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Idaho Health Insurance

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Facts and Figures

  • Place in State
    Health Report Card
  • Insured 1,290,895
  • Uninsured 234,100
  • Insurance
  • Number of
    Primary Care Physicians
  • Number of

Breakdown of Insureds

  • Employer-sponsored health insurance 60%
  • Private plans 8%
  • Medicaid 14%
  • Medicare 14%
  • Others 4%

Insurance Carriers

State Health Report Card

There are 179,000 or 15.7 percent of Idaho residents who smoke but this is an improvement from 22.3 percent in the past ten years. The number of Idaho residents who are obese have increased over the years. From 306,000 obese adults, the number has increased to 437,000 in ten years. In five years, adult residents with diabetes have increased from 6.8 percent to 7.9 percent which translates to 90,000 residents. The rate of preventable hospitalizations decreased within the past year. 18.9 percent of children under 18 are living in poverty. This is an increase from 12.4 percent five years ago. “Idaho ranks lower for determinants than for outcomes, indicating that overall healthiness may decline over time.”

Idaho Health Insurance Laws and Regulations

In the state, there are certain Idaho health insurance laws that provide protections for residents and regulations that govern the private health insurance market.

Unlike most states, there is no guaranteed renewability for Idaho health insurance plans. Your insurance provider may deny your application for renewal. To avoid this , make sure that your policy includes a guaranteed renewal clause. Idaho requires health insurance providers to offer three health plans – basic, standard and catastrophic which consumers may purchase anytime (if they were previously enrolled under an Idaho health insurance plan). There is an open enrollment period where they can apply for policies without restriction. When creating new Idaho health insurance plans, insurers can exclude coverage for a pre-existing condition. This means that if you have been diagnosed with an illness, it will not be covered. The pre-existing condition exclusion period ranges from six months to twelve months depending on the insurer. If you want to avoid this waiting period, make sure that your coverage is continuous. Changing insurers does not affect the continuity of the coverage. Small businesses who are looking into purchasing a group plan can apply for any Idaho health insurance plan available for small businesses in the area. Insurers are free to set their own terms and conditions. Idaho health insurance quotes for group coverage can vary according to the risk factors of the applicants. Self-employed individuals may not apply for group plans for small businesses.

Idaho health insurance companies are not allowed to impose a waiting period or exclusion period for a pre-existing health condition if an applicant has gone no longer than 63 days without health insurance.

Heath Care Reform

Young adults in Idaho can now stay under their parent’s policy. The new health law
mandates health insurance companies to allow parents to keep their children in
their policy until age 26. 11,736 young adults in Idaho have benefited from this
plan (as of June 2011).

Because of the new law, Medicare members no longer need to worry about their extra prescription cost. Once they reach the donut hole in 2010, they are sent a check for a $250 rebate. 16,559 seniors in Idaho have received the rebate to offset the cost of their prescription drugs. This resulted to an average of $8,665,605 for Idaho Medicare members. The Affordable Care Act claims to close the donut hole by 2020.

One of the provisions of the health care reform is to provide preventive care
services free of charge for Medicare members and free from cost-sharing for those enrolled under private plans. In 2011, 153,007 Medicare members and 283,000
private plan members in Idaho have received free preventive care services like
colonoscopy and mammograms.

When looking at Idaho health insurance quotes, applicants are assured that at least 80 percent of the price will go directly to health care services and other related improvements and no more that 20 percent on administrative costs. 463,000 Idaho residents are now able to
maximize their premium.

Insurers are no longer allowed to impose a lifetime limit on their members’ benefits.
566,000 Idaho residents are now free from having lifetime limits on their coverage.
Patients with chronic diseases don’t have to worry about maximizing their limit
because of their accumulating medical costs.

Through the Pre-Existing Condition Insurance Plan, Idaho residents who have
pre-existing condition can now have affordable coverage. As of 2011, 316
residents now have an Idaho health insurance. Without this provision, they
would still remain uninsured.

Insurance companies will not be able to exclude children from coverage because of a pre-existing condition, giving parents across Idaho peace of mind.

Insurance plans’ use of annual limits will be tightly regulated to ensure access to needed care.  This will protect the 754,000 residents of Idaho with health insurance from their employer, along with anyone who signs up with a new insurance plan in Idaho.

Health care reform aims to insure every American by 2014. To do this, they are
encouraging states to set up their own health insurance exchanges where residents
can easily purchase their Idaho health insurance. A $21.3 million grant was issued
to Idaho to fund the planning and development of its own health insurance marketplace.

A $4.6 million gant was given to Idaho to support health programs. A $25.5 million fund was given to Idaho to support the creation and improvement of health centers.



State Government Insurance Programs Offered


800-926-2588 TDD: 208-332-7205

Medicaid is a federal program designed to provide health insurance coverage to low-income individuals, families and disabled citizens.

Women’s Health Check Program


Women’s Health Check Program offers free screening for breast and cervical cancer, and full coverage for both cancers through Medicaid. This program is available to low-income women who do not have health insurance or whose insurance doesn’t cover mammograms or Pap tests.

Children’s Access Card

This is a state-sponsored program with the cooperation of Idaho health insurance carriers designed to address the rising number of uninsured in Idaho. Children’s Access Card provides Idaho children with up $100 to $300 per month to go towards health insurance premiums.

Access to Health Insurance (AHI)

Residents in Idaho who work in small businesses can get $100 to $500 a month to help them pay for health plan premiums.

Idaho State Health Plan For Children


Covers Regular checkups, Immunizations, Prescription drugs, Lab tests and x-rays, Hospital visits, and more. Pre-Existing Health Conditions also Covered

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