 31 to enroll for coverage for the rest of 2014 (enrolling on March 31 would cover you starting May 1). If you missed this date, with few exceptions, you will pay a penalty.
- If you missed the deadline to enroll, read about your options for coverage and how to avoid the penalty.
- For more information, read Why Get Health Insurance in the State Marketplaces
If You Don't Qualify: Private Plans
If you don’t qualify for a subsidy, you can still choose among the Health Exchange Plans, or consider one of the many private health insurance plans available in Idaho’s private marketplace. We have rated these private plans on a 1-star to 5-star basis, with 5-star plans providing the most comprehensive coverage. What’s the biggest difference between a private market health plan and a government-approved one? The trade-off is usually cost. Insurance companies can charge less for private plans with less-extensive network coverage or fewer benefits, which makes more-affordable options available to you.
- Compare private plans in the U.S. News Health Insurance Ratings for Idaho
- Read more here: Hidden Costs of 'Affordable' Health Insurance
Do I Have To Buy Health Insurance?
You may have heard that everyone in Idaho must have health insurance in 2014 or pay a penalty – Obamacare's so-called “individual mandate.” With a few exceptions, this is true. For 2014, not carrying insurance will cost $95 per adult plus $47.50 per child (up to $285 per family) or 1 percent of your family’s income, whichever is more.
U.S. News generally recommends getting health insurance of some kind, even if it is only catastrophic coverage. That's because unexpected medical expenses can easily bankrupt anyone who is uninsured.
- See the pros and cons of getting health insurance: Why Do You Need Health Insurance?
- For more on the penalty, read Should I Pay the Penalty?
- If your health insurance policy was cancelled in fall 2013, you may be eligible to renew it for 2014 coverage. Call your insurer to verify whether your plan is still available. For more info, read Cancelled Health Plans Leave Consumers Puzzled
Where To Buy Health Insurance
Idaho's Official Marketplace
Your Health Idaho is Idaho’s official portal for buying an Obamacare Health Exchange Plan under the Affordable Care Act. To sign up online for coverage on Your Health Idaho, be prepared to fill out a form that could take 30 minutes or longer. To complete the process quickly, have this info handy:
- Social security numbers for everyone in your household
- Your employer’s name and address
- Your most-recent pay stub or recent records of your wages
- Information about other types of income you receive, such as alimony, unemployment benefits or a pension
Insurance Companies and Brokers
Some people prefer to buy health insurance directly from an insurance company or through a broker. Thanks to strict regulation, you'll pay the same price for a plan regardless of where you buy it – whether on the Your Health Idaho website, through a broker or directly from an insurer – and regardless of whether you sign-up via phone, online, or by filling out paper forms.
U.S. News & World Report has teamed up with eHealth.com, an online broker licensed to sell health insurance, to help you buy the health plan you want. The eHealth customer service team can answer questions, determine whether you're eligible for a subsidy and help you apply for insurance.
Qualified Plans on Your Health Idaho
Beginning October 1, 2013, each state was required by law to have a new online marketplace where residents can buy health insurance. In these marketplaces, most states will offer five tiers of Obamacare Health Exchange Plans: platinum, gold, silver, bronze and catastrophic. Platinum plans will offer the highest level of coverage but tend to cost more in monthly premiums. Bronze plans will cover only a bare minimum of health care expenses but tend to have low premiums. If you are relatively healthy and want to pay less up front, consider a lower-tier plan such as bronze or silver.
You should also look at a Your Health Idaho plan if you are lower-income, because the government will give financial help on a sliding scale to pay for premiums, and better benefits if you select a silver-tier plan. If you have not already done so, we can tell you if a Your Health Idaho plan makes sense given your income on the State Overview tab, under the heading, "Do I Qualify For a Tax Break?"
Read ACA and Health Insurance: Which "Metal" Tier is Right for You? for more advice on choosing between metal tiers.
Blue Cross of Idaho. Blue Cross of Idaho is an independent licensee of the Blue Cross and Blue Shield Association, the oldest U.S. health insurance system. The Blue Cross and Blue Shield Association offers coverage in all 50 states, the District of Columbia and Puerto Rico and has 37 Blue Cross and Blue Shield companies that serve over 100 million members (one-third of all Americans), according to the company. Nationally, Blue Cross and Blue Shield companies have contracts with over 96 percent of hospitals and 91 percent of professional providers. Idaho residents who buy a Blue Cross and Blue Shield exchange plan may not have access to the entire network of doctors and hospitals.
BridgeSpan Health Company. BridgeSpan is affiliated with Regence BlueCross BlueShield of Oregon through its parent company, Cambia Health Solutions, according to the Oregon State Public Interest Research Group Foundation. BridgeSpan offers PPO exchange plans in Catastrophic through Gold tiers.
PacificSource Health Plans. Established in 1933, PacificSource is an independent nonprofit that has over 46,300 doctors and medical facilities in the northwestern U.S. In Idaho, PacificSource offers exchange plans in Catastrophic through Gold tiers.
SelectHealth. Established in 1983, this nonprofit has over 530,000 members in Utah and Idaho, according to eHealth. SelectHealth entered the Idaho insurance market through a partnership with St. Luke’s Health System. SelectHealth offers exchange plans in every tier.
Need More Help?
The Idaho Department of Insurance exists to help residents resolve issues with their insurance company, locate a doctor or other provider within their network, appeal a denial of service, and resolve billing problems with insurers and providers. The office can be reached at 800-721-3272 or emailed through an online contact form. Residents can file an insurance complaint online.
Frequently Asked Questions About Health Insurance
- Why Do You Need Health Insurance?
- Should I Pay the Obamacare Tax Penalty?
- How Can I Save Money on Health Insurance?
- What Should Women Look For When Buying Health Insurance?
- Are 'Affordable' Health Plans Really Affordable?
Last updated by Heilbrunn, Evi | April 1, 2014