High Risk Pool Individual Plans
High Risk Pool (HRP) plans are available to individuals and families who have applied for health coverage and have been declined because of reasons related to their current health condition or health history. HRP plan benefits and monthly premiums are determined by the Idaho Department of Insurance and are available for purchase through Regence BlueShield of Idaho.
Regence offers several plan options, including the Regence HRP Health Savings Account plan, which allows your client to set aside tax-free money to fund their deductible and other qualified medical expenses.
HRP Plan Highlights
- Four deductible options: $500, $1,000, $2,000 and $5,000
- Annual allowance of $200 for preventive care services (subject to deductible and coinsurance)
- After meeting a separate prescription drug deductible, drug costs are covered at 50%
- One plan option qualifies members for a Health Savings Account
Determining Eligibility
HRP plans are not applied for like traditional plans. Your client must first apply for an Individual & Family Plan. If your client is declined coverage because of reasons related to their current health conditions or health history, they may be eligible for a HRP health plan.
There are 4 categories of HRP plans: Basic, Standard, Catastrophic or HSA High Risk Pool Health Plan. To be eligible for coverage under any category, applicants must meet this criteria:
- Idaho resident or dependent of an Idaho resident who is not eligible for coverage under a group health plan, Medicare, Medicaid or any successor program, and who does not have other health insurance coverage.
- Been denied by a carrier for a preferred plan based on health status or claims experience or received a higher rate offer for a substantially similar preferred plan.
Materials
For more information on qualifications for HRP plans, visit the Idaho Department of Insurance web site. |
