FAQs

Open Enrollment is when anyone can enroll in medical insurance if they chose to. In Idaho it runs from October 15th till December 15th each year for coverage that will start January 1st of the new coming year.

If you need coverage outside of this time, then you'll need to have a qualifying event. At the base of most events is loss of coverage, however a few other events open the door such as birth of a child.

Qualifying life events are what can often open the door to get health insurance midyear. New coverage must be acquired within 60 days of the date or you'll have to wait till another life event or Open enrollment. The most frequently reported qualifying life events are these:

• Marriage or Divorce

  • In marriage, one of the spouses must have had qualifying insurance in the last 60 days.

  • In Divorce, they must lose coverage.

• Birth or Adoption

• Moving

  • Must have caused loss of coverage by moving out of an area that current insurance is not offered.

• Loss of Coverage

• Changing Jobs

• Gaining Legal Status

If you're looking for help to afford the health insurance premiums, all programs are based on the amount of income you make and who you claim on your taxes.

The government uses the Federal Poverty tables to access how much of your income you can spend on health insurance.

We can help you know what that looks like for you.

The only way you can know is to understand your needs and find a plan that fits those in the most advantageous way. In general, you'll want to keep in mind:

• which doctors and facilities you'll need access to and how often you'll go

• prescription drugs that you need to maintain health

• pending services, surgeries, or pregnancy

• budgetary constraints

• premium and max out of pocket considerations

We'll work with you to discuss your needs and help you figure this out more easily.

There are more ways to make health insurance affordable than in the past. You may be surprised by what is possible. Of course, it does depend on your situation. Without the extra help of many programs, insurance is still expensive.

We do our best to help you find something that is both effective and affordable. If that doesn't occur, we'll send you to resources that may help even if the insurance doesn't.

Your Options are these:

• Idaho Medicaid (if eligible)

• Your Health Idaho Exchange- private health insurance with a tax credit (if eligible) or full cost coverage.

• Employer Sponsored Health Insurance (if available and open to enroll)

• Medicare (if you're eligible)

Even if we don't know you yet, we happily help you figure out which option would be best for you (even if it turns out you're better off in a plan that we don't sell)

This question has many variables to consider. First we'll want to consider your health needs and that of your family if you have one and then the rates to add dependents onto a plan.

There is a change in the law as of December 2023 that allows for spouse and dependents to receive help through the Your Health Idaho Exchange to pay their premiums on an individual plan. This applies only if the plan is considered unaffordable by a calculation that the government puts out each year.

If it's just you, it's usually more efficient to take your employer coverage.

We can make the calculations with you to verify which direction is best for you and any dependents you may have.

Many of these counties especially ones close together have many of the same plans. Some may have different networks in one county than another. The rates are set by each county so if you move, even if the new county has the exact same policy with the same company that you had previously, the rates may be different than what you had before.

Let us know if you have questions about your options.