Health Insurance Exchanges or Marketplaces are State-based competitive shopping portals where people and small businesses can shop for and buy private health insurance. Consumers will have the same health plan choices available as members of Congress. The marketplaces are not private insurance companies or government-run health plans.
Idaho Insurance Marketplace is a private entity and is unaffiliated with the State of Idaho and their public exchange Your Health Idaho. Consumers can enroll in plans directly through either the state of Idaho's Exchange or through our website at the same price. Here at Idaho Insurance Marketplace we employee licensed brokers and advisors who are available to provide plan recommendations and are certified to assist consumers in enrolling in Idaho's State based Exchange. Only licensed brokers are able to give product recommendations and advice.
There is no cost to you for using any of our services.
The rates through the State of Idaho's Exchange are exactly the same as those offered here through Idaho Insurance Marketplace - Guaranteed!
No. However the only way to qualify for the subsidy is if you purchase insurance through the Marketplace or Exchange. Using Idaho Insurance Maketplace's services allows you to compare plans and rates including subsidies side by side; before going to the state/federal exchange to complete your purchase. We help you through the application process and in applying for those subsidies.
These are individuals that are intended to provide assistance to individuals applying for medical assistance and/or enrolling on the exchange. They will primarily be regulated by the State of Idaho's exchange. They are NOT licensed brokers and they cannot make product recommendations.
Under the new Patient Protection and Affordable Care Act starting in 2014 the federal government requires most Americans to have qualified health insurance coverage or be forced to pay a penalty. In 2014 the penalty is $95 for adults and $47.50 for children, with a maximum of $285 per family or 1 percent of the family income, whichever is greater.
All marketplace plans are separated into 4 different categories: Bronze, Silver, Gold, and Platinum. Platinum plans are the richest in benefits; Gold plans are the second richest and so on. The metal designation is used to help when comparing plans. As a general guideline Platinum plans cover 90% of medical cost, Gold plans 80%, Silver plans 70% and Bronze 60%. Bronze plans are designed with the lowest monthly premium and highest cost sharing—such as deductibles, coinsurance and or copayments—when health care services are utilized. Platinum plans generally have the highest monthly premium and lower cost sharing responsibility for the patient.
Health plans offered both inside and outside of the Marketplace, offer a comprehensive package of items and services, known as essential health benefits. Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care. Insurance policies must cover these benefits in order to be certified and offered in the Health Insurance Marketplace.
For most people, the answer is that we will have to buy a new metal plan through the Idaho Exchange. When your plan renews in 2014 you will need to move to a new exchange plan, unless your current plan is in a grandfathered status. Grandfathered plans are rare, so most people will need to move to a new plan.
It is the health insurance exchange for small employers (Small Business Health Options Program).
Open enrollment is a specified timeframe in which you can not only buy health insurance products, but you can apply for a subsidy. Some insurance carriers will allow you to buy health insurance outside of open enrollment, but you will not qualify for a subsidy unless you meet 'special enrollment' guidelines such as, your current plan is expiring and will not continue (2014 only), loss of group coverage, marriage, divorce, newborn child and adoption. Specific open enrollment periods are as follows:
Initial open-enrollment period — October 1, 2013, through March 31, 2014. Annual enrollment period — for benefit years starting on or after January 1, 2015 will be October 15 through December 7 of the preceding year.
There are a lot of myths in regards to the new health care laws and plans that are offered, the simple answer is no. However you may qualify for a subsidy to assist you with the cost of health insurance premiums. There are several factors which determine the amount of the subsidy you qualify for including your income, age and family size. Some subsidized premiums may be close to $0.
PPO (Preferred Provider Organization) is a network of doctors and hospitals. Although you have the freedom to use any doctor or hospital you receive the greatest benefit by using doctors or hospitals that are a part of the PPO network.
PPO providers are contractually required to provide services to the health insurance plan's members at a discounted rate. You won't be required to pick a primary care physician but will be able to see doctors and specialists within the network at your own discretion.
You will have a deductible to pay before the insurance company starts covering your medical bills. You will also have a co-pay for most services or be required to cover a certain percentage of the total charges for your medical bills. With a PPO plan, services rendered by an out-of-network provider are typically covered at a lower percentage than services rendered by a network provider.
This is a very complicated question. In part because the answer varies so much depending upon your personal circumstances, how long you need coverage, your preferences and other relevant factors. Our professionally trained and licensed agents work closely with you one on one to insure that we place you with the health insurance plan that best suits your needs. For that very reason we send your completed application (with your permission) to ALL of the available insurance carriers in the state of Idaho, something that no other insurance agent or company offers.
A "deductible" is a specific dollar amount that your health insurance company requires that you meet (pay out-of-pocket) before your health plan begins to make payments for claims. All insurance plans offer what is called "pre-deductible" benefits. These are benefits that are available without the deductible being met. These benefits always include wellness services and may also include; doctor office co-pays, Rx, accident benefits, chiropractic, vision, lab and X-ray.
A "co-pay" is a specific dollar amount that your health insurance plan requires that you pay for services. For example, your health insurance plan may require a $30 co-payment for an office visit or brand-name prescription drug, after which the insurance company often pays the remainder of the charges.
At Idaho Insurance Marketplace we take very seriously our responsibility to safeguard your personal history and health information. Every place on our website that gathers personal information is protected via SSL (Secure Socket Layer) and can be verified by clicking on the SSL verification at the start of our online application. All data is stored in the most secure fashion.
Idaho Insurance Marketplace is a private entity and is distinct from the Federally Facilitated Marketplace and State of Idaho Exchange - Your Health Idaho. Consumers may opt to use their services at any time.
2824 Poleline Rd. Suite A
Pocatello, ID 83201
Toll Free: (855) 723-0444
info@idahomarketplace.org
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