Idaho is known for its potatoes, but it also has an abundance of natural wonders including national forests, waterfalls, hot springs, gorges and mountains. Those who live in Idaho have access to many activities, including ski resorts like Sun Valley, which attracts plenty of tourists, and all other outdoor recreation imaginable. As one of the destinations for gold mining in the early foundations of the country, there are several ghost towns in Idaho that add some character to the state. Idaho is also home to the nation’s largest stretch of highway that passes through a national forest, the Lewis & Clark Highway.

Residents of Idaho have two options when it comes to quality health insurance companies in their state, which includes Blue Cross Blue Shield of Idaho and PacificSource Health Plans. To get an accurate idea of the plans available in your area and the pricing for you and your family, enter your zip code in the space below. If you need additional assistance or have any health insurance questions, please call one of our agents at 888 803 5917 or contact us through the site.

 

 

Health Status

The population of Idaho has become less healthy over the past two years due to several factors. It is still a fairly health state, but according to the UnitedHealth Foundation they rank 19th in 2011, whereas they ranked 9th in 2010. The amount of obese adults has seen a jump in the past ten years, and is currently at 306,000 residents over age 19. A related increase in diabetes has also occurred in the past five years, which now affects 90,000 adults in Idaho. Other factors considered were the number of primary care doctors available per capita, which is the lowest amount in the country. There is also an elevated percentage of uninsured individuals in Idaho, which was recorded at 17% of the total population.

Despite the decline in health overall, there are still some good properties to note in Idaho, such as the relatively low amount of air pollution due to the natural surroundings, a low number of preventable hospitalizations, and a moderately well funded public health system. The percentage of smokers also decreased in the past decade, now at 15% of all adult residents (which is still 179,000 adults). If Idahoans decide to improve their health, it is important to start out by getting a health plan. Of course eating well and exercising regularly can help improve the  quality of health for all residents, and potentially limit the number of overweight and diabetic individuals. You have come to the right place to take care of your health – get a quote to find out how affordable plans in your area can be!

 

Health Insurance Plans

 

Blue Cross of Idaho

  • SimplyBlue plans are PPOs, which gives you the freedom to use in-network or out-of-network providers for your medical care. There are four deductibles to choose from: $2,500, $5,000, $7,500 and $10,000 for individuals, and $5,000, $10,000, $15,000 and $20,000 for families. When your plan begins, you can use any in-network provider for preventive care at 100% coverage. There is also unlimited prescription drug coverage on generics as soon as your plan starts, and your first four doctor’s office visits are a $25 copay. After you have met the deductible, you pay 30% coinsurance for a large number of in-network medical services, including maternity care with a separate deductible. Using in-network providers will result in greater savings, though if you prefer an out-of-network doctor you have the option for an increased rate.
  • EssentialBlue Plus plans also connect you to the PPO network from Blue Cross of Idaho, with the ability to seek non-network care for a higher amount of coinsurance. These plans come with the benefit of the BlueCard PPO network, which makes care available to you in other states outside Idaho. Deductibles are $1,000, $2,000, $3,000 and $5,000 for individuals, and twice as much for families. Without a deductible, you can get generic prescription drugs as soon as your plan starts, and maternity care is available with its own deductible. In-network preventive care is no cost to you, including immunizations, mammograms, cholesterol and diabetes screenings and more. Limited benefits are available once you reach the deductible for 20% coinsurance, including selected outpatient services and emergency care.
  • HSA Blue PPO plans have the lowest monthly premiums and the highest level of coverage. These plans offer the most health care services, including inpatient hospital care, surgery, home health care, physician’s visits, physical therapy and more for either 80%, 90% or 100% coverage after deductible with network providers. These plans also offer coverage for out-of-network services, which varies depending on the type of care. Individual deductible options are $2,000, $3,000 or $5,000, and twice as much for families. Immediate benefits include preventive care, which cost nothing when you use in-network services. HSA Blue PPO plans are optimized for use with a health savings account for more flexibility and control over how you pay for medical bills.

 

 

PacificSource

  • BrightIdea plans are available in three types: Preferred, Value or HSA, and give you access to the BrightPath Network. This network contains over 3,000 medical providers throughout the state. Each of these plans covers preventive care at 100% as soon as the plan becomes effective. Preferred plans give members the highest level of coverage, with access to doctor’s office visits, prescription drugs, vision and chiropractic before you meet the deductible. Once the deductible is met, Preferred plans cover 70%, Value plans cover 60%, and HSA plans cover 80% of major medical costs. Value plans offer physician visits and prescription drugs immediately, and HSA plans give you the opportunity to better manage your health care costs with a savings account.
  • SmartHealth plans offer a larger network (over 8,000 providers in the state) and come in two options: Smart Health PPO and SmartHealth HSA. All SmartHealth plans offer in-network preventive care at no charge from the start of your plan. By choosing a PPO or HSA plan, you receive benefits covered at 75% after you meet the deductible, including inpatient hospital stays, outpatient surgery, X-rays and lab work and more. HSA plans have one deductible, $3,000 for individuals and $6,000 for families, and PPO plans have a wider range of deductibles to choose from. As soon as your plan begins, the first four doctor’s office visits are a $30 copayment, and covered in full afterwards.

 

 

Public Health Options

The state of Idaho provides a number of programs for individuals who are unable to afford health insurance coverage and need to receive medical care. Some programs are available to any resident regardless of income, but most of the services offered are aimed at the low-income, uninsured population of Idaho. There are services offered for individuals with certain conditions, as well as immunizations offered, and assistance with nutrition and wellness for various groups. The nation’s main provider of health care coverage to low-income families and children is, of course, Medicaid, which is open to many individuals who meet the criteria. For a detailed list of Idaho Medicaid eligibility requirements, locate Idaho on our Medicaid Eligibility by State page. For a full list of programs in the state, visit the Idaho Department of Health and Welfare.

  • Medicaid: medical insurance for Idaho residents with limited income or health care needs.
  • Idaho Health Plan for Children: the Children’s Health Insurance Plan in Idaho that gives Medicaid services to children under 19 with a low income.
  • Idaho Immunization Program: immunizations provided for free for Idahoans of all ages throughout the state.
  • Women’s Health Check: free breast and cervical cancer screenings for women without insurance and have low-income, or meet certain age requirements.

 

Health Insurance Laws

In Idaho, there are health insurance regulations in place for the benefit of the insurance company and the policy-holder as well. At the moment, health insurance companies are still permitted to accept or deny individuals for policies based on their health status. The Affordable Care Act has brought many changes to the health insurance market, including a law that states that all adults be provided a health plan no matter what their medical history or current condition. This helps those who have been determined as having a pre-existing condition or considered high-risk.

In Idaho, pre-existing conditions are defined by the prudent person standard, meaning any condition a person has received or could have received care for in the past. If a health insurance company decides that you have a pre-existing condition based on your medical history, they may sell you a plan with increased premiums, or exempt themselves from covering care for that condition. Exclusion periods of up to 12 months are permitted in Idaho, giving the insurer the right to sell you a plan but not pay for certain kinds of treatment. If you switch insurance companies, you can use your former plan as a credit towards the exclusion period to help pay for services the plan does not cover.

While waiting for the ACA regulations to become effective in 2014, individuals with pre-existing conditions have an alternative to overpriced health insurance. The Pre-Existing Condition Plan is available in every state, and in Idaho it is operated by the U.S. Department of Health and Human Services. These plans offer a reasonable way to have health care coverage with similar benefits to a basic plan through a private insurer. PCIPs will expire in 2014, and all former members will have to apply for a health plan with a state-run health exchange (another ACA addition), Blue Cross or PacificSource. The ACA also removed the ability for insurers to use exclusion periods, and rates will not be increased based on health status.

Part of the HIPAA law is guaranteed renewal, which gives people in Idaho with insurance the freedom to continue using their health plans. Under the condition that the policy-holder has been paying their premiums and other necessary fees, and has not committed fraud or infringement against their plan agreement, they are eligible for guaranteed renewability. This law states that an insurer must offer to renew the same plan an individual had the year before at the end of their term. It additionally protects insured persons by forbidding a health insurance company from canceling your benefits if you suddenly get an illness of any sort once you have started your plan. This is important to keep in mind whenever you purchase health insurance or seek to continue your benefits with the same insurer.