Idaho Health Insurance - Health Plan One

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Health Insurance for the Well Informed

In Idaho, medical underwriting is allowed based on health status, experience, duration, age and gender. Medical underwriting is the process that slows insurance carriers to review the medical history of prospective members. There is a 6 month look back and 12 month exclusionary period limit for preexisting conditions for those without prior health coverage.

For medically uninsurable individuals, those utilizing their HIPAA rights are guaranteed health insurance coverage through any Idaho insurance carrier. For those with credible health coverage within the past 12 months, insurance carriers must offer basic, standard, and catastrophic policies. There is also a high risk pool available for individuals who meet the following criteria:

Coverage in the high-risk pool includes doctor visits, prescription drugs, outpatient and in-hospital care, maternity, ambulance, labs and x-rays, skilled nursing care, hospice, home health visits, transplants, rehabilitation, durable medical equipment, mental health and substance abuse, physical, speech and occupational therapy, and preventive care.

In Idaho, medical underwriting is allowed with a variance of plus or minus 50% of the indexed rate based on the health status of the group. For preexisting condition requirements, the carrier may look back in a consumer’s medical history 6 months and impose a 12 month exclusionary period for those that did not have prior medical coverage.

Idaho offers COBRA (Consolidate Omnibus Budget Reconciliation Act of 1985). COBRA enables former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health coverage at group rates. Many companies with 20 or more employees that offer health insurance are required to offer employees and their dependents continuation coverage for benefits that were lost due, for example, to job loss, reduction in hours worked, death, or divorce.

Medicaid is a joint state and federal program that furnishes medical assistance to eligible low income families and to eligible aged, blind and/or disabled people whose income is insufficient to meet the cost of necessary medical services. Below outlines the specifics:

Income requirements:

Ages 1-5: 150% of the Federal Poverty Level

Ages 6-19: 150% of the Federal Poverty Level

Pregnant Women and Infants

Pregnant Women: 133% of the Federal Poverty Level

Infants Ages 0-1: 150% of the Federal Poverty Level

Non-Working: 24% of the Federal Poverty Level

Working: 31% of the Federal Poverty Level

Other populations

Supplemental Security Income Recipients- 74% of the Federal Poverty Level

Covered Services

Hospitalization, physician services, nursing home care, and prescription drugs.

There are no co-payments.

You may learn more about Idaho Medicaid at http://www.healthandwelfare.idaho.gov/.

Idaho offers the CHIP program to children with family incomes of up to 185% of the Federal Poverty Level who are ineligible for Medicaid and who meet residency requirements. Idaho also offers an infant to toddler program for children with developmental delays. Please visit the CHIP website for more detailed information at http://www.idahochild.org/.

Idaho Health Insurance Quotes

Idaho Health Insurance Companies

Idaho Individual Health Insurance Information

Idaho Group & Small Business (2-50 employees) Health Insurance

Idaho COBRA Individual Health Coverage

Medicaid in Idaho

Other Idaho Health Insurance Programs