2016 Idaho Individual and Family Plans

The information on this page is for plans beginning January 1, 2016.  

Medical Plans

All plans are available direct with PacificSource and through YourHealthIdaho.org.


 

Plan

Deductible*

OOP*

Co-insurance

HSA-eligible?

SBCs and Policies
by Network
Summaries
by Network
  Balance Bronze 6850
$6,850
$6,850
0%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Balance Bronze 6850 (0)***
$0
$0
0%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Balance Bronze 6850 (AI)***
$6,850
$6,850
0%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Value Bronze 6450
$6,450
$6,450
0%
Yes
BIN / PSN / SAN / SCN
 BIN / PSNSAN / SCN
Value Bronze 6450  (0)***
$0
$0
0%
No
BIN / PSN / SAN / SCN
BIN / PSN / SANSCN
Value Bronze 6450 (AI)***
$6,450
$6,450
0%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Value Bronze 3500
$3,500
$6,450
50%
Yes
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Value Bronze 3500  (0)***
$0
$0
0%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Value Bronze 3500 (AI)***
$3,500
$6,450
50%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
  Balance Silver 2500 
$2,500
$6,850
30%
No
BIN / PSN / SAN / SCN
BIN / PSNSAN / SCN
Balance Silver 2500 (0) ***
$0
$0
0%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Balance Silver 2500 (AI) ***
$2,500
$6,850
30%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Balance Silver 2500 (73) **
$2,300
$5,450
30%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Balance Silver 2500 (87) **
$500
$2,000
30%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Balance Silver 2500 (94) **
$250
$500
30%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Value Silver 3600 
$3,600
$3,600
0%
Yes
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Value Silver 3600 (0)***
$0
$0
0%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Value Silver 3600  (AI)***
$3,600
$3,600
0%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Value Silver 3600 (73) **
$3,200
$3,200
0%
No
BIN / PSN / SAN / SCN
BIN / PSN / SANSCN
Value Silver 3600 (87) **
$1,200
$1,200
0%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
Value Silver 3600 (94) **
$500
$500
0%
No
BIN / PSN / SAN / SCN
BIN / PSNSANSCN
  Balance Gold 1000 
$1,000
$5,000
20%
No
BIN / SAN / SCN
BINSANSCN
Balance Gold 1000 (0)***
$0
$0
0%
No
BIN / SAN / SCN
BINSANSCN
Balance Gold 1000 (AI)***
$1,000
$5,000
20%
No
BIN / SAN / SCN
BINSANSCN
  Catastrophic
$6,850
$6,850
0%
No

*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.

Dental Plans


  Dental Advantage 0-20-50
   Kids Dental Advantage 0-20-50     Sample Handbook

Rates


       

Brochures and Forms


Brochures:

Enrollment Forms:  

Enroll Online:  

Limitations: Dental Advantage

Visit our Idaho Forms and Materials page for more sales materials.

Network Availability


Plan availability varies depending on geographic location. All network plans are available direct with PacificSource and through YourHealthIdaho.org.

PacificSource Network (PSN)

 
 Idaho PSN

Available in the following counties:

  • All counties

Notable features:

  • Access to participating PSN providers in Oregon, Idaho, Montana, and southern counties in Washington, as well as access to a nationwide travel network of providers
  • Referrals not required for specialty care
  • Plans eligible for health savings accounts
 

SmartChoice Network (SCN)

 
 Idaho SCN

Available in the following counties:

  • 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
 

Notable features:

  • Partner with a primary care provider (PCP)
  • Referrals not required for specialty care
  • Plans eligible for health savings accounts
 

SmartAlliance Network (SAN)

 
 Idaho SAN

Available in the following counties:

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

Notable features:

  • Referrals not required for specialty care
  • Plans eligible for health savings accounts
  • Includes the only Level II Trauma Center in the region

Network includes:

  • All hospitals and clinics in the Saint Alphonsus Health System
  • Primary Health Medical Group
  • West Valley Medical Center and Providers
  • Weiser Memorial Hospital and Providers
  • Walter Knox Memorial Hospital
 

BrightIdea Network (BIN)

 
 Idaho BIN

Available in the following counties:

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

Notable features:

  • Referrals not required for specialty care
  • Plans eligible for health savings accounts

Network includes:

  • St. Luke's Health System
  • West Valley Medical Center
  • Walter Knox Medical Center
  • Weiser Memorial Hospital
  • Minidoka Memorial Hospital
  • North Canyon Medical Center