Idaho Health Insurance

Idaho Health Insurance

From scenic mountain ranges and pristine wilderness to a growing economy and close-knit communities, Idaho remains a desirable place to live, and understanding your health insurance options here is key to protecting your health and finances.

If you’re currently without coverage, here’s what you need to know about getting insured in Idaho.

Health Insurance Options in Idaho

Idaho offers a range of health insurance options tailored to residents’ needs, depending on age, income, employment, and family size. Here are the most common coverage types available:

Employer-Sponsored Insurance

Many Idahoans receive health insurance through their employer. If your workplace offers coverage, this is usually the most cost-effective and convenient option.

ACA Marketplace Plans

The Affordable Care Act (ACA) allows individuals and families to buy health insurance through federal or state Marketplaces. These plans offer essential health benefits, free preventive care, and protection for preexisting conditions.

If you don’t have employer coverage, you may qualify for subsidies to lower your premiums. Use our ACA Subsidy Calculator to check your eligibility.

Starting this year, the Centers for Medicare & Medicaid Services (CMS) is requiring income verification to confirm eligibility for premium subsidies. As part of this effort, CMS will reduce the ACA subsidies by $5 per month for individuals who are automatically re-enrolled in fully subsidized plans without verified eligibility.

ACA Plan Types

ACA marketplace plans are available in four tiers: Bronze, Silver, Gold, and Platinum, each with distinct costs and coverage levels. Plans also vary by provider networks and out-of-pocket expenses, so compare carefully to find what fits your needs.

• Bronze: Low monthly premiums, higher out-of-pocket costs; ideal for minimal healthcare usage.
• Silver: Moderate costs; eligible for cost-sharing reductions (CSRs).
• Gold: Higher monthly premiums with lower out-of-pocket costs; best for frequent healthcare users.
• Platinum (if available): Highest premiums, lowest out-of-pocket costs.

Metal Tier Breakdown

Short-Term Medical Plans

Short-term medical (STM) plans offer temporary health coverage and can be a practical solution for individuals who are between jobs, recently lost employer coverage, waiting for ACA or Medicare eligibility, or need affordable protection during a coverage gap.

These plans are available in Idaho and follow federal rules, but they are not regulated by the ACA. That means they can deny coverage based on pre-existing conditions and typically do not include comprehensive benefits like maternity, mental health, or preventive care.

While not a substitute for long-term insurance, STM plans may be ideal when you’re temporarily uninsured and need basic protection.

STM Plan Enrollment: Unlike ACA-compliant plans, you can enroll in short-term health plans year-round.

Quick Coverage Start: Many short-term plans can begin as soon as the next day after your application is approved.

Medicaid

Idaho’s Medicaid program provides free or low-cost coverage for eligible low-income residents. Benefits typically include preventive care, doctor visits, hospital services, prescriptions, mental health support, and more.

Following expansion, Medicaid is now available to a broader population, including childless adults and low-income working families.

Children’s Health Insurance Program (CHIP)

Known as CHIP in Idaho, this program helps cover children and pregnant women in families who earn too much for Medicaid but still need affordable insurance. It ensures access to essential services such as immunizations, checkups, and dental care.

Student Health Insurance

College students in Idaho have several options, including staying on a parent’s plan until age 26, enrolling in a school-sponsored plan, or applying through the ACA Marketplace. Depending on your income, you may also qualify for Medicaid, CHIP, or low-cost catastrophic or short-term plans. Learn more about Idaho student health insurance.

Medicare

Medicare plans are available for residents aged 65+ and younger individuals with qualifying disabilities. Options include:

• Medicare Advantage (Part C): A bundled alternative to Original Medicare offered by private insurers. Often includes extra benefits and provider networks.
• Prescription Drug Plans (Part D): Helps pay for medications and some vaccines. Offered by private companies.
• Medicare Supplement (Medigap): Covers costs that Original Medicare doesn’t, like deductibles and coinsurance.

COBRA Coverage

If you’ve recently lost job-based insurance, COBRA allows you to continue your employer coverage temporarily—typically at full cost.

Enrollment Periods in Idaho

Open Enrollment for 2026 Coverage:

November 1, 2025 – December 16, 2025
During this window, all eligible residents can apply for, renew, or change their marketplace health plans through Your Health Idaho.

Special Enrollment Period:

Available year-round for those experiencing qualifying life events (QLE), such as:

• Loss of coverage
• Marriage or divorce
• Birth or adoption of a child
• Relocation
• Major change in income

You typically have 60 days from the qualifying event to enroll.

Health Insurance Providers in Idaho

As of 2025, these insurers typically offer individual and family plans through Your Health Idaho:

• Blue Cross of Idaho Health Services
• Mountain Health Co-Op
• PacificSource Health Plans
• Regence BlueShield of Idaho
• SelectHealth

Plan availability may vary by county or ZIP code. Some insurers may offer standardized plans if Idaho introduces a public option or similar initiative.

Understanding Health Insurance Costs

When selecting a plan, be sure to understand these common cost terms:

• Premium: Monthly payment to maintain your plan.
• Deductible: What you pay before insurance covers services.
• Copayment (Copay): Fixed amount per visit/service.
• Coinsurance: Shared costs with your insurer after the deductible.
• Out-of-Pocket Maximum: Your yearly cost cap for covered services.
• In-Network vs. Out-of-Network: Staying in-network helps you avoid higher charges.

Understanding health insurance doesn’t have to be overwhelming. This glossary offers clear definitions of key terms to help you make confident coverage decisions.

Bottom Line

Health insurance in Idaho comes with diverse options — from employer plans and ACA marketplace coverage to government programs like Medicaid and Medicare. By understanding your choices and enrollment windows, you can find a plan that fits your healthcare needs and budget.

Need help choosing a plan? Use our ACA Subsidy Calculator to see if you are eligible for ACA plan financial aid or speak with a licensed insurance agent about all your options.