2018 Idaho Individual and Family Plans

The information on this page is for plans beginning January 1, 2018.  

Medical Plans

All plans are available direct with PacificSource and through YourHealthIdaho.org.

Medical policy samples by plan and network: 


 

Plan

Deductible*

Out-of-pocket Maximum*

Office Visits

Co-insurance

SBCs
by Network
Summaries
by Network
Bronze HSA 6550
$6,550 
$6,550 
After deductible, covered in full
After deductible, covered in full
Bronze 6550 (0)***
$0
$0
After deductible, covered in full
After deductible, covered in full
Bronze 6550 (AI)*** 
$6,550
$6,550
After deductible, covered in full
After deductible, covered in full
Silver HSA 3000
$3,000
$5,000
After deductible, covered in full
After deductible, 25%
Silver 3000 (0)***
$0
$0
After deductible, covered in full
After deductible, covered in full
Silver 3000 (AI)***
$3,000
$5,000
After deductible, covered in full
After deductible, 25%
Silver 3000 (73)**
$1,800
$5,000
After deductible, covered in full
After deductible, 25%
Silver 3000 (87)**
$750
$1,500
After deductible, covered in full
After deductible, 20%
Silver 3000 (94)**
$250
$600
After deductible, covered in full
After deductible, 20%
Gold 1500
$1,500
$5,000
After deductible, covered in full
After deductible, 10%
Gold 1500 (0)***
$0
$0
After deductible, covered in full
After deductible, covered in full
Gold 1500 (AI)***
$1,500
$5,000
After deductible, covered in full
After deductible, 10%
Catastrophic
$7,350 
$7,350 
After deductible, covered in full+
After deductible, covered in full

*Deductible and out-of-pocket limit amounts shown above are the costs for individuals. Amounts for families are twice the individual amounts.

**This is a cost-sharing plan. Cost-sharing plans are only available to those who qualify financially and enroll through YourHealthIdaho.org.

***The Affordable Care Act (ACA) has special provisions for members of federally recognized American Indian tribes that purchase healthcare coverage through the Marketplace, including zero-cost health services for those whose income is at or below 300 percent of the Federal Poverty Level. Please note that even with a zero cost-sharing plan, out-of-network providers can bill for the amount over the network rate.

+The first three primary care practitioner (PCP) office and home visits office visits combined are paid at 100 percent. After that, PCP office visits are subject to deductible and co-insurance.

 

Dental Plans


Dental Advantage 0/20/50 - Sample policy
 
Kids Dental Advantage 0/20/50 - Sample policy
 

 

Rates


2018 Idaho Individual and Family Plan Rates

 

Brochures and Enrollment Forms


Idaho Individual Kit

You can now order sales kits for individual and small group clients online!

Order printed materials today >  

 

Brochures:  

Enrollment Forms:  

Enroll Online:  

Visit our Idaho Forms and Materials page for more sales materials.

 

Network Availability (Medical)


Network availability varies depending on geographic location.

PacificSource Network (PSN)

 

Availability: If an individual or family lives in one of the following counties, they can choose a plan on the PacificSource Network (PSN): 

  • Bannock
  • Bear Lake
  • Benewah
  • Bingham
  • Bonner
 
  • Bonneville
  • Boundary
  • Butte
  • Caribou
  • Clark
 
  • Clearwater
  • Custer
  • Franklin
  • Fremont
  • Idaho
 
  • Jefferson
  • Kootenai
  • Latah
  • Lemhi
  • Lewis
 
  • Madison
  • Nez Perce
  • Oneida
 
  • Power
  • Shoshone
  • Teton
 

Notable features: The PacificSource Network (PSN) includes the broadest access to in-network providers and facilities, such as hospitals and urgent care centers. Plans on the PacificSource Network will typically cost more because members will have more providers to choose from. Please note that not all plans are available on the PacificSource Network. See the medical plans listed above for details.

 

 
 

BrightPath Network

 

Availability: If an individual or family lives in one of the following counties, they can choose a plan on the BrightPath Network:

  • Ada
  • Adams
  • Blaine
 
  • Boise
  • Camas
  • Canyon
 
  • Cassia
  • Elmore
  • Gem
 
  • Gooding
  • Jerome
  • Lincoln
 
  • Minidoka
  • Owyhee
  • Payette
 
  • Twin Falls
  • Valley
  • Washington
 

Notable features: The BrightPath Network is designed to give members a coordinated-care experience through select provider groups and facilities. This level of provider collaboration means great care at a lower cost. This network includes coverage with St. Luke's providers and facilities, as well as other local healthcare providers.