IFP100_080918_Idaho_Medical_Individual_cover2019 Idaho Individual and Family Plans 

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

 

We offer plans in two networks.

Access more providers with our PacificSource Network.

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 you’ll have more providers to choose from.

PacificSource Network Availability

If you live in one of the following counties, you can choose plans on the PacificSource Network:

  • 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
 

Lower your costs with our BrightPath network.

The BrightPath network is designed to give you a coordinated-care experience through select provider groups and facilities. This level of provider collaboration means great care at a lower cost.

BrightPath Network Availability

If you live in one of the following counties, you can choose BrightIdea plans 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
 

 

Review medical plans.

Deductible and out-of-pocket limit amounts shown below are the costs for individuals. Amounts for families are twice the individual amounts. If members receive services from out-of-network providers, their deductible and out-of-pocket limit will be higher than the amounts listed in the chart below. 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. 

 

Review dental plans.

Dental Advantage 0-20-50 1000 - Sample policy

Dental Advantage 0-20-50 1500 - Sample policy

Kids Dental Advantage 0-20-50 - Sample policy

 

Get more information.

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Money 60 Remember: The only way to get help paying for your health insurance premiums is to purchase through the marketplace. You may also qualify for lower out-of-pocket costs. Click here for more information >