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Idaho State Health Insurance Programs – Easy Access to Information

Easy Access to Information

Under the Idaho Individual Health Insurance Availability Act , every insurance company that is approved by the Idaho Department of Insurance to market individual health benefit plans in Idaho must actively offer health benefit plans to individuals, including the five High Risk Reinsurance Pool Plans for those who don’t qualify because of health reasons. The Idaho Department of Health & Welfare has other programs to help those less fortunate or in special situations.

Easy Access to Information

If you are not approved for health insurance because of health conditions or if you are quoted a higher price than an equivalent High Risk Pool Plan.

INDIVIDUAL HIGH RISK REINSURANCE POOL PLANS (HRP Plans) FOR IDAHO RESIDENTS


Idaho Department of Insurance
The Idaho Department of Insurance HRP Plans
The purpose of the HRP Plans is to make health insurance coverage available to Idaho residents not covered by employment-related insurance. Idaho residents may be eligible for the HRP Plans regardless of health status or claims experience.

If you need help to determine if you qualify or apply for coverage
If you want to learn more about the program from the Department of Insurance
If you want to visit the Idaho Department of Insurance Home Page


If you need help paying for your children’s health insurance.

Department of Health and Welfare

Children’s Access Card

The Access Card helps families buy health insurance for qualifying children.  The Access Card is a premium assistance program administered in partnership with Idaho insurance carriers.

An eligible child qualifies for up to $100 per month in premium assistance.  Families with 3 or more eligible children may receive up to $300 per month.  Children in families whose income is between 133% and 185% of federal poverty guidelines may be eligible.  Parents are responsible for premium payments, co-pays and deductibles.

Contact Information

If you need help paying your health insurance premiums at work.

Department of Health and Welfare

Access to Health Insurance (AHI)

Access to Health Insurance (AHI) helps employees of small businesses and their families enroll in employer-sponsored insurance. Idaho Medicaid is working to make several improvements to the Access to Health Insurance program to make enrollment easier. One of these changes will be following carrier guidelines on employer contributions to employee premiums.

Contact Information

If you need more help than just premium assistance.

Department of Health and Welfare

Idaho Medicaid's Benefit Plans

Medicaid now does more to improve your health, find new health problems early, and manage current health problems. If you are eligible for Medicaid, you will get benefits based on your health needs.

1. The Medicaid Basic Plan is for healthy low-income children and adults with eligible dependent children. This plan provides complete health, prevention, and wellness benefits for children and adults who don't have special health needs. Most Medicaid participants will be enrolled in this benefit plan.

2. The Medicaid Enhanced Plan is for participants with disabilities or special health needs. This plan includes all benefits in the Basic Plan, plus additional benefits.

3. The Medicare-Medicaid Coordinated Plan is for participants who are eligible and enrolled for both Medicare and Medicaid.

Contact Information

If you are a woman who wants to stay healthy.

Department of Health and Welfare

Women’s Health Check

Women’s Health Check gives eligible women the gift of good health care with free mammograms and Pap tests.
Every woman is at risk for breast and cervical cancer. The risk increases as you get older, but it’s easier to cure when found early. That’s why having annual mammograms and regular Pap tests is an important part of keeping yourself well and feeling more secure about your health.
Exams are available from more than 250 qualified Idaho health care providers. Enrollment is simple. Contact a Women’s Health Check enrollment center for information.
Schedule your women’s health check today.

Contact Information

If you are on Medicare and need help

Senior Health Insurance Benefit Advisors Program - SHIBA


Idaho Department of Insurance
The Idaho Department of Insurance SHIBA Program
They can help you put together the pieces of the senior health insurance puzzle! They will help you answer questions such as:
  • I'm turning 65. What does Medicare cover and what companies sell Medicare Supplements in Idaho?
  • What other options for senior health insurance do I have beyond Medicare Supplements?
  • What is Medicare Advantage?
  • What rights and protections do I have under Medicare?
  • How can I help my parents with health insurance?
  • I've been considering long-term care insurance, but is it a good option for me?
  • I can't make sense of my Medicare statements and medical bills. What do I do next?

Senior Health Insurance Benefits Advisors (SHIBA) is part of a network of state health insurance assistance programs across the United States. In Idaho, SHIBA is funded by the Health Care Financing Administration (HCFA), the federal agency which administers the Medicare program, and the Idaho Department of Insurance.



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