Idaho Health Insurance

Written by Helen Glenn Court
Bookmark and Share

Whether you're whitewater rafting on the Salmon River, mountain biking the Lower Hulls Gulch, or just commuting to work in Boise, the last thing you want to let slide is your Idaho health insurance policy. Illness and accidents come when we least expect them, after all. The moment is never convenient. You never know what's around the corner.

When was the last time you opened your calendar and tried planning for an abscessed tooth, a sprained ankle on a hike in the mountains, or a skid into an oncoming car in the freezing rain? The idea behind your Idaho health insurance is to guard against what you can't anticipate. All the healthy eating, sleeping, and living in the world can't forestall an emergency appendectomy. It's that simple.

A Few Facts about Idaho Health Insurance

There are more regulations on health insurance in the state of Idaho, you might be surprised to learn, than in most other states. Some protect you the consumer, and some favor Idaho health insurance companies. Every insurance company is required by law, however, to offer three types of policy: basic, standard, and catastrophic.

Idaho's regulations dictate the particulars of the state's standard health insurance policies--that is, what procedures and treatments are covered, and what those costs will be. These plans are available year-round to anyone who has held an Idaho health insurance policy. During the open enrollment period anyone may opt into a policy. One thing to bear in mind, though, once you sign onto a policy, is that health insurance companies operating in Idaho are not required by law to guarantee policy renewal if the clause is not written into the contract.

It's also important to know beforehand that Idaho health insurance companies may lawfully exclude someone from coverage on the basis of a pre-existing condition. Idaho defines this as a condition diagnosed or treated within the previous year. If you quit smoking cigarettes, for example, only in the previous 12 months, or are still a smoker, you might be denied coverage. This stipulation applies, however, only when you are applying for coverage for the first time or have had a long lapse in coverage.

Types of Idaho Health Insurance Coverage

There are two basic types of health insurance policy. The first, fee-for-service (indemnity) plans, have the most flexibility but cost more. The second, managed care plans, cost considerably less but have considerably more restrictions on practitioners you choose, facilities you use, and procedures you undergo. There are three types of managed care plans--HMO, PPO, and POS. MSA is often included in this group, though it is not actually an insurance policy per se. The differences are best explained by a licensed Idaho health insurance agent or representative.

The emphasis of fee-for-service plans is choice. You see the doctors you want to see, get immediate treatment for emergencies and illnesses, but are expected to cover routine costs out of pocket. You pay a monthly health insurance policy premium, an annual deductible" amount before the policy coverage kicks in, and a per-visit co-insurance" fee.

The emphasis of managed care plans is prevention. Most regular doctor visits, annual check-ups, and immunizations are covered. Many medical treatments are also covered, but you must follow a strict procedure. If you choose a healthcare practitioner outside the network of regular providers, you pay a high premium. It's often difficult to get coverage for procedures not deemed life threatening. You pay a low monthly premium and a minimal per visit co-payment fee.

Bookmark and Share