En español | Most Idaho residents are eligible to buy health insurance through Your Health Idaho, the state’s Affordable Care Act (ACA) marketplace, during open enrollment, which is available now through through Dec. 15, 2022.
If you experience a qualifying life event — such as the birth of a child, a move, a marriage, a divorce or the loss of your employer-provided health insurance — you may be able to enroll or change your coverage outside of open enrollment.
Most people already enrolled in ACA marketplace plans have seen their premiums go down because the 2021 American Rescue Plan Act (ARPA) increased tax credits for insurance premiums and expanded the number of households who qualify for them. Every household that pays more than 8.5 percent of its household income now qualifies for federal tax credits to help them afford health insurance. These enhanced subsidies are now available through 2025.
Prior to the 2021 law, such tax credits were only available to people earning less than a certain salary ($54,360 for one person). Most Americans with a marketplace plan can save an average of about $800 per year, according to the federal government.
Create an account with Your Health Idaho. Include your Social Security number, your date of birth, your phone number and a valid email address when you register for an account. Call customer service at 855-944-3246 with questions.
When you apply for Your Health Idaho coverage, your eligibility for a tax credit or other cost savings also will automatically be determined. Use Your Health Idaho’s Tax Credit Estimator to estimate your savings for health insurance coverage.
From there, you can apply for insurance online, by phone, by mail or through a local enrollment expert.
Once you’re enrolled, you’ll need to pay your first monthly premium to your insurance provider for your coverage to begin.
Coverage and cost depend on where you live, the type of plan you choose, your estimated household income, and the age and disability status of you and your family.
If you qualify for Medicaid, you will be able to get free or low-cost coverage and may not need to worry about premiums or copays, depending on your level of income.
All Your Health Idaho plans cover 10 “essential” benefits, including:
Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family.
All Idaho plans cover basic dental services for children, including cleanings and exams. But adults who want dental coverage must add it to their policy. Deductibles and out-of-pocket costs vary between plans; enrolling in a family plan can cut costs.
Every eligible household that pays insurance premiums that exceed 8.5 percent of its annual income qualifies for federal tax credits for insurance premiums through 2025.
According to Megan O’Reilly, AARP vice president of government affairs for health and family, subsidy recipients ages 50 to 64 have already seen average annual savings of over $950.
Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction that would help you pay for such out-of-pocket expenses as deductibles and copays. You must enroll in a Silver-level plan to get this assistance. Your Health Idaho estimates that more than 80 percent of people who are currently enrolled qualify for financial help.
Your Health Idaho’s plans are organized into three categories:
Idaho residents under age 30 can also apply for a catastrophic plan offering low premiums but limited coverage. You can compare estimated plan costs using Your Health Idaho’s website.
If you already have coverage through your employer or directly through an insurance provider but are eligible for lower premiums, you can switch to Your Health Idaho during open enrollment. But you may not qualify for tax credits if you opt out of your employer’s plan — unless those premiums exceed a certain portion of your household income. The premiums would need to be more than 9.12 percent of your household income for individual coverage in order for you to qualify for the tax credits.
If you get coverage through the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) because you were terminated from a job or recently lost employer health insurance, you may be eligible for a Your Health Idaho plan during special enrollment. Before you enroll in COBRA, choose and apply for a Your Health Idaho plan. Otherwise, you won’t be eligible for special enrollment until your COBRA coverage ends. If you’re not sure about whether to switch out of COBRA, you can ask for free advice from a local insurance agent or broker.
That depends. Major insurance providers, including Blue Cross of Idaho and Select Health, offer Your Health Idaho plans, but not all doctors accept them. Talk to your doctor to see whether they will accept a marketplace plan.
It depends. You can enroll as a family. But in some cases, some family members may also be eligible for certain subsidies or other programs, depending on age, income and disability, or caregiver status. Such families may choose to enroll separately. Family members may still be able to see the same doctor or go to the same medical practice, depending on the types of insurance plans accepted.
This guide was updated on Nov. 1 with information about open enrollment.
This story is provided by AARP Idaho. Visit the AARP Idaho page for more news, events, and programs affecting retirement, health care, and more.
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