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Idaho Health Insurance

 

All health insurance policies in Idaho are considered guaranteed renewable as long as your premiums are paid up to date.  So this means your health insurance can not be canceled because you become sick.

 

Idaho mandates that health insurance companies cover newborns and adopted children for the first 60 days, on their parent’s policy.  But inversely pregnancy is, and can be considered a pre-existing condition, except on group health policies.  Pregnancy is a pre-existing condition but not on group health insurance.

 

Idaho has a high risk pool called HRP.  This stands for Idaho's High Risk Reinsurance Pool.  This is coverage that is offered to any resident that qualifies.  To qualify you must be an Idaho resident, have been denied health insurance from an insurance company, or be paying insurance premiums that are more expensive than you would be on an HRP plan.  You are also able to buy this plan if you are HIPAA eligible.

 

Rates for HRP are set just like any other insurance policy; age, family size, choice of plan, smoker/non smoker.  There are 4 plan options for HRP.  There are two catastrophic policies and two comprehensive policies.  In general every policy will exclude your pre-existing condition for 12 months.

 

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Idaho's Division of Insurance is a good place to look for additional information about health insurance.  To visit them directly click here.

 

                              Request an Idaho Health Insurance Quote

 

 

Idaho Small Business Health Insurance

 

In Idaho, a group health plan, can not base your health insurance premiums on your health.  This is called non discrimination.  Small Business Health Insurance in Idaho is also guaranteed issue, meaning that you can not be turn down for coverage.  But Large Businesses with 50+ employees can be turned down relative to health history.

 

Pre-existing exclusions are limited on the amount of time they can exclude coverage.  Also if you have current coverage, without lapses, that will be credited against your pre-existing period.  Pregnancy is not considered a pre-existing condition on a group health plan.

 

The maximum pre-existing waiting period is 12 months for an employee. If you are a late enrollee your maximum waiting period is 18 months.  Any pre-existing periods must be applied only after written notice.

 

Idaho mandates what type of plans each insurance company is able to offer small businesses.  There is the small employer basic health benefit plan, the standard health benefit plan, and the catastrophic health benefit plan.  Idaho Small Businesses have found this helps to make it easier to compare feature for feature.

 

For additional information about Small Business Health Insurance in Idaho click here.

 

                              Request an Idaho Small Business Health Insurance Quote

 

 

Idaho Individual Health Insurance

 

All Idaho Health Insurance Policies have to cover disabled children on their parent’s policy into their adulthood.

 

In Idaho, insurance companies are able to decide if they want to insure you or not.  They can either rate you up or just refuse coverage.  Also Idaho does not mandate what you buy, so insurance companies are able to design specific policies for specific consumers, rather than make insurance companies offer similar policies.

 

In Idaho, if you have had credible health insurance coverage within 63 days the largest pre-existing exclusion period you can face is 12 months.  Pregnancy in Idaho is considered a pre-existing condition and exclusions would apply.

 

Relative to Pre-Existing Conditions, Insurance companies in Idaho must give credit to prior credible coverage as long as there was not more than a 63 day lapse in coverage.

 

The rates that an individual pays for an Idaho Health Insurance Plan are based on age, location, health history, family size, sex etc.  Sadly there is no limit on how much an insurance company can charge and individual for coverage.

 

The State of Idaho has a great program designed to insure their uninsured population of Children.  It is called Idaho Child.

 

For additional information about Individual Health Insurance in Idaho click here.

 

                              Request an Idaho Individual Health Insurance Quote

 

 

Idaho Self Employed Health Insurance

 

In Idaho, Self Employed Individuals are not able to buy Self Employed health insurance from group plans.  If you are self employed you are treated like an individual and therefore subject to the laws and regulations that govern Idaho individual health insurance policies.

 

Another option for affordable Idaho Self Employed Health Insurance is often associations or self employed groups.  Just keep in mind that not all of these groups, or associations are regulated by the state.

 

One benefit for Self Employed people is that they are able to deduct 100% of their health insurance premiums from their taxes!

 

For additional information about Self Employed Health Insurance in Idaho click here.

 

                                Request an Idaho Self Employed Health Insurance Quote     

 

 

Idaho Temporary Health Insurance   

 

Many situations may arise where you find yourself without health insurance, or about to be without health insurance.  These reasons could range from graduating college to being in-between jobs.  Instead of going without health insurance you should look into getting a Idaho Temporary Health Insurance Policy.  These policies will be cheap, with high deductibles and low coverage, but getting an Idaho Temporary Health Insurance Policy is much better than going with out health insurance. 

 

 In Idaho, Temporary Health Insurance is not guaranteed renewable.  This is a very important point to make.  If you try to renew a temporary policy the insurance company has the right to refuse you coverage.  At the very least they can increase your premiums drastically.                           

 

For additional information about Temporary Health Insurance in Idaho click here.

 

                              Request an Idaho Temporary Health Insurance Quote

 

 

What types of Idaho Health Insurance are there?

 

HMO- Health Maintenance Organization.  This type of insurance is called managed care.  This means you have certain network of doctors and hospitals in Idaho that you have to go to for care.  Most Idaho HMO’s have office visit co-payments that range from $10 to $35, and hospital deductibles that range from $250 to $1,500.  Often the most affordable health insurance plans are HMO’s due to the fact they are managed care.

 

PPO-Preferred Provider Organization.  This type of insurance is also called managed care but it gives the consumer much more freedom; they allow you to visit any doctor or hospital in or out of network.  Most Idaho PPO’s have an in network and an out of network charge.  If the in network co-insurance is 100% then the out of network co-insurance would be 80%.  If the in network co-insurance is 90% then the out of network co-insurance would be 70%   Typically Idaho PPO’s offer co-payments for doctor visits as well as hospitalization. 

 

Indemnity Plan - In Idaho, as health insurance rates continue to rise, many people are finding it more affordable to drop their health insurance and buy a Idaho Major Medical Health Insurance Plan.  An Indemnity plan can also be called a major medical plan or catastrophic health insurance.  Whatever you call it, typically an Idaho Indemnity Plan would cover more “major” claims.  An Indemnity plan has an annual deductible and will usually allow you to pick different co-insurance options.  Indemnity plans allow you access to any doctor or hospital, and for this reason they are typically very expensive.

 

Discount Medical Plans – In recent years many Discount Medical Plans have started to surface.  These plans have relatively inexpensive, but consumers must realize that this is not insurance.  All these companies do is to get their customers discounted rates (20-50% off) on certain procedures at certain physicians and hospitals. 

 

Federal Mandated Health Insurance Laws

 

HIPAA

Along with Idaho Health Insurance Laws, there are Federal Laws that regulate Health Insurance companies.   HIPAA (Health Insurance Portability and Accountability Act of 1996). This act mandated federal standards for individual and group health insurance plans.  Some of the standards that it established were relative to guaranteed renew ability, crediting for prior health coverage and pre-existing condition waiting periods.

 

ERISA

Large corporations do not have health insurance policies.  Typically they are self funded, meaning the corporation pays for all of their employee’s medical bills instead of buying health insurance.  Most of these “self funded” companies are regulated by the federal government under ERISA (Employee Retirement Income Security Act)

 

COBRA

In Idaho it is mandated, by the state, that all companies that offer an Idaho Group Health Insurance Policy must also enable their employees to extend their health coverage temporarily; called Cobra.  An Idaho Cobra Insurance is typically available for a time period under 29 months.   In Idaho you are given 60 days to decide if you are going to take Idaho Cobra Insurance or not.  Once you have passed on the opportunity to take Cobra, you are not eligible to receive it.

 

Cobra Insurance was introduced in 1985.  Cobra stands for Consolidated Omnibus Budget Reconciliation Act.  If you would like more information about your Cobra Insurance options please contact your companies HR department.

 

Often employees are surprised at the cost of an Idaho Cobra Insurance.  The reason for this is that they are now responsible for 103% (100% of the premium plus a 3% administration fee) of a monthly health insurance premium when they probably only paid 20% while employed. 

 

Whether nor not to take Cobra is an important question, and you should realize there are alternatives to an Idaho Cobra Insurance Policy.  One should realize what they plan to do in the future.  If you are looking for another job, and it will be a few months before you get a job, it might make sense to look for an Idaho Temporary Health Insurance Plan.  If you are contemplating working at a consultant, it would be in your best interest to look into an Idaho Self Employed Health Insurance Policy.   

 

 

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