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, dental, and vision insurance plan that is right for you. Your Health Idaho is also the only place Idahoans can apply for and receive the Advance Premium Tax Credit (APTC) that can lower your monthly health insurance premiums.

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’s Customer Support Center at 855-944-3246.

Open Enrollment is typically held from October 15 through December 15. This is when Idahoans can enroll in a private health insurance plan for the coming year. Idahoans already enrolled through Your Health Idaho can make changes to or renew their existing coverage.

Outside of Open Enrollment, Idahoans who experience a Qualifying Life Event (QLE) are able to enroll in health insurance coverage.

Open Enrollment for 2024 health insurance plan year will be held October 15 – December 15, 2023.

If you experience a Qualifying Life event (QLE) such as marriage, divorce, birth or adoption of a child, or loss of current 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 make changes to their current plan. Visit Special Enrollment to learn more.

Your Health Idaho has hundreds of certified agents and brokers across the state available at no cost to you, ready to answer your questions, walk you through the application, and help you pick a plan. Find an agent or broker near you by visiting our Find Help page.

You can also contact our Customer Support Center at 855-944-3246 or by clicking the chat icon in the lower right hand corner of our website.

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 through Your Health Idaho is determined by the plan you choose. You may also qualify for a tax credit that would cover some or all of the cost of monthly premiums or Cost-Sharing Reductions on Silver Tier plans that can cover 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 Tier 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 in which you receive a tax credit will prevent you from receiving future tax credits.

Special Enrollment

A life changing event, also known as a Qualifying Life Event (QLE) must be reported to Your Health Idaho.

For more details, go to Report a Change.

Typically, all Qualifying Life Events require validation.

Your documentation must be received and validated, and you must have completed your new enrollment within the Special Enrollment Period. For a list of acceptable validation documents and more information, visit our Special Enrollment page.

Notices appear in your Your Health Idaho account secure inbox and an alert that you received the notice will be sent to the email address linked to your account. Be sure to log in to your account and read the notices you receive.

  • The first notice will acknowledge that you reported a change and requested a Special Enrollment Period
  • A follow-up notice will request any required validation documents to verify your change
  • Additional communication may be sent to the email address linked to your account or your designated agent or broker to request additional documentation or notify you 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 will receive a notice in your secure Your Health Idaho 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 on any notices about your change from 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 a response within 7-10 business days
  • You submitted validation documents but haven’t received a response within 10 business days
  • Your 60-day Special Enrollment Period has nearly ended

You can’t enroll in a plan before your event is validated but you can browse and compare plans through Your Health Idaho anytime. Your Health Idaho encourages you to preview plans to prepare for enrollment. If you save a plan as a favorite, you must still complete enrollment after validation.

The notices you receive from Your Health Idaho indicate your financial eligibility before the event is validated. Consider this while shopping for a plan.

A Consumer Connector can best support you if you need specific enrollment dates or have a unique situation. To get help at no cost to you, go to Find Help and pick a certified agent or broker in your area.

You can report a loss of coverage before it ends in certain circumstances.

For instance, if you will be losing employer-sponsored coverage, you can report the loss up to 60 days before coverage ends. Request a letter from your employer to validate the loss of coverage through Your Health Idaho.

A creditable coverage letter from your insurance carrier or previous employer shows the dates of your previous coverage and if your insurance coverage met Minimum Essential Benefits. The letter should also give the termination date of your coverage and state that coverage wasn’t terminated due to non-payment.

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 previous coverage up to 60 days prior to life changing events like these. Request a creditable coverage letter from your previous insurance carrier, or take a screen shot of your insurance account, that shows coverage dates to prove previous coverage. If the life change has not yet occurred, you will need to show that 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.

You must report, validate, and enroll in the plan you want within 60 days of your life event to use your Special Enrollment Period. If your event is validated, but you don’t enroll in a plan in time, the Special Enrollment Period ends and you may not enroll until Open Enrollment or you have another Qualifying Life Event.

More Information

If you still have questions, please visit our Contact Us page to learn more about who to contact.

Consumer Connectors are available at no cost to you across the State of Idaho. These agents, brokers, and enrollment counselors are certified by Your Health Idaho and are available to answer your questions, walk you through the application, and help you pick a plan that’s right for you. Find free help in your area.