Individual Health Insurance

How do I get health insurance in Idaho?

Getting a health insurance plan can be a little tricky if you want to qualify for all the benefits to which you may be eligible. The Idaho state based exchange has our citizens dealing with 3 different entities when purchasing health insurance with an accompanying tax credit. The Idaho Department of Health and Welfare handles eligibility for the APTC (tax credit). Your Health Idaho handles enrollment in and changes to your health insurance plan. Then of course you have the insurance company such as Blue Cross of Idaho through whom you receive your benefits and coverage. As independent brokers, we are skilled in the application process and knowledgeable about the eligiblity criteria. And remember. . . you don’t pay a penny more to work with an insurance broker; the prices are the same.

Do you want to quickly compare health insurance plans in Idaho? The most convenient way to see all plans is through the yourhealthidaho.org website. There you can see all plans available in your area with just your zip code, birth dates, smoking status, and income estimate. However, be sure to speak with one of our knowledgeable agents before applying or choosing a plan. We can help you decide what tax credit (APTC) benefits you may be eligible for to help lower your insurance premiums each month. Additionally, you may be eligible for a Cost Share Reduction (CSR) on a Silver plan which can help reduce your deductible and out of pocket maximum. And if you are not eligible for a tax credit, we can help you determine that before you waste a lot of time and frustration dealing with the yourhealthidaho.org website. If you are not eligible for the tax credit subsidy, then it is much easier to purchase a plan by going direct through one of the links on our home page

What companies offer individual health insurance in Idaho?

Click here for a list from the Idaho Department of Insurance. These are the only companies authorized to sell real individual health plans. Companies selling discount health plans and supplemental health plans are not on their list. Be sure you are dealing with a real health insurance plan so you are well covered and so you don’t become subject to the individual mandate penalty for not having a qualified health plan.

We work with the largest Idaho health insurance companies including Blue Cross of Idaho, Regence Blue Shield of Idaho, SelectHealth, Mountain Health CO-OP, BridgeSpan, and PacificSource. Most of these companies have proven track records of stability and fairness. They are not-for-profit companies, unlike others that have shareholders to pay which only adds an additional layer of costs.

Your health insurance coverage is only as good as the company standing behind it. We too often speak with customers of other insurance companies that are not receiving everything they were promised. The problem is that once you select a plan during open enrollment, you will likley be stuck with that plan the rest of the year, so make sure you are getting the right coverage while you can.

What are the “best” health insurance plans in Idaho?

Health insurance plans now fall under several categories to reflect the level of coverage they provide such as Bronze, Silver, Gold, and Platinum. It would reason that Platinum plans are the best coverage and Bronze plans are the lowest level of coverage. This is true for individuals and families purchasing coverage without the tax credit and out of pocket subsidy. However, for those whoe incomes fall between 100% and 250% of the Federal Poverty Level (FPL), the Silver plans become enhanced. This means a Silver plan could potentially have a lower deductible and or out of pocket maximum than a Gold or Platinum plan. So be sure you understand the benefits you are eligible for in order to find the best health insurance plan for your family.

What do we recommend for family health insurance coverage?

Everyone has a unique situation and desire for benefits and what they are willing to pay for those benefits. So it is hard to say that any one plan is good for everyone since medical needs are so unique. Gold plans are great, but not everyone can afford that level of coverage. Health insurance has changed dramatically in recent years. Previously you could never buy the cheapest high deductible plan and then upgrade to a lower deductible once you became sick or injured. Now the system is setup in a way that allows you to change plans from year to year, regardless of your health. This leads some to the conclusion that it is better to pay less for a higher deductible health insurance plan now if you are healthy and then upgrade to a better plan the next open enrollment period if it appears you may have health expenses coming. One of the best ways to protect yourself from catastrophic losses and save money on your premiums is to select a Health Savings Account plan (HSA). These plans not only give you major medical coverage, but they also give you the right to contribute to a Health Savings Account at the bank or credit union of your choice. Then if you do need better coverage in the future in the way of a lower deductible or copays, you can continue to spend your HSA funds even as you enjoy the better benefits. The idea behind an HSA is that you are investing in your own healthcare future rather than spending more on a lower deductible and sending that extra money to the insurance company. Continue reading for more of the benefits of an HSA plan.

What are the benefits of Health Savings Accounts (HSA’s)?

First to be clear, you cannot setup a Health Savings Account at a bank or credit union unless you have a Qualified High Deductible Health Plan. The insurance companies typically make it pretty easy to know if your plan qualifies by specifically using HSA in the name of the insurance policy. Chances are if it does not say HSA anywhere, then it does not qualify.

Here is a list of benefits of Health Savings Accounts:

1) Annual contributions are tax deductible up to the IRS limits (even if you don’t itemize)

2) Earnings are tax free

3) Qualified distributions for medical, dental, and vision expenses are tax free

4) Only one spouse has to have a HSA health plan while the whole family can access his or her account funds

5) The money is yours to keep and roll over – unlike an FSA which is use it or lose it

6) Funds can be used to pay for Medicare premiums and Long Term Care insurance

7) At age 65, funds can also be withdrawn for retirement income with no penalty, just income tax

8) Premiums for your HSA health plan are often less expensive, giving you more room in your budget to contribute

9) There are no income limitations for high earners like there is with a Roth IRA

10) You choose what bank or credit union to administer the account – many offer no fees and extra investment options such as mutual funds

11) Great way to pay for services not covered by a health plan such as dental, vision, Lasik eye surgery, and orthodontia

12) Great way to fund maternity expenses for the self-employed that have a high maternity deductible

13) HSA contributions can be made when you want. You can fund the annual maximum at one time, on a monthly or bi-monthly basis, or fund it as you incur health expenses and need to pay for them

14) Almost all financial institutions will give you (and spouse if you authorize) a debit card for easy access to your funds.

If you have a hard time appreciating some of the tax benefits of HSA’s then try thinking along these lines.

First, consider the fact that HSA account holders are receiving free money (in the form of tax breaks) just because they select a certain kind of insurance plan and setup and fund a certain kind of savings account. You are missing out on this “free money” by not doing an HSA.

Second, if the idea of tax benefits is obscure, think of it as getting about a 20-30% discount on all your qualified medical, dental, or vision expenses. If for example you are in the 15% federal tax bracket and 6% state, then it is worth a 21% discount. If you are in the 25% federal and 6% state then it is like a 31% discount. If you have ever gone shopping because a store is having a sale, then how can you not like the idea of a year-round sale on all your qualified health expenses.

Third, really consider the tax benefits. Are you currently contributing to a Roth IRA, Traditional IRA, SEP, SIMPLE, 401(k), or some other tax favored investment vehicle allowed under the IRS code? If you are, then great; you should be. However, compare the tax benefits of each of those to the tax benefits of the HSA. With all of those you either get a tax deduction to contribute or you get tax free withdrawals, as is the case with the Roth IRA. None of them give you both. Now consider the tax benefits of an HSA. It offers the best of both worlds: a tax deduction for your contributions and tax free withdrawals.

Google “IRS Publication 969 – Rules Surrounding HSA and Other Tax Favored Accounts” to pull up the IRS Publication that discusses HSA rules
Google “IRS Publication 502 – Qualifying Medical, Dental, and Vision Expenses” to see what items count as qualified medical expenses