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Individual and Family Coverage
Medical Insurance Options
In Idaho, Medical or Health Insurance is provided through a few sources. As a part of helping people, we generally will see if they qualify for any programs that will help save money. We generally check Idaho Medicaid eligibility first, then coverage on the Your Health Idaho exchange (this is where you can get tax credits to help pay the cost of the private health insurance). If neither of those are effective, then we’ll discuss the value of short term medical plans with you to see if they fit.
Idaho Medicaid
There are many facets to the programs available through the Idaho Department of Health and Welfare, however, health coverage is mostly what we assist people to understand. Eligibility depends on your family size and monthly income. There can be small copays and some very small out of pocket costs. It is based on the Federal Poverty Tables.
Your Health Idaho Exchange Coverage
The exchange provides Affordable Care Act (ACA) plans through different carriers like Blue Cross of Idaho, Regence BlueShield, Select Health, Pacificsource, and others by the use of tax credits that lower your cost.
Like Medicaid, it utilizes the Federal Poverty Tables and family makeup to determine the amount of tax credit to offset your monthly premiums for any plan you pick.
Be aware that the credits are based on the projected income you place on your application with the exchange. When you file taxes for that year, you will pay you and anyone you claim on taxes will make for that year.
Short Term Medical
This is temporary health insurance that fills in a small space of time between benefits. For those with zero health issues that just want less expensive peace of mind.
FAQs
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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.
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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
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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.
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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.
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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.
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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)
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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.
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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.
Other Helpful Products We Offer
Dental Insurance
If you have great teeth and never get a cavity, then you’re one of the lucky ones, and Dental Insurance might not be for you.
If you’re like us (great smiles, but not fabulous teeth), then consider reviewing the options with us for Dental Insurance so a broken tooth doesn’t break the bank.
Vision Insurance
From the eye appointment to the specialized contacts and glasses, it’s easy to see (yes, pun intended) that Vision Insurance can save you money. A specific need can be majorly met with a specific plan.
And if Vision Insurance isn’t for you, but glasses are, there are other options we can offer as well. Give us a call to learn more or click below!
Life Insurance
What really is Life Insurance? It’s financial protection. No, not for you — you’re dead! For your loved ones.
But in all seriousness, a death in a family is devasting in generally every way. And if the death is of the breadwinner or financial provider in the family, the effects are often financially devastating as well. Life Insurance is like investing in the wellbeing of your family after you die - whenever that may occur.
We could explain it more here, but Khan Academy gives straightforward answers and explanations in this video here: Introduction to Life Insurance
Disability Insurance
Disability Insurance protects your income should you become disabled and unable to continue working in your industry or career. It guarantees a certain percentage of your normal income continues to come to you over the duration of your disability. Like Life Insurance, individual Disability Insurance prices depend on your age, current state of health, and other factors.
