Idaho Health Insurance

Idaho’s health insurance regulations are quite unlike those that are currently in place in many other states, so it’s especially important to learn as much as you can before shopping for a new health policy here.  The list below contains information to help you get started with this process.

• Unlike most states, Idaho does not require its health insurance companies to offer guaranteed renewability for every policy they sell.  This means that, if your policy does not have a clause saying otherwise, your insurer may legally decline to renew your policy once its term has expired.  Therefore, you should generally try to have a guaranteed-renewability clause included in your insurance contract before you purchase any new coverage.
• Idaho’s regulatory laws require insurers to always offer three standardized health plans: basic, standard, and catastrophic.  Unlike other health coverage that may be offered, these standardized plans are always available to any individual that has previously had health coverage in Idaho.  Additionally, there is an annual open-enrollment period during which these policies are available to all Idaho residents, without restriction.
• Pre-existing conditions, defined as health issues that have been diagnosed or treated within the previous six months, may be declared exempt from coverage under any new health policy, at your insurer’s discretion.  This exemption period can last for up to twelve months after the policy goes into effect, but changing to another health plan or insurer never requires you to go through this waiting period again.  Maintaining continuous health coverage will also prevent you from having to go through such an exemption.
• While health insurers in Idaho are required to offer the three standardized plans to all eligible buyers, they are given full discretion to deny any application for a non-standard policy on the basis of health, age, or other risk factors.  They may also use these criteria to determine the premiums of any insurance policy they sell.
• If a small business in Idaho with 2 to 50 employees wishes to purchase group health coverage, insurers in this state are required by law to offer them any policy that is available to other small businesses in this state.  Insurers are allowed to set some conditions for this coverage, though, such as requiring a minimum level of participation among the employees or a minimum per-employee contribution to premiums from the employer.
• Although a small-business health plan may be cancelled by the insurer if the above conditions are not met, it is illegal in Idaho for health coverage to be dropped on the basis of illness among the insured company’s staff.  Rates are also somewhat restricted by state law, though they may be affected by considerations like the employees’ health, age, sex, and so on.
• Self-employed Idaho residents with no other employees are not eligible to purchase group insurance as a small business, but they may be able to deduct a portion of the premiums for individual coverage from their tax liability.

Due to the unusual nature of Idaho’s insurance regulations, you should take care to examine the wording of any health policy before you purchase it.  If you can, make sure that your coverage comes with guaranteed renewability so that you can avoid losing your coverage unexpectedly.  Above all, be sure to stay as well-informed as possible so that you can take full advantage of any competing offers.

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