2020 Idaho Individual and Family Plans

The information on this page is for plans beginning January 1, 2020.  

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At your service: plans and networks come with choice

Our health plan products are a unique combination of networks and plan designs to fit the needs of you and your family. For 2020 we’re offering two new products: Navigator and Voyager. The county where you live determines which one of these you can enroll in.

Your product’s provider network determines which doctors, hospitals, and other healthcare providers are covered by in-network benefits for you. All of our Navigator and Voyager products also offer out-of-network benefits, for more freedom and choice.

Navigator gives you exceptional coordinated care

In our effort to simplify health insurance, Navigator provides a more integrated approach to care—helping members get the right care, at the right time, in the right place. Navigator helps ensure a better member experience by promoting doctor-patient engagement and shared decision-making.

Navigator is available in the following counties:  

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

Voyager gives you the broadest choice of providers

Voyager is our rebranded evolution of the PSN (PacificSource Network) product. As a preferred provider organization (PPO), Voyager means greater choice for members. For those who prefer a more self-guided experience, Voyager gives members expanded access to our broadest network of providers.

Voyager is available for purchase by people living in the following counties:

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

 

Review medical plans

Deductible and out-of-pocket limit amounts shown below are the costs for individuals. Amounts for families are twice the individual amounts. If members receive services from out-of-network providers, their deductible and out-of-pocket limit will be higher than the amounts listed in the chart below. All plans are available direct with PacificSource and through YourHealthIdaho.org.

Medical policy samples by plan and network (PDFs): 

Product

Deductible

Out-of-pocket Maximum

Preventive Services
No deductible, member pays:

Office Visits
After deductible, member pays:

SBCs (PDFs)
by Network
Summaries (PDFs)
by Network
Gold 1500 $1,500 $5,000 Covered in Full 10% Navigator / Voyager Navigator / Voyager
Gold 1500 (0)*** $0 $0 Covered in Full Covered in Full Navigator / Voyager Navigator / Voyager
Gold 1500 (AI)*** $1,500 $5,000 Covered in Full 10% Navigator / Voyager Navigator / Voyager
Gold 2000 $2,000 $6,000 Covered in Full Primary/Urgent Care: $20*, Specialist: $40* Navigator Navigator
Gold 2000 (0)*** $0 $0 Covered in Full Covered in Full Navigator Navigator
Gold 2000 (AI)*** $2,000 $6,000 Covered in Full Primary/Urgent Care: $20*, Specialist: $40* Navigator Navigator
Silver 3000 $3,000 $8,150 Covered in Full Primary/Urgent Care: $35*, Specialist: 40% Navigator Navigator
Silver 3000 (0)*** $0 $0 Covered in Full Covered in Full Navigator Navigator
Silver 3000 (AI)*** $3,000 $8,150 Covered in Full Primary/Urgent Care: $35*, Specialist: 40% Navigator Navigator
Silver 3000 (73)** $2,500 $6,500 Covered in Full Primary/Urgent Care: $35*, Specialist: 40% Navigator Navigator
Silver 3000 (87)** $1,000 $2,000 Covered in Full Primary/Urgent Care: $25*, Specialist: 25% Navigator Navigator
Silver 3000 (94)** $400 $700 Covered in Full Primary/Urgent Care: $25*, Specialist: 20% Navigator Navigator
Silver HSA 3500 $3,500 $6,750 Covered in Full 25% Navigator / Voyager Navigator / Voyager
Silver 3500 (0)*** $0 $0 Covered in Full Covered in Full Navigator / Voyager Navigator / Voyager
Silver 3500 (AI)*** $3,500 $6,750 Covered in Full 25% Navigator / Voyager
Navigator / Voyager
Silver 3500 (73)** $2,200 $6,000 Covered in Full 25% Navigator / Voyager
Navigator / Voyager
Silver 3500 (87)** $1,000 $1,600 Covered in Full 20% Navigator / Voyager
Navigator / Voyager
Silver 3500 (94)** $400 $700 Covered in Full 20% Navigator / Voyager
Navigator / Voyager
Silver 4000 $4,000 $7,900 Covered in Full Primary/Urgent Care: $20*, Specialist: $40* Navigator Navigator
Silver 4000 (0)*** $0 $0 Covered in Full Covered in Full Navigator Navigator
Silver 4000 (AI)*** $4,000 $7,900 Covered in Full Primary/Urgent Care: $20*, Specialist: $40* Navigator Navigator
Silver 4000 (73)** $2,800 $6,500 Covered in Full Primary/Urgent Care: $20*, Specialist: $40* Navigator Navigator
Silver 4000 (87)** $1,000 $2,000 Covered in Full Primary/Urgent Care: $20*, Specialist: $40* Navigator Navigator
Silver 4000 (94)** $400 $800 Covered in Full Primary/Urgent Care: $20*, Specialist: $40* Navigator Navigator
Bronze 5500 $5,500 $8,150 Covered in Full Primary/Urgent Care: $35*, Specialist: 50% Navigator Navigator
Bronze 5500 (0)*** $0 $0 Covered in Full Covered in Full Navigator Navigator
Bronze 5500 (AI)*** $5,500 $8,150 Covered in Full Primary/Urgent Care: $35*, Specialist: 50% Navigator Navigator
Bronze HSA 6750 $6,750  $6,750  Covered in Full Covered in Full Navigator Navigator
Bronze 6750 (0)*** $0 $0 Covered in Full Covered in Full Navigator Navigator
Bronze 6750 (AI)***  $6,750 $6,750 Covered in Full Covered in Full Navigator  Navigator
Bronze 7000 $7,000 $8,150 Covered in Full Primary/Urgent Care: $35*, Specialist: 40% Navigator  Navigator
Bronze 7000 (0)*** $0 $0 Covered in Full Covered in Full Navigator  Navigator
Bronze 7000 (AI)*** $7,000 $8,150 Covered in Full Primary/Urgent Care: $35*, Specialist: 40% Navigator  Navigator
Catastrophic+ $8,150  $8,150  Covered in Full Primary visits 1-3 no deductible, covered in full. Visits 4+ covered in full after deductible.
Urgent Care/Specialist: Covered in Full
Navigator Navigator 

*Not subject to deductible.

**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.

+Only available for people under 30, or people of any age with a hardship exemption or affordability exemption. 

 

Decide on a dental plan

Good dental health can lead to better overall health. You can add one of our dental plans to your health plan, or select dental-only. Available for purchase year-round, not just during open enrollment.

Dental Advantage 0-20-50 1000 - Sample policy
Dental Advantage 0-20-50 1500 - Sample policy  
Kids Dental Advantage 0-20-50 - Sample policy

 

Get more information 

Download a brochure (PDFs): 

Contact us. We're happy to help!

Compare rates, and apply online

2020 Idaho Individual and Family Plan Rates (PDF) 

I'd like to purchase insurance online, through:

I'd prefer to use the paper enrollment form:  

Money 60 Remember: The only way to get help paying for your health insurance premiums is to purchase through the marketplace. You may also qualify for lower out-of-pocket costs. Click here for more information

 

 

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