Pivot Health Short Term Medical Plans Available in Idaho
- By Deb Shields
Idaho residents in search of insurance coverage alternatives to marketplace exchange plans can also purchase short term health insurance coverage from Pivot Health. Also known as short term medical, or temporary insurance, this type of plan is designed to provide health care coverage until a more permanent insurance option becomes available.
In Idaho, short term health insurance has terms lasting 90-days, 180-days or up to 364 days. But you can cancel at any time.
The Benefits of Short Term Health Insurance
Similar to marketplace exchange plans, short term health insurance provides benefits for doctor and specialist visits, emergency care, X-rays, lab tests and hospitalizations. Some plans even include prescription drug coverage. For many consumers, short term medical is a smart coverage choice for many reasons, including:
- Affordable coverage
- short term health insurance premiums can be up to 50 percent lower than premiums for marketplace exchange plans. In fact, in 2017, a 30-year-old paid an average monthly premium of $79 for a short term medical plan, versus $311 for an unsubsidized bronze marketplace exchange plan.
- Flexible coverage duration
- whether you need coverage for as a little as one month, or as long as up to nearly a full year, short term health insurance provides you the flexibility to select the coverage duration which meets your needs.
- No network restrictions on many plans
- unlike marketplace exchange plans which pay benefits at lower rates if you don’t use in-network providers, most short term health insurance plans enable you to seek treatment from any providers and facilities you prefer. Prefer a PPO plan with in-network doctors? Pivot Health has that option as well with low deductibles. Just look for “PPO” next to the plan name when running a quote.
- Easy online application process
- answer a brief medical history when you apply, and you’ll learn within seconds if you have been approved for short term health insurance coverage.
- Coverage when you want it
- qualified applicants select the date they want coverage to start, which can be as soon as 24 hours from the time of application. No need to wait for special enrollment circumstances or the annual enrollment period, as marketplace exchange plans require.
Pivot Health short term medical plans also include the following non-insurance benefits:
- Discounted telehealth doctor consultations
- Save yourself time spent in your doctor’s waiting room. Simply connect directly with a doctor whenever and wherever it works for you – telehealth consultations are unlimited and available 24/7. These low-cost consultations can be less expensive than what your cost for a standard office or urgent care facility visit.
- Savings on eyewear and eye care
- Enjoy discounts ranging from 15 percent to 40 percent on eye exams, eyeglass lenses, frames for eyeglasses and contact lenses.
- Discounts on prescription drugs
- Save up to 75 percent on prescription drugs at thousands of pharmacies across the country, making it easier for you to budget prescription medications.
Not sure if short term health insurance is right for you? Typical consumers of this type of plan include individuals who:
- Are between jobs and want a different coverage choice than COBRA
- Don’t receive group insurance coverage from their employer
- Are waiting for employer-sponsored health care benefits to begin
- Can’t afford employer’s health insurance coverage
- Lost coverage from their parents’ plan
- Missed the annual open enrollment period for health insurance exchange plans
- Don’t qualify for a special enrollment to purchase insurance through the health insurance exchange
- Are uninsured due to life circumstances
The Latest in Idaho Health Insurance News
The good news for Idaho residents is that marketplace plans premiums will be increased by an average of five percent in 2019, a significantly lower change than the staggering double-digit premium rate increases the state has experienced over the past three years. Increases are lowest for the bronze and silver level plans, and highest for the catastrophic plans. Insurance industry analysts say that prior years’ premium hikes have helped insurers return to profitability after experiencing hundreds of millions in claim losses during the first few years that ACA plans were offered.
Unfortunately, the general trend across the country shows that the number of adults without health insurance is once again increasing. After dropping to an all-time low of 10.9 percent in late 2016 after the passage of the Affordable Care Act (ACA), the rate of uninsured adults in 2018 has risen to 15.5 percent. In Idaho, the most recent County Health Rankings report shows that the rate of uninsured individuals varies greatly by county: Clark County estimates that 27 percent of their residents have no health insurance coverage, while Ada County reports an uninsured rate of just 9 percent, significantly below the national uninsured rate.
To help reduce marketplace exchange premiums and ultimately increase resident participation in the exchanges, Idaho has recently enacted a number of initiatives:
Interstate Insurance Sales
In early 2018, Governor Otter signed a new act into law which allows out-of-state insurers to sell health insurance policies in Idaho. Insurers must meet certain licensing requirements, pay Idaho’s premium tax and high-risk pool fees, and provide coverage for Idaho’s state-mandated benefits. Under this legislation, Idaho joins the ranks of several other states which may enter into agreements with other states to allow for interstate insurance sales, although most individual market insurers currently do not have interstate provider networks.
“Extended Bronze” Plans
Under the ACA legislation, participating marketplace insurers are required to provide cost-sharing reduction (CSR) plans to enrollees with a low income. In October of 2017, when the federal government ceased reimbursing insurers for those plans, participating insurers engaged in “silver loading”, which meant they significantly increased the cost of the silver-level plans. Enrollees who receive federal subsidies for their marketplace coverage experienced little impact on their premium costs.
However, silver plan enrollees who don’t receive premium subsidies were required to bear the full cost of the silver loading. To provide enrollees without subsidies a more affordable marketplace exchange option, insurers in Idaho created new “extended bronze” plans which were first offered in 2018. These plans provide higher benefits than bronze plans, but lower benefits than silver plans. Because the government is still not providing CSR payments to insurers, extended bronze plans will probably be a good choice again in 2019 for Idahoans who don’t receive federal subsidies, but find that they need to enroll in a marketplace exchange plan.
Proposal to Sell “State-Based” Plans
Seeking alternative coverage solutions for middle-class uninsured Idahoans – many of whom are self-employed professionals who make too much money to qualify for federal subsidies but can’t afford to pay marketplace exchange plan premiums – the Idaho Department of Insurance drafted a proposal in early 2018 to allow insurers to sell state-based plans that would not have to comply with ACA requirements.
The federal Centers for Medicare & Medicaid Services (CMS) rejected the proposal, explaining that the plans did not comply with ACA regulations and could not be implemented. The CMS did remark, though, that with certain modifications, Idaho’s state-based plans could be offered as short term medical plans, which are exempt from the ACA’s regulations.
Short Term Health Insurance in Idaho
In Idaho, short term health insurance premiums may have terms up to 364 days. A number of insurers offer short term medical plans in the state, and nearly 4,000 residents have this type of coverage. It’s clear that Idahoans are interested in a broader range of health insurance choices, which can be more affordable than marketplace exchange coverage.
A Report on Idaho’s Well-Being
The most recent Gallup-Healthways State of American Well-Being report examined how well-being varies by state. Idaho ranked 8th out of the 50 U.S. states (up from its previous ranking of 18th), based on survey responses to questions covering different categories of well-being.
Idaho’s highest-ranking category, scoring 2nd in the country overall, was for:
- liking where you live, feel safe and having pride in your community
In the second quintile of rankings were Idaho’s scores for the following categories (ranking 19th, 17th and 17th, respectively):
- liking what you do each day and being motivated to achieve your goals
- managing your economic life to reduce stress and increase security
- having good health and enough energy to get things done daily
Idaho’s lowest-ranked category (45th) was for:
- having supportive relationships and love in your life
Overall, Idaho residents report a positive sense of well-being.
The State of Health in Idaho
The most recent Commonwealth Fund’s Scorecard on State Health System Performance, which is based on 2016 data, gave Idaho an overall ranking of 15 out of 51 (the 50 states plus the District of Columbia), up four places from the prior scorecard ranking. The scorecard ranked indicators in a number of areas, which improved or declined as shown below:
|Area||2018 Ranking||Change from Prior Scorecard|
|Access and affordability||39th||A drop of five places|
|Prevention and treatment||24th||No change|
|Avoidable use and cost||5th||A drop of one place|
|Healthy lives||11th||A rise of four places|
|Disparity||5th||A rise of 14 places|
Since the previous scorecard (based on 2015 data) was released, Idaho improved its rankings in the following areas by decreasing the number of:
- Uninsured adults ages 19-64 (from 23 to 15 percent)
- Uninsured children ages 0-18 (from 9 to 5 percent)
- Adults who went without care because of cost (from 16 to 14 percent)
- Individuals with high out-of-pocket medical spending (from 22 to 16 percent)
- Children ages 19-35 months who did not receive all recommended vaccines (from 30 to 26 percent)
- Patients discharged without home recovery instructions (from 12 to 10 percent)
- Home health patients whose mobility did not improve (from 37 to 27 percent)
- Adult smokers (from 17 to 15 percent)
- Obese adults (from 30 to 28 percent)
- Infant mortality rate per 1,000 births (from 5.4 to 4.7 percent)
Areas in which Idaho has declined since the last scorecard ranking include higher rates of:
- Adults without a dental visit in the past year (from 13 to 16 percent)
- Employee health insurance contributions as a share of median income (from 5 to 7 percent)
- Mortalities within 30 days of hospitalization (from 13.6 to 14.6 percent)
- Adults with a mental illness reporting an unmet need (from 23 to 25 percent)
- Home health patients requiring a hospital admission (from 14 to 15.2 percent)
2018 Health Insurance Plans in Idaho
After using the federal exchange the first year that ACA plans were offered, Idaho developed its own state-run marketplace exchange. Called “Your Health Idaho”, the state exchange is one of the most robust marketplace exchanges in the country, with four participating health insurers:
- Blue Cross of Idaho (offered in all counties)
- Mountain Health Co-Op (offered in all counties)
- PacificSource (offered in all counties)
- SelectHealth (offered in all counties but 12)
Alternative health insurance coverage solutions, such as short term health insurance offered by Pivot Health, cover nearly 4,000 Idaho residents.
Medicaid in Idaho
On November 6, 2018, Idahoans voted “yes” on Idaho Proposition 2, a ballot measure which would expand the state’s Medicaid program to include childless and low-income adults with income at or below 138 percent of the federal poverty level (about $17,000 for an individual, or $25,000 for a family of four).
Proponents of the expansion say that 62,000 Idaho residents fall into the Medicaid “coverage gap”. These residents have an income too high to qualify for Medicaid, but not high enough to qualify for subsidized health insurance plans purchased on the state marketplace exchange.
Now that Idahoans have approved the ballot measure during the election, it will still be up to state lawmakers and the newly-elected governor, Brad Little, to approve the state’s share of the funding for the expanded Medicaid program. Idaho’s portion of Medicaid funding will be approximately 10 percent, starting in 2020. With approximately 30 state lawmakers vocally declaring their opposition to the measure as recently as a week before the election, it remains to be seen how quickly the approved measure will be voted into law.
Until that time, it remains critically important for Idaho residents to have access to affordable, alternative health insurance coverage solutions.
Your Health Care Coverage Choices
If you are one of the more than 60,000 Idaho residents without health insurance because you think you can’t afford it, this is a great time to reconsider alternative coverage solutions. With a low-cost short term health insurance plan from Pivot Health, you can have coverage that provides you with the benefits you need, with the added peace of mind in having financial protection from costly medical emergencies.