Insurance & Medicare Broker Chris Antrim Answers Frequently Asked Questions About Health Insurance In Idaho

FAQ About Idaho Health Insurance

• What is

  Your Health Idaho

  ?

It is also known as Idaho Health Insurance Exchange it is an online marketplace for the U.S. state of Idaho. Making  Idaho families and small businesses to purchase, compare and choose health insurance coverage at federally subsidized rates.

• Who is qualified for coverage through Your Health Insurance?

To enroll on Your Health Idaho plans a person must be:

• A US citizen or National. Or if you’re not a US citizen, a person must be lawfully present in the country for an entire-time to plan to have health insurance.

  

• Lived in the U.S. and have a primary residence in Idaho.

• Considered a resident in the U.S. and Idaho tax-purposes.

• And you cannot be incarcerated or imprisoned.

• Where can I shop for Idaho plans?

At Your Health Idaho, you can shop and compare different coverage and plans side-by-side on just one website. This will determine where the right coverage is and if it’s suited to your budget.

• How to apply for coverage?

An individual can create an account and set up the following information to shop for plans and purchase coverage online. Or if you have no computer you can call their phone number and request a paper application.

• Can I still enroll even if it is not an Open Enrollment Period?

There are certain situations where you can apply for insurance even though it is not Open Enrollment, this is called the Special Enrollment Period (SEP). This allows a certain individual to apply for new health insurance. But there are 60 days to complete certain documents to get eligible for this period.

• Where can I ask for help?

Consumer Connectors are available across the State of Idaho providing free-assistance to everyone. The agents, brokers, and other counselors are certified by Your Health Idaho. They have the knowledge and expertise at navigating the application and giving the available

that is right for your family.

• What are the benefits covered on health insurance plans in Idaho?

Health Insurance plans in Idaho are covered ten essential health benefits such as:

• 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

• Medicine and drug prescription

• Preventive wellness and screenings

• Pediatric care (includes oral and vision health)

In Your Health Idaho, all plans are offered to meet the high standard of state and federal requirements.

• Can the individual with pre-existing conditions be denied in having health insurance? Or do they have to pay higher than the average?

All plans must cover treatment even for pre-existing medical conditions. No insurance company can reject you. Or even charge you more. Once you’re enrolled, the plan can’t deny your coverage or raise your monthly premiums based on your medical conditions.

• What are APTC and CSR?

Advance Premium Tax Credit or APTC is a form of tax credit that can be applied through your monthly premiums, this will help lower the cost of your coverage. Cost-sharing reductions or CSR is a discount that helps lower the amount you pay for out-of-pocket things like, deductibles, co-insurance, and co-payments.

• Can I still qualify for a tax credit even if I never filed income taxes before?

Yes. You can still receive tax credit even though you have never filed income taxes before. However, if you apply and are approved to receive the tax credit, you must file a tax return for that plan year.

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What is Qualifying-Life Event? How Do I Benefit From It?

FAQ About Qualifying-Life Event In Idaho

• Will I report a life-changing event? How?

Yes, this can affect your plans and maybe you become eligible for the

Qualifying Life Event

. You can report your life-changing event to the Department of Health and Welfare (DHW) or Your Health Idaho (YHI). This will depend on whether you want to receive or apply for cost-sharing.



• Do I need to present proof for the Qualifying Life Event?

Yes! All Qualifying Life events need proof or validation. When you report on something the Department of Health and Welfare will request documentation for proofs. The documents you present must be received and validated within the Special Enrollment Period.

• Should I receive a confirmation after reporting? And what notices is that?

If you report it in Your Health Idaho all notices will fall on your Your Health Idaho inbox and the alert notices will be received through the email you linked to your account. Once you received an email this is most likely a:

• The first notice acknowledges that you reported a Qualifying Life Event and requested a Special Enrollment Period.

• Follow-up notices asking for validation documents to prove your report. And if you applied at the Department of Health and Welfare they may also request validation documents.

• An additional communication might be sent to your email address or designated Consumer Connector. This alert may also request additional clarifications or communicate to discuss that the report doesn’t qualify for the Special Enrollment Period.

• Your Health Idaho may send up to three reminders to complete the submission of validation documents.

• You may receive a notice in Your Health Idaho inbox if your change is approved and you have a Special Enrollment Period. Make sure to enroll before SEP ends. You will also receive a notice indicating your financial eligibility before the event is validated. This will consider whatever assistance might be available when you look for a plan.

• Can I choose a plan before your Qualifying Life event is validated?

You can’t enroll on a plan before your change is validated. But still, you can browse and compare your plans anytime. We encourage you to review your plans to prepare for enrollment.

• What is a Creditable Coverage Letter?

A creditable coverage letter is issued to you by your insurance provider or previous employers showing the dates of coverage and if your insurance coverage meets the minimum essential benefits. The letter also indicated the termination dates and if the coverage wasn’t terminated due to non-payment.

• What if your Qualifying Life Event is not validated?

If the change is not validated within 60 days from the day of the event, a Special Enrollment Period will not open and your request will also be closed. If your initial documents are not qualified to support your report, you can provide additional documents for proof within the period.

• What happens when you don’t finish enrollment before the Special Enrollment Period ends?

If your request is approved, but you don’t enroll in a certain plan in time, the SEP will ends. Once you enroll in a plan you cannot make any changes to your coverage unless you have another Qualifying Life Event or a General Enrollment Period.

NOTE:

You must report, submit validation documents, and enroll in the plan within the 60 days prior to your life event to use your Special Enrollment Period.

These are the frequently asked questions many people ask about Health Insurance in Idaho. If you still have additional questions you can contact our phone number at (208)-409-3382 or visit our website Boise Health & Life Insurance Agency or go to

Remember that insurance is confusing and huge! Don’t shop alone, pack yourself with the knowledge to make the most out of your coverage. This will be your support in providing your healthcare and financial assistant. 

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