Key Takeaways
- Idaho requires a 10-day free look period for individual health insurance policies
- Idaho Department of Insurance regulates health insurance including HMOs
- Idaho operates Your Health Idaho, a state-based health insurance marketplace
- Pre-existing condition exclusions are prohibited in ACA-compliant plans
- Idaho expanded Medicaid under the ACA through voter initiative
Last updated: January 2026
Idaho Health Insurance Policy Requirements
Idaho regulates health insurance through state law and federal ACA requirements.
Regulatory Structure
Idaho health coverage is regulated by the Department of Insurance:
| Agency | Regulates |
|---|---|
| Idaho DOI | All health insurance, HMOs, PPOs |
| Dept. of Health & Welfare | Medicaid |
| Your Health Idaho | State-based marketplace |
Free Look Period
Idaho provides a 10-day free look period for individual health insurance:
- Policyholder can return for full premium refund
- Begins when policy is delivered
- Applies to individual health policies
Your Health Idaho Marketplace
Idaho operates Your Health Idaho, a state-based health insurance marketplace:
- State-controlled enrollment platform
- Only place to get premium subsidies in Idaho
- Open enrollment: November 1 - December 15
- Special enrollment periods for qualifying life events
- Premium tax credits available based on income
- Plans categorized by metal tiers (Bronze, Silver, Gold, Platinum)
Marketplace Features
- All plans cover essential health benefits
- No annual or lifetime limits on essential benefits
- Preventive care covered with no cost sharing
- Cost-sharing reductions available for Silver plans
ACA Compliance in Idaho
Idaho's health insurance market operates under federal Affordable Care Act (ACA) requirements:
Essential Health Benefits
All individual and small group plans must cover:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorders
- Prescription drugs
- Rehabilitative services
- Laboratory services
- Preventive and wellness services
- Pediatric services (including dental and vision)
Pre-Existing Condition Protections
For ACA-compliant plans:
| Market Segment | Pre-Existing Condition Exclusions |
|---|---|
| Individual (ACA) | Prohibited |
| Small Group (ACA) | Prohibited |
| Large Group | Federal rules apply |
Idaho Medicaid Expansion
Idaho expanded Medicaid through a 2018 voter initiative:
- Available to adults with income up to 138% FPL
- Implemented in 2020
- Covers comprehensive health services
Mental Health Parity
Idaho follows federal mental health parity requirements:
- Mental health benefits must be equal to medical benefits
- Same copays, deductibles, and limits
- Covers mental illness and substance use disorders
Test Your Knowledge
What is Idaho's health insurance marketplace called?
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Test Your Knowledge
What is the free look period for individual health insurance policies in Idaho?
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Test Your Knowledge
How did Idaho expand Medicaid?
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