Frequently Asked Questions
About Your Health Idaho
Your Health Idaho is Idaho’s state-based health insurance marketplace where you can shop, compare, and choose the health and dental insurance plan that is right for you. Your Health Idaho is also the only place Idahoans can access the Advance Premium Tax Credit (APTC).
To enroll in coverage through Your Health Idaho:
- You must be a U.S. citizen or national. If you are a non-citizen, you must be lawfully present in the U.S. for the entire time you plan to have health coverage.
- You must live in the U.S. and have a primary residence in Idaho.
- You must be considered a resident of the U.S. and Idaho for tax purposes.
- You cannot be incarcerated.
Applying and Enrolling in Coverage
At Your Health Idaho, you have options. You can shop and compare plans side-by- side on the Your Health Idaho website. View current plans and prices.
You can set up an account, shop for plans, and apply for coverage online. Visit Apply and Enroll for more information. No computer? No problem. To apply over the phone, call Your Health Idaho at 1-855-944-3246.
Open Enrollment is the annual period, usually held from November to December, when Idahoans can enroll in a private health insurance plan for the coming year. During Open Enrollment, Idahoans already enrolled with Your Health Idaho can make changes or renew their existing coverage.
Outside of Open Enrollment, only Idahoans who experience a Qualifying Life Event will be able to enroll in coverage.
Open enrollment for 2022 health insurance coverage will be held October 15 – December 15, 2022.
If you experience a Qualifying Life event (QLE) such as marriage, divorce, birth or adoption of a child, or loss of employer coverage, you may be eligible for a Special Enrollment Period (SEP). A SEP allows individuals and families to enroll in a new insurance plan or change plans if already enrolled. Visit Special Enrollment to learn more.
You can enroll in Medicaid or the Children’s Health Insurance Program (CHIP) any time, if determined eligible by Idaho Department of Health and Welfare. There is no limited enrollment period for these programs.
Consumer Connectors are available for free assistance across the state of Idaho. These agents, brokers, and enrollment counselors are certified by Your Health Idaho and are experts at navigating the application process and finding coverage that is right for your family. Find free help in your area.
Insurance Coverage and Benefits
All plans offered through Your Health Idaho meet the high standards of state and federal requirements. Every plan offered through Your Health Idaho is required to cover ten essential health benefits, including:
- Doctor visits
- Hospitalization
- Emergency services
- Mental health and substance abuse services
- Rehabilitative and habilitative services (like chronic disease management)
- Maternity and newborn care
- Laboratory tests
- Prescription medicine
- Preventive wellness and screenings
- Pediatric care (includes oral and vision health)
All plans must cover treatment for pre-existing medical conditions. No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started. Once you’re enrolled, the plan can’t deny you coverage or raise your rates based only on your health.
Cost-Savings on Your Health Idaho
The price of health insurance for individuals and families on Your Health Idaho is determined by the plan you choose. You may qualify for a tax credit that can help offset the cost of monthly premiums and out-of-pocket expenses. Tax credit and cost-sharing reduction eligibility is based on household size, income, and other factors. Visit Apply and Enroll to learn more about applying for cost savings.
With Your Health Idaho, you can compare a wide range of health insurance plans and choose the one that works best for you and your budget. View current plans and prices now.
The Advance Premium Tax Credit, or APTC, is a tax credit that can be applied to monthly premium payments to help lower the cost of coverage.
Cost-sharing reduction, or CSR, is a discount that lowers the amount you pay out-of-pocket for things like deductibles, co-insurance, and co-payments. To qualify for a CSR your income must be within a certain range and you must enroll in a Silver level health plan.
Yes, you can still qualify for a tax credit, even if you have never filed taxes before. However, if you apply for and receive a tax credit, you must file a tax return for that plan year.
Failure to file taxes for the year will prevent you from receiving future tax credits.
Special Enrollment
Report your change to Your Health Idaho (YHI)
For more details, go to Report a Change.
All Qualifying Life Events require validation.
Your documentation must be received and validated within the Special Enrollment Period. For a list of acceptable validation documents and more information, go to Special Enrollment.
All Your Health Idaho notices appear in your secure YourHealthIdaho.org inbox and an alert that you received the notice goes to the email address linked to your account. Be sure to log in to YourHealthIdaho.org and read the details in the notice.
- The first notice acknowledges that you reported a change and requested a Special Enrollment Period.
- A follow-up notice requests validation documents to prove the change if Your Health Idaho needs to complete additional validation.
- Additional communication might be sent to your personal email address or your designated Consumer Connector. These emails request additional clarification or communicate if the change doesn’t qualify for a Special Enrollment Period.
- Your Health Idaho sends up to three reminders to submit required validation documents.
- If your Qualifying Life Event is approved, you receive a notice in your secure YourHealthIdaho.org inbox that you have a Special Enrollment Period. Be sure to enroll before the Special Enrollment Period ends.
Based on your communication preferences, you might also receive notices via U.S. mail. Carefully read and act upon any notices about your change from the Department of Health and Welfare and Your Health Idaho.
Contact Your Health Idaho in these cases:
- You reported a change or requested a Special Enrollment Period from Your Health Idaho but haven’t received any notification back.
- You submitted validation documents but didn’t receive a response within 10 days.
- Your 60-day Special Enrollment Period has nearly ended or closed.
You can’t enroll in a plan before your event is validated. But, you can browse and compare plans on YourHealthIdaho.org anytime. Your Health Idaho encourages you to preview plans to prepare for enrollment. If you save a plan as a favorite, be sure to complete enrollment after validation.
The notices you receive from Your Health Idaho indicate your financial eligibility before the event is validated. Consider whatever assistance might be available when you shop for a plan.
A Consumer Connector can best support you if you need specific enrollment dates or have a unique situation. To get free help, go to Find Help and pick a certified agent or broker.
You can report a loss of coverage before it ends in certain circumstances.
For instance, if your employer coverage will end, you can report the loss up to 60 days before coverage ends. You can provide an employer letter to demonstrate loss of employer coverage, which you can request from your employer.
A creditable coverage letter from your insurance carrier or previous employer shows the dates of coverage and if your insurance coverage met minimum essential benefits. The letter should also show the termination date and that coverage wasn’t terminated due to non-payment.
You might qualify for a Special Enrollment Period if you are currently enrolled at Your Health Idaho and your Cost Sharing Reduction eligibility changes or if you become newly eligible for a tax credit.
If you are not currently enrolled at Your Health Idaho, you were previously ineligible for a tax credit, and you become newly eligible for a tax credit in Idaho due to an increase in income or a change in household dependents, you might qualify for a Special Enrollment Period.
If you have an income change that you think might qualify, contact Support for help or go to Find Help Near You to find a certified agent or broker for assistance.
For events like a permanent move or a change in marital status, a combination of validation documents is required. For a list of acceptable validation documents, go to Special Enrollment.
You can report coverage up to 60 days prior to life changing events like these. Get a creditable coverage letter from the insurance carrier, or a screen shot of your insurance account, that shows coverage dates to prove previous coverage. If the life change is in the future, you need to show the enrollment is current.
Upload validation documents through your secure Your Health Idaho account when you report your change or apply for coverage. Or, follow the instructions included in the Your Health Idaho notice to securely email the documents.
If the Qualifying Life Event is not validated within 60 days from the event, a Special Enrollment Period does not open and your request closes. If your initial documents are not accepted, you may provide additional documents for validation within the period.
If the event is validated, but you don’t enroll in a plan in time, the Special Enrollment Period ends. Once you enroll in a plan, you may not change plans until you have another Qualifying Life Event or during Open Enrollment. You must report, validate, and enroll in the plan you want within 60 days of your life event to use your Special Enrollment Period.
More Information
When questions or concerns come up, there are several options to help you navigate the enrollment process and maximize your benefits. Visit the Contact Us page to learn more about who to contact.
Consumer Connectors are available for free assistance across the state of Idaho. These agents, brokers, and enrollment counselors are certified by Your Health Idaho and are experts at navigating the application process and finding coverage that is right for your family. Find free help in your area.