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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.
Marketplace Plans:
- 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:
| Metal Tier | Insurance Company Pays | Consumer Pays |
| Bronze | 60% | 40% |
| Silver | 70% | 30% |
| Gold | 80% | 20% |
| Platinum | 90% | 10% |
Medicaid
Idaho’s Medicaid program provides free or low-cost coverage for eligible low-income residents. Medicaid Plan 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 health insurance. It ensures access to essential services such as immunizations, checkups, and dental care.
Student Health Insurance
College students in any state have multiple health insurance options, including staying on a parent’s plan until age 26, enrolling in a school-sponsored plan, or applying for coverage through the ACA Marketplace. Depending on your income and location, you may also qualify for Medicaid, CHIP, or low-cost catastrophic or short-term plans, making Idaho student health insurance accessible and flexible for a wide range of needs.
Medicare
Medicare plans are available for residents aged 65+ and younger individuals with qualifying disabilities. Options include:
- Medicare Advantage (Part C)
- Medicare Advantage is an alternative to Original Medicare offered by private insurers to those enrolled in Parts A and B. These plans often include extra benefits and cost protections but typically require using a specific network of providers.
- Prescription Drug Plans (Part D)
- Medicare Part D provides prescription drug coverage for anyone with Medicare, helping pay for medications and many vaccines. Offered by private insurers, these plans vary in cost and coverage and can be joined during specific enrollment periods.
- Medicare Supplement (Medigap)
- Medicare Supplement plans, or Medigap policies, help cover the out-of-pocket costs that Medicare Part A and Part B don’t pay. Since Original Medicare (Parts A and B) lacks an out-of-pocket maximum, these plans can limit your expenses for medical services.
COBRA Coverage
If you’ve recently lost job-based insurance, COBRA allows you to continue your employer coverage temporarily—typically at full cost.
Short-Term Plans
Short-term medical (STM) plans offer flexible, low-cost coverage for up to four months, ideal for healthy individuals in transition. However, STM plans aren’t guaranteed issue, lack subsidies, and may exclude key benefits like maternity, mental health, and pre-existing conditions, making them less suitable for long-term or comprehensive needs.
Explore all non-ACA health plans that may fit your needs and lifestyle.
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:
- Job loss
- Marriage or divorce
- Birth or adoption of a child
- Relocation
- Change in income
You typically have 60 days from the qualifying event to enroll in a new health plan.
- 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 carriers may also offer standardized plans if Idaho provides a public option or similar program.
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—from agents to costs like copayments, coinsurance, and deductibles—to help you make confident coverage decisions.
Bottom Line
Health insurance in Hawaii 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.
