Idaho Health Insurance Plan Benefits & What's Included

What's included in the plan, or do I have to pay extra for some coverage?

Does the plan include the following, or do I have to buy additional coverage/riders for these benefits?

  • Pregnancy/Maternity
  • Doctor office visits
  • Prescription drugs
  • Emergency room visits
  • Treatment of an accident if not admitted to a hospital
  • X-rays and laboratory tests if not admitted to a hospital
  • Wellness benefits (annual physical exam, well-child care, etc.)
  • Skilled nursing care, home health care, hospice
  • Chemotherapy or radiation if not admitted to a hospital
  • Air ambulance

Are there benefit limits?

Does the plan have limits on the amount of benefits it will pay for certain types of treatment or services? Are the limits for a calendar year or for each insured's lifetime?

  • Prescription drugs
  • Mental health and/or chemical dependency
  • Chiropractic
  • TMJ or other jaw joint treatment
  • Home health or hospice care
  • Physical, speech, occupational, or other therapy services

What are the maximum benefits the policy will pay?

  • $1,000,000 during each insured's lifetime?
  • Separate lifetime maximums for some services, such as organ transplants?

YES NO


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