2019 Idaho Individual and Family Plans

The information on this page is for plans beginning January 1, 2019.  

Medical Plans


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

Medical policy samples by plan and network (PDFs): 

Plan

Deductible*

Out-of-pocket Maximum*

Preventive Services
No deductible, member pays:

Office Visits
After deductible, member pays:

SBCs (PDFs)
by Network
Summaries (PDFs)
by Network
Gold 1500 $1,500 $5,000 Covered in Full 10% PacificSource /
BrightPath
PacificSource /
BrightPath
Gold 1500 (0)*** $0 $0 Covered in Full Covered in Full PacificSource /
BrightPath
PacificSource /
BrightPath
Gold 1500 (AI)*** $1,500 $5,000 Covered in Full 10% PacificSource /
BrightPath
PacificSource /
BrightPath
Silver HSA 3000 $3,000 $6,650 Covered in Full 25% PacificSource /
BrightPath
PacificSource /
BrightPath
Silver 3000 (0)*** $0 $0 Covered in Full Covered in Full PacificSource /
BrightPath
PacificSource /
BrightPath
Silver 3000 (AI)*** $3,000 $6,650 Covered in Full 25% PacificSource /
BrightPath
PacificSource /
BrightPath
Silver 3000 (73)** $2,300 $5,000 Covered in Full 25% PacificSource /
BrightPath
PacificSource /
BrightPath
Silver 3000 (87)** $1,000 $1,500 Covered in Full 20% PacificSource /
BrightPath
PacificSource /
BrightPath
Silver 3000 (94)** $400 $650 Covered in Full 20% PacificSource /
BrightPath
PacificSource /
BrightPath
Bronze HSA 6650 $6,650  $6,650  Covered in Full Covered in Full BrightPath BrightPath
Bronze 6650 (0)*** $0 $0 Covered in Full Covered in Full BrightPath BrightPath
Bronze 6650 (AI)***  $6,650 $6,650 Covered in Full Covered in Full BrightPath  BrightPath
Catastrophic+ $7,900  $7,900  Covered in Full Primary visits 1-3 no deductible. Visits 4+ covered in full after deductible.
Urgent Care/Specialist: Covered in Full
BrightPath BrightPath 

*Deductible and out-of-pocket maximum 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.

+Only available for people under 30, or people of any age with a hardship exemption or affordability exemption. 

 

Dental Plans (PDFs)


Dental Advantage 0-20-50 1000 - Sample policy
Dental Advantage 0-20-50 1500 - Sample policy  
Kids Dental Advantage 0-20-50 - Sample policy

Rates


2019 Idaho Individual and Family Plan Rates (PDF) 

 

Brochures and Enrollment Forms 


Brochures: 

IFP100_080918_Idaho_Medical_Individual_cover

You can order sales kits for individual and small group clients online!

Order printed materials today >  

Brochures (PDFs): 

Enrollment Forms (PDFs):  

Enroll Online:  

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

 

Network Availability (Medical)


Network availability varies depending on geographic location.

PacificSource Network (PSN)

 

Availability: If an individual or family lives in one of the following counties, they can choose a plan on the PacificSource Network (PSN): 

  • Bannock
  • Bear Lake
  • Benewah
  • Bingham
  • Bonner
 
  • Bonneville
  • Boundary
  • Butte
  • Caribou
  • Clark
 
  • Clearwater
  • Franklin
  • Fremont
  • Idaho
 
  • Jefferson
  • Kootenai
  • Latah
  • Lewis
 
  • Madison
  • Nez Perce
  • Oneida
 
  • Power
  • Shoshone
  • Teton
 

Notable features: The PacificSource Network (PSN) includes the broadest access to in-network providers and facilities, such as hospitals and urgent care centers. Plans on the PacificSource Network will typically cost more because members will have more providers to choose from. Please note that not all plans are available on the PacificSource Network. See the medical plans listed above for details.

 

BrightPath Network

 

Availability: If an individual or family lives in one of the following counties, they can choose a plan on the BrightPath Network:

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

Notable features: The BrightPath Network is designed to give members a coordinated-care experience through select provider groups and facilities. This level of provider collaboration means great care at a lower cost. This network includes coverage with St. Luke's providers and facilities, as well as other local healthcare providers.