Individual Plans2017 Idaho Individual and Family Plans

The information on this page is for plans beginning January 1, 2017.  

 

We offer plans in three networks.

Access more providers with our PacificSource Network.

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 you’ll have more providers to choose from.

PacificSource Network Availability

If you live in one of the following counties, you can choose plans on the PacificSource Network:

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

Lower your costs with our SmartAlliance and BrightPath networks.

The SmartAlliance and BrightPath networks are designed to give you a coordinated-care experience through select provider groups and facilities. This level of provider collaboration means great care at a lower cost.

SmartAlliance Network Availability

If you live in one of the following counties, you can choose plans on the SmartAlliance Network:

  • Ada
  • Boise
 
  • Canyon
  • Gem
 
  • Owyhee
  • Payette
 
  •  Washington
 
   

BrightPath Network Availability

If you live in one of the following counties, you can choose BrightIdea plans on the BrightPath Network:

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

 

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: 

 

Plan

Deductible*

Out-of-pocket limit*

Co-pay for office visits

Co-insurance after deductible

SBCs
by Network
Summaries
by Network
Bronze HSA 6550
$6,550 
$6,550 
No charge
No charge
Bronze HSA 6550 (0)***
$0
$0
No charge
No charge
Bronze HSA 6550 (AI)*** 
$6,550
$6,550
No charge
No charge
Silver HSA 3000
$3,000
$5,000
No charge
25%
Silver HSA 3000 (0)***
$0
$0
No charge
No charge
Silver HSA 3000 (AI)***
$3,000
$5,000
No charge
25%
Silver HSA 3000 (73)**
$1,800
$5,000
No charge
25%
Silver HSA 3000 (87)**
$750
$1,500
No charge
20%
Silver HSA 3000 (94)**
$250
$600
No charge
20%
Gold 1500
$1,500
$3,000
No charge
20%
Gold 1500 (0)***
$0
$0
No charge
No charge
Gold 1500 (AI)***
$1,500
$3,000
No charge
20%
Catastrophic
$7,150 
$7,150 
No charge+
No charge

*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 visits are paid at 100 percent. After that, PCP office visits are subject to deductible and co-insurance.

 

Review dental plans.

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

 

Get more information.

Download a brochure:

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Compare rates, and apply online.

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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 >