Health Insurance in Idaho: What You Need to Know

Having health insurance is important for everyone, no matter where you live. In Idaho, there are a variety of health insurance options available for residents, but navigating the different plans and providers can be overwhelming. This guide will provide you with everything you need to know about health insurance in Idaho.

Why Health Insurance Matters

Health insurance is important for several reasons. First and foremost, it helps you manage the cost of healthcare. Medical bills can be expensive, and without insurance, you could be left with a huge bill that you can’t afford to pay. Health insurance also gives you access to preventative care, which can help you stay healthy and catch health issues early on. Finally, health insurance provides peace of mind knowing that if you do get sick or injured, you will have access to the care you need.

Some people may think that they don’t need health insurance because they are young and healthy, or because they don’t think they can afford it. However, going without health insurance can be risky and costly in the long run. In fact, the Affordable Care Act (ACA) requires most Americans to have health insurance, or pay a penalty.

Types of Health Insurance in Idaho

There are several types of health insurance available in Idaho, including:

Individual & Family Plans

Individual and family plans are sold on the individual market by insurance companies and brokers. They are purchased by people who are not eligible for employer-sponsored health insurance, or who prefer to buy their own coverage instead of relying on their employer.

In Idaho, individual and family plans are sold on the state’s health insurance exchange, Your Health Idaho. The exchange offers a variety of plans from different insurance companies, and can help you determine if you’re eligible for financial assistance to help pay for your coverage.

When you’re shopping for an individual or family plan, it’s important to consider the following:

• Monthly premium: This is the amount you pay each month to keep your insurance coverage.
• Deductible: This is the amount you have to pay out of pocket before your insurance kicks in.
• Copayments and coinsurance: These are additional costs you may have to pay for certain healthcare services.
• Provider network: Make sure the plan you choose includes your preferred doctors and hospitals.

Group Health Plans

Group health plans are offered by employers to their employees, and often have lower premiums and better coverage than individual plans. In Idaho, small businesses with 50 or fewer employees can purchase group health insurance through the state’s SHOP exchange.

When you’re shopping for a group health plan, it’s important to consider the following:

• Monthly premium: This is the amount your employer will deduct from your paycheck each month to keep your insurance coverage.
• Deductible: This is the amount you have to pay out of pocket before your insurance kicks in.
• Copayments and coinsurance: These are additional costs you may have to pay for certain healthcare services.
• Provider network: Make sure the plan you choose includes your preferred doctors and hospitals.

Medicare

Medicare is a federal health insurance program for people who are 65 or older, as well as some younger people with disabilities. There are four parts to Medicare:

• Part A: This covers hospitalization and inpatient care.
• Part B: This covers outpatient care, such as doctor’s visits and preventive services.
• Part C: This is also known as Medicare Advantage, and is a combination of Parts A and B offered by private insurance companies.
• Part D: This covers prescription drugs.

If you are eligible for Medicare, it’s important to enroll during the appropriate enrollment period to avoid any penalties.

Medicaid

Medicaid is a joint federal and state program that provides health insurance to people with low income. In Idaho, Medicaid is called Idaho Medicaid or the Idaho Health Plan.

To be eligible for Medicaid in Idaho, you must meet certain income and household size requirements. If you think you may be eligible for Medicaid, you can apply online at the Idaho Health Plan website.

FAQs About Health Insurance in Idaho

What is Your Health Idaho?

Your Health Idaho is Idaho’s state-based health insurance exchange. It is where Idaho residents can shop for and enroll in individual and family health insurance plans.

When is open enrollment for health insurance in Idaho?

The open enrollment period for individual and family health insurance plans in Idaho typically runs from November 1 to December 15 each year. However, if you experience a qualifying life event, such as getting married or losing your job, you may be eligible for a special enrollment period.

What are the penalties for not having health insurance in Idaho?

Under the Affordable Care Act, most Americans are required to have health insurance, or pay a penalty. The penalty for not having health insurance in Idaho is $695 per adult and $347.50 per child, or 2.5% of your household income, whichever is greater.

What financial assistance is available to help pay for health insurance in Idaho?

Financial assistance in the form of tax credits and cost-sharing reductions is available to help lower the cost of health insurance for eligible Idaho residents. To find out if you’re eligible, visit Your Health Idaho or speak with a licensed insurance agent.

Can I keep my current doctor if I switch health insurance plans in Idaho?

It depends on the plan you choose. Before you enroll in a new plan, make sure to check the plan’s provider network to ensure that your preferred doctors and hospitals are included.

Conclusion

Health insurance is essential for everyone, and in Idaho, there are several options available to meet your healthcare needs. Whether you’re shopping for an individual or family plan, a group plan through your employer, or government-sponsored insurance like Medicare or Medicaid, it’s important to consider your needs and budget when selecting a plan. By understanding your options and the different types of plans available, you can make an informed decision and get the coverage you need to stay healthy.