High-Risk Pool

Many states offer a public plan for those citizens who have been denied coverage in the private market (or who’ve been charged very high premiums) because carriers believe they’d be too expensive to insure. However, Idaho only operates a high-risk re-insurance plan.

Mini-COBRA Policies (Small Group)
Federal Law requires large businesses to provide health insurance for their former employees up to eighteen months after a split. In most cases, smaller businesses (2-19 employees) are required to cover their employees—mini-Cobra policies. However each state has different eligibility for these “mini-Cobra” companies. In Idaho, the law only requires smaller businesses to cover past employees who are either pregnant or disabled for twelve months after termination of employment.

Medicare Savings Program (Premium Support)
Most states have a form of premium support for low-income Medicare beneficiaries; the amount of support is directly correlated to the beneficiary’s income as a percentage of the Federal poverty level.

In Idaho,

Qualified Medicare Beneficiaries—individuals are covered who have a monthly income under $903 and couples with a monthly income under $1,215 and no limits on assets;
Specified Low-Income Medicare Beneficiaries—individuals are covered who have a monthly income under $1,083 and couples with a monthly income under $1,457;
Qualified Individuals—individuals are covered with a monthly income under $1,219 and for couples with a monthly income under $1,640.

Please note that for all types of beneficiaries there is an asset limit of $6,600 for individuals and $9,910 for couples.

State Pharmaceutical Assistance Program
Many states have Pharmaceutical Assistance Programs (SPAP) that help residents pay for prescription drugs as a result of financial needs, age, or medical condition. These states have specific restrictions on who can receive these benefits. Idaho offers a state funded assistance program to those who are HIV positive. The Idaho HIV SPAP pays an eligible client’s Medicare Part D Prescription Drug Plan co-pays and out-of-pocket responsibilities during the coverage gap period. In order to be eligible for this assistance program, a beneficiary must be an Idaho resident, tested HIV positive and enrolled in Medicare Part D Prescription Drug Plan.

State Health Insurance Assistance Program (SHIP)
SHIBA is part of a network of state health insurance programs (SHIP) across the United States and its territories. In Idaho, SHIBA is funded by the Centers for Medicare and Medicaid Services (CMS), the federal agency which administers the Medicare program, and the Idaho Department of Insurance. SHIBA volunteer counselors offer unbiased information, counseling and assistance regarding senior health insurance. Counselors are fully capable of answering your questions regarding:

Prescription Drug Plan Coverage
Medicare Advantage Plans
Medicare Supplemental Policies (Medigap)
Medicare Savings Programs and,
Long Term Care Insurance

State Tax Credits for Private Health Insurance
Idaho offers a credit for employers of any size amounting to $1000 per new employee each year. The employee must be paid an average of $15.50/hour and be eligible to receive employer-sponsored coverage. The amount of credit that can be claimed in any tax year is limited to 50% of the tax otherwise imposed and may not exceed 3.25% of the taxpayer's net income.

Low-Income Subsidy (“extra-help”) for Prescription Drugs
This program is a subsidy for Part D recipients with resources under $13,070 (or $26,120 for a couple) to receive money towards a Medicare prescription drug plan. The benchmark of support is different depending on which region of the country you live in. In Idaho in 2012, the low-income subsidy was $40.86.

If you live in Idaho, and you are interested in getting a Medicare Plan, please contact the Medicare experts at eAmeriFamily Insurance. They are industry veterans and will guide you through the process of getting the right Medicare, Medicare Advantage, MediGap, or Medicare Supplement Plan for you.