Idaho Health Insurance

Need affordable health insurance in Idaho but not sure where to start? Get answers to some of the top questions about buying Idaho health insurance.

When you hear Idaho you may think potatoes. But make no joke because Idaho has been at the forefront of the Affordable Care Act (Obamacare) with its own state-run health insurance exchange since 2014.¹ Nearly 215,000 residents had no health insurance at that time. Idaho has made progress by lowering its uninsured population to about 192,000 as of 2018. This number represents 11% of the state’s 1.7 million residents.

Idaho offers several health insurance options for individuals, families, and small business owners. Depending on your income, you may even qualify for cheap health insurance in Idaho. To help you get started, we’ve come up with answers to some of the most frequently asked questions about buying health insurance in Idaho.

1. When Is Open Enrollment In Idaho?

Idaho’s open enrollment for 2020 health insurance under the Affordable Care Act (ACA) takes place from November 1, 2019 to December 16, 2019.²  This is just one day longer than the usual enrollment deadline on December 15. But this still makes Idaho among a handful of states that have an extended Open Enrollment Period (OEP). Outside of the OEP, you can use Special Enrollment Periods to sign up for health insurance year-round if you have a qualifying life event. Idaho gives you 60 days from the date of your qualifying event to submit proof and enroll in a health plan.³

2. How Do I Enroll in Idaho Health Insurance?

You can enroll in ACA health coverage directly through the Idaho Health Insurance Marketplace at YourHealthIdaho.org. Your Health Idaho offers metal plans in bronze, silver, and gold as well as catastrophic health insurance. All Idaho metal plans include essential health benefits, but Idaho catastrophic plans aren’t required to include them.⁴

You can also use a website like HealthCare.com to compare ACA plans sold in the private marketplace. Our website also lets you connect with licensed Idaho health insurance agents who can help you choose the best coverage.

3. How Much Does Idaho Health Insurance Cost?

A Marketplace silver plan in Idaho costs $520 a month on average for 2020—up from $498 for 2019.⁵ If you qualify for Obamacare subsidies, your monthly premium could be much less. How much you pay also depends on the plan type you choose. Among metal plans, bronze-level coverage usually has the cheapest Idaho health insurance premiums but the highest out-of-pocket costs.

Below are the average monthly premiums for 2020 Idaho health insurance plans:⁶

• Average Lowest-Cost Bronze Premium: $329
• Average Lowest Cost Silver Premium: $512
• Average Lowest-Cost Gold Premium: $551

Keep in mind that these costs don’t reflect any savings you may qualify for.

4. What Are My Idaho Coverage Options If I Have Low Income?

Marketplace Plans (Obamacare)

Your income must be between 139% and 400% of the federal poverty level (FPL) to qualify for premium tax credits (subsidies) on a Marketplace plan.⁷ This means a single adult must earn no more than $4,163 per month (as of 2019) to get Idaho subsidy assistance for 2020 coverage.

Another way you can save money on Idaho health insurance is through cost-sharing reductions (CSRs). CSRs go toward your out-of-pocket expenses for things like copays and prescription drugs, but only for silver plans. Generally, you must earn between 100% and 250% of the FPL to qualify.⁸

Medicaid

More than 237,000 Idahoans have Medicaid as of October 2019.⁹ Idaho is one of the states that have expanded its Medicaid program to low-income residents who earn at below 138% of the FPL.⁷ You may qualify for Idaho Medicaid if you meet income requirements and you’re either pregnant, a child under 19, the parent or caretaker of a child, 65 or older, or are blind or disabled.

CHIP

If you make too much to qualify for Medicaid and you have uninsured children in your household under 19 years of age, they may qualify for low-cost coverage through Idaho’s Children’s Health Insurance Program (CHIP). You might pay just $10 to $15 a month for each enrolled child. Nearly 26,000 residents have CHIP as of October 2019.⁹

5. How Do I Apply for Idaho Health Coverage Assistance?

Financial assistance for Marketplace health insurance and eligibility for Medicaid and CHIP are all part of the Idaho Health Coverage Assistance program.¹⁰ Before you apply for assistance, it’s recommended that you use the Idaho tax credit estimator to see if your income would qualify you for cost-savings.

To get financial assistance, you must:¹¹

1. Create an account with Your Health Idaho
2. Apply for assistance with the Idaho Department of Health and Welfare (DHW). If approved, DHW will send your eligibility information to Your Health Idaho. 
3. Follow the instructions from DHW to complete your application for health insurance via Your Health Idaho
4. Enroll in an eligible plan to get subsidies applied to your coverage. 

6. What About Medicare for Idaho Seniors and People With Disabilities?

Medicare is a federal health insurance program for seniors 65 and older and younger adults with disabilities. Nearly 324,000 Idahoans have Medicare Part A hospital and Part B medical insurance as of 2018.

About 7 out of 10 enrollees get Part A and B through the federal government’s Original Medicare program. The rest get these benefits through private Medicare Advantage plans, which usually include Part D prescription drug coverage.

Private insurers also sell individual Part D drug plans, which are often paired with Original Medicare. As of 2018, more than 126,000 Idahoans have a standalone Part D plan.¹²

If you choose coverage through Original Medicare, you can also add a Medicare Supplement plan (called Medigap). Idaho (and most states) offers 10 standard Medigap plans that help pay some to all of your covered out-of-pocket costs. These include copayments, coinsurance, and deductibles. 

7. Are There Health Benefits for Recognized Tribes, American Indians, and Alaska Natives in Idaho?

More than 29,000 American Indians and Alaska Natives call Idaho home, which represents about 1.7% of the state’s total population. If you live in Idaho and you’re a member of a federally-recognized tribe, an American Indian, or an Alaska Native, you could get coverage through Your Health Idaho and pay nothing for out-of-pocket expenses like copays, coinsurance, and deductibles. To qualify, your income must be between 100% and 300% of the federal poverty level.

However, if you receive Idaho health insurance benefits through tribal programs, urban Indian programs, or the Purchased and Referred Care program, you won’t pay any out-of-pocket medical expenses regardless of your income.

You also have the option to buy or change your Idaho health coverage at any time throughout the year if you’re part of a federally-recognized tribe.¹³

8. Can I Apply for Small Business Health Insurance in Idaho?

Yes. If your Idaho-based business has up to 50 full-time employees, you can apply for coverage with Idaho’s Small Business Health Options Program (SHOP) via a certified agent or broker.

To use the Idaho SHOP Marketplace, you must offer coverage to all your eligible full-time employees. However, if you wait to apply after the open enrollment deadline, then at least 70% of eligible employees must enroll in your SHOP plan.

9. Which Companies Offer Idaho Health Insurance Plans?

Idaho Individual Health Insurance Companies

You can choose from five Idaho health insurance companies for 2020 individual and family plans. Of the five, only one doesn’t sell plans through the Idaho health insurance exchange.

1. Blue Cross of Idaho Health Services
2. Mountain Health Co-Op
3. PacificSource Health Plans
4. SelectHealth
5. Regence BlueShield of Idaho (off-exchange only)

Idaho Small Business Health Insurance Companies

There are nine Idaho companies offering small employer health plans for 2020. These are:

On the Exchange

1. Blue Cross of Idaho Health Services
2. Mountain Health Co-Op
3. PacificSource Health Plans
4. SelectHealth

Off the Exchange

1. Aetna Health of Utah
2. Aetna Life Insurance Company
3. National Health Insurance Company
4. Regence BlueShield of Idaho
5. UnitedHealthcare