2025 Open Enrollment for
Affordable Care Act (ACA) Health Insurance for Idaho Residents
About ACA Health Insurance
The Affordable Care Act (ACA) is a comprehensive healthcare reform law that requires qualified insurers to offer individual health insurance plans that meet minimum essential coverage standards. These plans aim to make healthcare more affordable and ensure that Idaho residents, including those with pre-existing conditions, can obtain coverage.
With an ACA health plan, you pay a monthly premium along with a co-pay for services. When selecting a plan, it’s essential to consider the deductible, which is the amount you pay out-of-pocket before your insurance starts covering costs, and the out-of-pocket maximum, which is the total amount you’ll pay each year before your insurance covers you completely.
While all ACA plans include dental and vision coverage for children, they may not provide this coverage for adults, so if you need it, you might have to buy it separately. Mission Oaks Insurance is here to answer all your questions about ACA Health Plans at no cost to you. Learn more about ACA Health Insurance by clicking the tabs below or calling us at (208) 929-5705.
Eligibility Requirements
Eligibility for ACA healthcare plans varies, but most people, including non-U.S. citizens with worker or student visas, can purchase insurance during the open enrollment period. Here’s a summary of who is eligible:
General Eligibility
- Residents of Idaho who do not have access to affordable health insurance through their employer or other government programs like Medicaid, Medicare, or TRICARE are eligible for a health insurance plan through Your Health Idaho.
- Non-U.S. citizens with valid worker or student visas are also eligible.
Tribal Members
- Members of federally recognized American Indian and Alaska Native tribes can enroll or change their plans once a month.
Low-Income Households
- Low-income families may qualify for free or low-cost coverage through Medicaid, which allows for enrollment year-round.
To check your eligibility, contact us using the form or by giving us a call today. We are looking forward to helping you get affordable health care coverage in Idaho.
Enrollment Periods
OPEN Enrollment
The open enrollment or general enrollment period starts October 15th and ends December 15th in Idaho.
SPECIAL Enrollment
If you miss the early or open enrollment periods, you can only sign up for a health care plan through the Idaho Health Insurance Exchange if you experience a qualifying life event, such as:
- Birth or adoption of a child
- Loss of employer-provided health insurance
- Marriage or divorce
- Moving to a new area
- Other special circumstances
How to Sign Up for ACA Health Insurance
To start an Idaho health insurance plan that is right for your family, fill in the form to the right or call us at (208) 929-5705. Mission Oaks Insurance provides "no cost" assistance to help you choose the right plan for your circumstances..
Plan Categories
Marketplace health insurance plans are divided into three main categories in Idaho
Bronze Plans: These plans come with the lowest monthly premiums but have the highest deductibles and copays. They typically cover about 60% of healthcare costs.
Silver Plans: With moderate monthly premiums, deductibles, and copays, Silver plans cover around 70% of care costs. They are also the only plans eligible for cost-sharing subsidies, which can help reduce out-of-pocket expenses.
Gold Plans: Gold plans have higher monthly premiums but offer lower deductibles and copays. They cover approximately 80% of healthcare costs, making them a good choice for those who expect more medical expenses.
In addition, Idaho residents under 30 can apply for a Catastrophic Plan. This option features low premiums but provides limited coverage, making it suitable for those seeking basic healthcare protection.
What is Covered
Every health plan available includes coverage for 10 essential health benefits
Outpatient Care: Services you receive without being admitted to a hospital.
Emergency Services: Care provided in urgent situations.
Hospitalization: Coverage for surgeries and overnight stays in a hospital.
Pregnancy and Newborn Care: Comprehensive support before and after childbirth.
Mental Health Services: Treatment for mental health and substance use disorders, including counseling and therapy.
Prescription Medications: Coverage for necessary prescription drugs.
Rehabilitative Services: Support for recovering physical and mental skills after injuries or chronic conditions.
Laboratory Services: Tests and diagnostics to monitor health.
Preventive Services: Wellness check-ups and chronic disease management.
Pediatric Care: Services for children, including oral and vision care (note that adult dental and vision care are not considered essential benefits).
Plans also provide
Birth Control Coverage
Breastfeeding Support
These are the minimum requirements for all plans but the specific services included in each category may be different depending on the state.
Many plans may also offer extra benefits, such as:
Dental and vision coverage
Programs for managing specific health needs, like weight management and diabetes
When we help you compare plans, we will go into detail about each and help you choose the best option for your needs.
ACA Health Plan Costs
The cost of a Marketplace health insurance plan varies. We will work closely with you to find a plan that suits your needs and budget. Just fill out the form to get started.
Financial Assistance
If your household spends more than 8.5% of its annual income on health insurance premiums, you may be eligible for federal tax credits to help lower those costs.
If you qualify for a premium tax credit, you might also be eligible for cost-sharing reductions. These can help cover out-of-pocket expenses like deductibles and copays.
Your Health Idaho estimates that more than 80% of current enrollees qualify for some form of financial assistance, making health insurance and healthcare more affordable.
*Available to Idaho residents
*Open Enrollment from Oct 15 - Dec 15
Hi, I'm Alison, and I'm looking forward to assisting you
call us at (208) 929-5705 or fill out the form for help with Obamacare.
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