Idaho Health Insurance Consumer Guide

In order to sign up for private health coverage through Your Health Idaho, you must:⁵

• Be an Idaho resident and lawfully present in the United States
• Not be incarcerated
• Not be enrolled in Medicare

So most Idaho residents are eligible to enroll in coverage through the exchange. But eligibility for financial assistance is a bigger question for most people, and there are a few additional eligibility rules to qualify for subsidies through Your Health Idaho. 

To qualify for income-based Advance Premium Tax Credits (APTC) or cost-sharing reductions (CSR), you must:

• Not be eligible to enroll in an affordable employer-sponsored health plan. If you have access to an employer’s health plan and aren’t sure if it’s considered affordable, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies to offset the cost of a Your Health Idaho plan. 
• Not be eligible for Idaho Medicaid or CHIP.

Beyond those basic parameters, qualifying for Your Health Idaho’s subsidies will depend on your household’s income and how that compares with the cost of the second-lowest-cost Silver plan in your area – which will depend on your age and location.

Your Health Idaho’s open enrollment period is shorter than any other state’s enrollment window, and both its start and end dates are unique. In Idaho, open enrollment begins October 15 and ends December 15.⁶ So enrollment starts about two weeks earlier than it does in other states, but ends a month earlier. Idaho is the only state where open enrollment ends in December.

All enrollments submitted during open enrollment in Idaho will have January 1 coverage effective dates.

After open enrollment ends, you may still be eligible to enroll or make a plan change if you experience a qualifying life event, such as giving birth or losing other health coverage. And some people can enroll year-round even without a specific qualifying life event.⁷

Enrollment in Idaho Medicaid and CHIP is available year-round for eligible residents.

To enroll in an ACA Marketplace/exchange plan in Idaho, you can: 

• Visit Your Health Idaho, which is Idaho’s health insurance exchange (Marketplace). The Your Health Idaho website will allow you to compare available health plans, determine whether you’re eligible for financial assistance, and enroll in a health plan. 
• Enroll in a Your Health Idaho plan with the help of an insurance broker or certified enrollment counselor.

You can reach Your Health Idaho’s call center at 855-944-3246.

Income-based subsidies (APTC, created by the Affordable Care Act) are available to lower the amount you pay for your health coverage each month. These subsidies are available to enrollees who meet the eligibility requirements and select a metal-level health plan through Your Health Idaho.

Eighty-five percent of the people who selected a plan through Your Health Idaho during the 2023 open enrollment were eligible for premium subsidies. These subsidies paid an average of $487/month, reducing the average enrollee’s premium to about $96/month. ⁸

Source: CMS.gov ⁹

If your household doesn’t earn more than 250% of the federal poverty level, you’ll also be eligible for federal cost-sharing reductions (CSR) as long as you select a Silver-level plan through Your Health Idaho. These subsidies will reduce your deductible and other out-of-pocket expenses, making health care more affordable. Twenty-seven percent of Your Health Idaho enrollees were receiving CSR benefits as of early 2023.¹⁰

If you’re eligible for APTC and CSR, you can use them both if you enroll in a Silver-level plan through Your Health Idaho (APTC can be used with any metal-level plan, but you can only get CSR benefits if you enroll in a Silver plan). 

Depending on your income and circumstances, you may be able to enroll in free or low cost health coverage through Idaho Medicaid or CHIP. Learn more about whether you might be eligible for these programs in Idaho.

For 2023 coverage, eight insurers offer exchange plans in Idaho (a record high for the Idaho exchange) and all eight intend to continue to offer coverage in 2024.¹¹

The following insurers offer medical plans through Your Health Idaho, with plan availability varying from one location to another:

• Blue Cross of Idaho
• Mountain Health CO-OP
• PacificSource
• Select Health
• Regence BlueShield of Idaho
• Molina
• St. Luke’s Health Plan 
• Moda Health

Molina joined the Idaho marketplace in 2022. And for 2023, St. Luke’s Health Plan and Moda Health joined.^{12 13}

Idaho has a reinsurance program as of 2023, which kept overall average (pre-subsidy) premiums about 12% lower than they would otherwise have been.¹⁴  Average premiums would have increased without the reinsurance program, but instead, average premiums decreased by about 3.6% for 2023.¹⁵

For 2024, Idaho’s insurers have proposed overall flat rates (0% change from 2023), although there is variation from one insurer to another.¹⁶ The carriers have proposed the following average rate changes:

These rate proposals are under review by the Idaho Department of Insurance, and rates will be finalized before open enrollment starts in the fall of 2023.

Average rate changes apply to full-price rates, and most enrollees do not pay full price: Eighty-six percent of Your Health Idaho enrollees were receiving premium subsidies in 2023, offsetting some or all of their monthly premium cost.¹⁷

Subsidy amounts vary from one enrollee to another and change annually depending on the cost of the second-lowest-cost Silver plan relative to the enrollee’s household income. The American Rescue Plan and the Inflation Reduction Act have resulted in larger, more widely available subsidies, and will continue to be true at least through 2025.

If the cost of your Idaho plan is going up for the coming year, you may want to consider some of the other plans that are available through Your Health Idaho. You may find alternatives that meet your needs and have a lower monthly premium.

During the open enrollment period for 2023 coverage, nearly 80,000 people selected private plans through Your Health Idaho.¹⁸

As of early 2023, effectuated enrollment (always a little lower than the number of plan selections) stood at nearly 69,000 people.¹⁹

Source: 2014,²⁰ 2015, ²¹ 2016,²² 2017,²³ 2018,²⁴ 2019,²⁵ 2020,²⁶ 2021,²⁷ 2022,²⁸ 2023,²⁹ 2024³⁰

Your Health Idaho – This is the state-run exchange/Marketplace in Idaho, where you can compare plans, determine financial assistance eligibility, and select a health plan. You can reach Your Health Idaho at 855-YHIdaho (855-944-3246)

State Exchange Profile: Idaho – The Henry J. Kaiser Family Foundation overview of Idaho’s progress toward creating a state health insurance exchange.

Idaho Department of Insurance – Regulates the insurance industry in Idaho, and addresses consumers’ questions and complaints related to insurance.
(208) 334-4250 / toll-free (800) 721-3272.

Idaho Senior Health Insurance Benefits Advisors – A service for Idaho Medicare beneficiaries and their caregivers, providing information and assistance with questions related to Medicare eligibility, enrollment, and claims.