Skip to content

Idaho Individuals and Families

Choosing a Plan

Picking a health plan starts by considering a coverage tier: Catastrophic, Bronze, Silver, Gold, and Platinum. These tiers represent different levels of coverage and cost-sharing. 

Weigh the trade-offs between deductibles and different coverage costs like copays.

You may qualify for a very low or $0 premium plan.

Premium tax credits might be available to lower monthly premiums.

All premiums are calculated based on each person’s individual circumstances such as age, location, and plan type.

2024 / Idaho

Catastrophic Plans

Overview

Good choice if…
you’re under 30 and don’t use medical services often, yet want coverage in case of emergency and for annual preventive health screenings or checkups.

Only available for people under 30.

Premium Level
Lowest

Average Cost Split*
You pay 100%
CO-OP pays 0%.

Includes Signature Benefits
• 24/7 Telehealth access
• Dental & Vision exam reimbursements
• 100% Preventive Care coverage
• Travel Support
… Learn More

*Cost split refers to what you pay out-of-pocket vs what your plan pays (coinsurance). Estimated average based on in-network rates for coverage tier. Plans vary. Consult the specific plan documents (listed under plan documents and details) for exact details.

Your county determines which network you're eligible to use and is generally partnered with a hospital:

Access - St. Alphonsus Regional Medical Center

Link - St. Luke Medical Center

Engage - Available in every other county not available  Access and Link

Read More

Catastrophic

Link

Deductible
$9,450

Max out-of-pocket

$9,450

Coinsurance (you pay)

0%

Tier 1-Preferred Generic Drug

0% After Deductible

Primary Care Visit

0% 3 visits Before Deductible

Specialist Visit

0% After Deductible

Mental Health Visit

0% 3 Visits Before Deductible

Catastrophic

Engage

Deductible
$9,450

Max out-of-pocket

$9,450

Coinsurance (you pay)

0%

Tier 1-Preferred Generic Drug

0% After Deductible

Primary Care Visit

0% 3 visits before deductible

Specialist Visit

0% After Deductible

Mental Health Visit

0% 3 visits before deductible

Catastrophic

Access

Deductible
$9,450

Max out-of-pocket

$9,450

Coinsurance (you pay)

0%

Tier 1-Preferred Generic Drug

0% After Deductible

Primary Care Visit

0% 3 visits before deductible

Specialist Visit

0% After Deductible

Mental Health Visit

0% 3 visits before deductible

Overview

Good choice if…
you’re mostly healthy already and want to keep monthly premiums relatively low so you’re willing to accept higher out-of-pocket costs.

Premium Level
Low

Average Cost Split*
You pay 40%
CO-OP pays 60%

Includes Signature Benefits
• 24/7 Telehealth access
• Dental & Vision exam reimbursements
• 100% Preventive Care coverage
• Travel Support
… Learn More

*Cost split refers to what you pay out-of-pocket vs what your plan pays (coinsurance). Estimated average based on in-network rates for coverage tier. Plans vary. Consult the specific plan documents (listed under plan documents and details) for exact details.

Your county determines which network you're eligible to use and is generally partnered with a hospital:

Access - St. Alphonsus Regional Medical Center

Link - St. Luke Medical Center

Engage - Available in every other county not available  Access and Link

Read More

Bronze

Link High Deductible

Deductible
$7,500

Max out-of-pocket

$7,500

Coinsurance (you pay)

0%

Tier 1-Preferred Generic Drug

0% After Deductible

Primary Care Visit

0% After Deductible

Specialist Visit

0% After Deductible

Mental Health Visit

0% After Deductible

Bronze

Link

Deductible
$9,450

Max out-of-pocket

$9,450

Coinsurance (you pay)

0%

Tier 1-Preferred Generic Drug

0% After Deductible

Primary Care Visit

0% 3 visits Before Deductible

Specialist Visit

0% After Deductible

Mental Health Visit

0% 3 Visits Before Deductible

Bronze

Engage High Deductible

Deductible
$7,500

Max out-of-pocket

$7,500

Coinsurance (you pay)

0%

Tier 1-Preferred Generic Drug

0% After Deductible

Primary Care Visit

0% After Deductible

Specialist Visit

0% After Deductible

Mental Health Visit

First visit $0, then 0% After Deductible

Bronze

Engage

Deductible
$8,700

Max out-of-pocket

$8,700

Coinsurance (you pay)

0%

Tier 1-Preferred Generic Drug

0% After Deductible

Primary Care Visit

$50 No Deductible

Specialist Visit

$100 No Deductible

Mental Health Visit

First Visit $0, then $50 No Deductible
One Moment...

Overview

Good choice if…
you anticipate needing some medical care throughout the year but not excessively, a silver plan can provide a good balance between monthly costs and out-of-pocket expenses.

Premium Level
Medium

Average Cost Split*
You pay 30%
CO-OP pays 70%

Includes Signature Benefits
• 24/7 Telehealth access
• Dental & Vision exam reimbursements
• 100% Preventive Care coverage
• Travel Support
… Learn More

*Cost split refers to what you pay out-of-pocket vs what your plan pays (coinsurance). Estimated average based on in-network rates for coverage tier. Plans vary. Consult the specific plan documents (listed under plan documents and details) for exact details.

Your county determines which network you're eligible to use and is generally partnered with a hospital:

Access - St. Alphonsus Regional Medical Center

Link - St. Luke Medical Center

Engage - Available in every other county not available  Access and Link

Read More

Silver

Link 94 Option 2

Deductible
$0

Max out-of-pocket

$1,000

Coinsurance (you pay)

20%

Tier 1-Preferred Generic Drug

0% No Deductible

Primary Care Visit

0% No Deductible

Specialist Visit

$35 No Deductible

Mental Health Visit

0% No Deductible

Income Eligibility Required

Silver

Link 94

Deductible
$0

Max out-of-pocket

$1,000

Coinsurance (you pay)

20%

Tier 1-Preferred Generic Drug

0% No Deductible

Primary Care Visit

0% No Deductible

Specialist Visit

$25 No Deductible

Mental Health Visit

0% No Deductible

Income Eligibility Required

Silver

Link 87 Option 2

Deductible
$800

Max out-of-pocket

$2,800

Coinsurance (you pay)

30%

Tier 1-Preferred Generic Drug

0% No Deductible

Primary Care Visit

0% No Deductible

Specialist Visit

$45 No Deductible

Mental Health Visit

0% No Deductible

Income Eligibility Required

Silver

Link 87

Deductible
$600

Max out-of-pocket

$2,800

Coinsurance (you pay)

30%

Tier 1-Preferred Generic Drug

$5 No Deductible

Primary Care Visit

0% No Deductible

Specialist Visit

$40 No Deductible

Mental Health Visit

0% No Deductible

Income Eligibility Required

Silver

Link Option 2

Deductible
$8,000

Max out-of-pocket

$9,000

Coinsurance (you pay)

40%

Tier 1-Preferred Generic Drug

$10 No Deductible

Primary Care Visit

0% No Deductible

Specialist Visit

$75 No Deductible

Mental Health Visit

0% No Deductible

Silver

Link 73 Option 2

Deductible
$7,500

Max out-of-pocket

$7,550

Coinsurance (you pay)

40%

Tier 1-Preferred Generic Drug

$10 No Deductible

Primary Care Visit

0% No Deductible

Specialist Visit

$75 No Deductible

Mental Health Visit

0% No Deductible

Income Eligibility Required

Silver

Link

Deductible
$6,000

Max out-of-pocket

$8,150

Coinsurance (you pay)

30%

Tier 1-Preferred Generic Drug

$10 No Deductible

Primary Care Visit

0% No Deductible

Specialist Visit

$75 After Deductible

Mental Health Visit

0% No Deductible

Silver

Engage Option 2

Deductible
$7,500

Max out-of-pocket

$9,000

Coinsurance (you pay)

40%

Tier 1-Preferred Generic Drug

$5 No Deductible

Primary Care Visit

$40 No Deductible

Specialist Visit

$75 No Deductible

Mental Health Visit

First Visit $0, then $40 No Deductible

Silver

Engage 87

Deductible
$600

Max out-of-pocket

$2,800

Coinsurance (you pay)

30%

Tier 1-Preferred Generic Drug

$5 No Deductible

Primary Care Visit

$15 No Deductible

Specialist Visit

$40 No Deductible

Mental Health Visit

First Visit $0, then $15 No Deductible

Income Eligibility Required

Silver

Engage 73 Option 2

Deductible
$6,700

Max out-of-pocket

$7,500

Coinsurance (you pay)

40%

Tier 1-Preferred Generic Drug

$5 No Deductible

Primary Care Visit

$40 No Deductible

Specialist Visit

$75 No Deductible

Mental Health Visit

First Visit $0, then $40 No Deductible

Silver

Engage 73

Deductible
$4,500

Max out-of-pocket

$6,600

Coinsurance (you pay)

30%

Tier 1-Preferred Generic Drug

$10 No Deductible

Primary Care Visit

$40 No Deductible

Specialist Visit

$65 After Deductible

Mental Health Visit

First Visit $0, then $40 No Deductible

Income Eligibility Required

Silver

Engage

Deductible
$5,700

Max out-of-pocket

$8,150

Coinsurance (you pay)

30%

Tier 1-Preferred Generic Drug

$10 No Deductible

Primary Care Visit

$40 No Deductible

Specialist Visit

$75 After Deductible

Mental Health Visit

First Visit $0, then $40 No Deductible

Silver

Access 94

Deductible
$0

Max out-of-pocket

$1,000

Coinsurance (you pay)

20%

Tier 1-Preferred Generic Drug

0% No Deductible

Primary Care Visit

$10 No Deductible

Specialist Visit

$35 No Deductible

Mental Health Visit

First Visit $0, then $10 No Deductible

Income Eligibility Required

Silver

Access 87

Deductible
$750

Max out-of-pocket

$2,600

Coinsurance (you pay)

30%

Tier 1-Preferred Generic Drug

$5 No Deductible

Primary Care Visit

$15 No Deductible

Specialist Visit

$50 No Deductible

Mental Health Visit

First Visit $0, then $15 No Deductible

Income Eligibility Required

Silver

Access 73

Deductible
$5,000

Max out-of-pocket

$7,400

Coinsurance (you pay)

40%

Tier 1-Preferred Generic Drug

$10 No Deductible

Primary Care Visit

$20 No Deductible

Specialist Visit

$60 No Deductible

Mental Health Visit

First Visit $0, then $20 No Deductible

Income Eligibility Required

Silver

Access

Deductible
$6,500

Max out-of-pocket

$8,500

Coinsurance (you pay)

40%

Tier 1-Preferred Generic Drug

$10 No Deductible

Primary Care Visit

$30 No Deductible

Specialist Visit

$60 No Deductible

Mental Health Visit

First Visit $0, then $30 No Deductible

Overview

Good choice if…
you see doctors frequently or are anticipating upcoming  events such as surgery or pregnancy. Lower copays, deductibles, and out-of-pocket maximums compared to bronze or silver plans, can save you money in the long run.

Premium Level
High

Average Cost Split*
You pay 20%
CO-OP pays 80%

Includes Signature Benefits
• 24/7 Telehealth access
• Dental & Vision exam reimbursements
• 100% Preventive Care coverage
• Travel Support
… Learn More

*Cost split refers to what you pay out-of-pocket vs what your plan pays (coinsurance). Estimated average based on in-network rates for coverage tier. Plans vary. Consult the specific plan documents (listed under plan documents and details) for exact details.

Your county determines which network you're eligible to use and is generally partnered with a hospital:

Access - St. Alphonsus Regional Medical Center

Link - St. Luke Medical Center

Engage - Available in every other county not available  Access and Link

Read More

Gold

Access

Deductible
$1,000

Max out-of-pocket

$6,500

Coinsurance (you pay)

30%

Tier 1-Preferred Generic Drug

$5 No Deductible

Primary Care Visit

$30 No Deductible

Specialist Visit

$50 No Deductible

Mental Health Visit

First Visit $0, then $30 No Deductible

Gold

Engage

Deductible
$1,000

Max out-of-pocket

$6,500

Coinsurance (you pay)

30%

Tier 1-Preferred Generic Drug

$5 No Deductible

Primary Care Visit

$30 No Deductible

Specialist Visit

$50 No Deductible

Mental Health Visit

First Visit $0, then $30 No Deductible

Gold

Link

Deductible
$1,000

Max out-of-pocket

$7,000

Coinsurance (you pay)

30%

Tier 1-Preferred Generic Drug

$5 No Deductible

Primary Care Visit

0% No Deductible

Specialist Visit

$50 No Deductible

Mental Health Visit

0% No Deductible
Load More

2024 / Idaho

Platinum Plans

Overview

Good choice if…
you have chronic conditions, ongoing medical treatments, or need regular specialist visits. These plans have the lowest out-of-pocket costs which can significantly reduce recurring healthcare expenses over the course of the year.

Premium Level
Highest

Average Cost Split*
You pay 10%
CO-OP pays 90%

Includes Signature Benefits
• 24/7 Telehealth access
• Dental & Vision exam reimbursements
• 100% Preventive Care coverage
• Travel Support
… Learn More

*Cost split refers to what you pay out-of-pocket vs what your plan pays (coinsurance). Estimated average based on in-network rates for coverage tier. Plans vary. Consult the specific plan documents (listed under plan documents and details) for exact details.

Your county determines which network you're eligible to use and is generally partnered with a hospital:

Access - St. Alphonsus Regional Medical Center

Link - St. Luke Medical Center

Engage - Available in every other county not available  Access and Link

Read More

Platinum

Link

Deductible
$500

Max out-of-pocket

$1,500