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Idaho Health Insurance

Learn more about each insurance carrier here: Cigna, Cigna PDP

Compare health insurance quotes from nearby states: Wyoming Health Insurance, Washington Health Insurance

Idaho Health Insurance

Shopping for health insurance in the state of Idaho might seem like a daunting task. Thankfully, there are many options open to Idahoans who are uninsured or underinsured. Whether you're healthy or not, this page will provide you with valuable information for obtaining health coverage. Read on to learn about COBRA, small group, and the difference between group and individual coverage. If you're healthy enough to obtain coverage on the individual market or if you have a small business and qualify for small group, Health Plan One can help. If not, review the information on this page about Idaho Medicaid, Home Care, CHIP, Access to Health Insurance, Women's Health Check, Immunization Program, and the high risk pool. All of these government programs can help those who are medically uninsurable or who cannot afford private coverage obtain basic health coverage.

What Every Idahoan Should Know About Health Insurance

The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not medically underwritten, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.

Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through Health Plan One. Simply visit our Short-Term information page for your free quotes. It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.

What If I'm Between Jobs?

As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs to invest in an individual/family insurance policy through Health Plan One.

With individual coverage, you choose the health insurance carrier and benefits you want with the help of Health Plan One. We will quote plans for you and your family from all the different carriers available in Idaho so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs, a plan on the individual market through Health Plan One could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Idaho each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months.

If you're healthy and are unhappy with the health insurance offered by your employer, are between jobs, or are not offered benefits by your company, enter your zip code into the Health Plan One quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat (see the button to the right) or toll-free at (877) 567-5267 to answer any questions.

Small Groups

If you are self-employed, you could qualify for a small group plan in Idaho. You must have 2 or more eligible employees, who each work at least 20-30 hours per week (this number varies by carrier). There is no standard amount of time in business required prior to applying for coverage. All carriers in Idaho do medically underwrite for small group plans. This means that though no one in the group can be denied coverage, the carrier can increase the rates based on the health history of employees enrolling. Health Plan One can help you by quoting plans for small groups. Simply call us at (877) 567-5267.

If you're not healthy, there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.

To learn more about Small Group plans in Idaho, visit our Idaho Small Business Group Plan page

Idaho Medicaid

The Medicaid program is meant to provide basic health coverage to low-income Idahoans at little or no cost. Medicaid has different programs available to different groups of people, for example: children under 19 and their families, pregnant women, people 65 and over, the blind and disabled, and women diagnosed with breast or cervical cancer/pre-cancer. There are income requirements associated with each Medicaid program, in addition to several other eligibility criteria. Benefits vary based on the level of coverage you qualify for. For more information, visit the program's homepage at: http://healthandwelfare.idaho.gov/Medical/Medicaid/tabid/123/default.aspx

For detailed income guidelines and benefit summaries, click here:http://healthandwelfare.idaho.gov/Medical/Medicaid/MedicaidParticipants/tabid/220/Default.aspx

The managed care program which is mandatory for most Medicaid participants in Idaho is called Healthy Connections. For more information on managed care and Healthy Connections in particular, click here:http://healthandwelfare.idaho.gov/Medical/Medicaid/HealthyConnections/tabid/216/Default.aspx

For more information on the pharmacy coverage available to Medicaid participants, click here:http://healthandwelfare.idaho.gov/Medical/PrescriptionDrugs/tabid/119/Default.aspx

The Idaho Smiles program offers dental coverage for those enrolled in the Idaho Medicaid Basic Plan option. For more information on dental care through Medicaid, click here: http://www.bcidaho.com/about_us/idaho_smiles.asp

For information on the Preventative Health Assistance program open to Medicaid participants, which is designed to help individuals live a healthier lifestyle, click here:http://healthandwelfare.idaho.gov/Medical/Medicaid/PreventiveHealthAssistance/tabid/221/Default.aspx

Medicaid provides several home care assistance options for those who are elderly, disabled, or have suffered a traumatic brain injury and require assistance to continue living in their homes, rather than moving into an institution. Personal Care Services assist Medicaid participants with personal care and hygiene, medically related household duties, and transportation. There are also 3 Home and Community-Based Waivers available through the state. For more information on these waivers and the other options open to Medicaid recipients in need of assistance with home care, click here: http://healthandwelfare.idaho.gov/Medical/Medicaid/HomeCare/tabid/215/Default.aspx

Visit MedicareSolutions.com for information on Idaho Medicare

Idaho's State Children's Health Insurance Program (CHIP)

Idaho CHIP is the Idaho version of the federal SCHIP program which provides low-cost or free health care coverage to eligible children in the state in association with the Medicaid program. The program is meant to ensure that Idaho children whose parents make too much money to qualify them for Medicaid but too little to afford private health insurance receive basic health coverage. Benefits of the plan include regular checkups, immunizations, prescription coverage, lab tests, x-rays, hospital visits and much more. In order to qualify, a child must live in Idaho and be:

For full program details, click here:http://healthandwelfare.idaho.gov/Medical/Medicaid/IdahoHealthPlanforChildren/tabid/219/Default.aspx

Women's Health Check & Mental Health Services

The Women's Health Check program offers free breast and cervical cancer screenings to qualified female residents. Exams are available from more than 250 qualified Idaho providers throughout the state. The program is available to uninsured women who do not have an income above a certain level. Women's Health Check covers annual clinical breast examinations, annual mammograms, annual pap tests, and necessary diagnostic services. Income requirements and other information are available here:

http://healthandwelfare.idaho.gov/Health/DiseasesConditions/Cancer/WomensHealthCheck/tabid/255/default.aspx

The state funds and operates community-based mental health care facilities and services throughout the state via Regional Mental Health Centers (RMHC). These RMHCs are distributed through the seven geographical regions of the state. For a map of these regions as well as contact information for each of the centers and services offered at each, click here:http://healthandwelfare.idaho.gov/Medical/MentalHealth/tabid/103/default.aspx

Access to Health Insurance (AHI)

The Access to Health Insurance (AHI) program helps employees of small business and their families enroll in employer-sponsored health coverage. AHI is not itself health insurance; it is a premium assistance program that makes health insurance more affordable for employees of qualified small businesses. Premium assistance up to $100 per month per person is available to qualified employees and their families with a maximum premium contribution of $500 per month, per family. Enrollment is limited to 1000 adults. In order to qualify, employers must:

  • Operate an Idaho small business of 2-50 employees
  • Currently not offer health insurance as a benefit
  • Be willing to pay at least 50% of the employee's premium
  • Have at least one employee who meets the income guidelines for premium assistance

Employee requirements:

  • Work for a participating small business employer
  • Not have health insurance at the time of application
  • Be a US citizen or legal resident of the US, 18 years or older, and an Idaho resident

For more information on the program and it's more detailed requirements, click here:http://healthandwelfare.idaho.gov/Medical/HealthInsurancePremiumAssistance/tabid/122/default.aspx

Idaho Immunization Program

The Idaho Immunization Program provides free vaccines for children of all ages to participating providers. The program's website has helpful information about when/against what your children should be vaccinated. It also lists providers who administer the state supplied vaccines. For more information click here:http://healthandwelfare.idaho.gov/Health/Immunizations/tabid/98/Default.aspx

Idaho High Risk Reinsurance Pool Plans

The purpose of the high risk pool (HRP) plans is to make basic health coverage available to Idaho residents not covered by employer group insurance. Idahoans may be eligible for the HRP plans regardless of health status. HRP plans are offered through the health insurance carriers that are approved to offer individual plans in Idaho. There are 4 ways you may be eligible to enroll in an HRP plan. For full details, view the program's brochure here:http://www.doi.idaho.gov/Pubs/high_riskbr.pdf

It is important to know that though the high risk pool is the insurer of last resort for many Idahoans, HRP plans may exclude benefits for a pre-existing condition for 12 months after the start of coverage. However, there are ways around this requirement. For instance, no pre-existing condition limitation or exclusion may be applied to a federally eligible individual if the individual applies for coverage within 63 days of the termination date of prior creditable coverage.

For a full list of programs offered by the Idaho Department of Health and Welfare, click here:http://healthandwelfare.idaho.gov/Health/tabid/60/default.aspx

For more information on health insurance in specific Idaho cities: Boise.