Medical

The State of Idaho offers three medical plan options so employees can select the plan that best meets their needs,  and gives access to providers in their geographic area. Each medical plan provides comprehensive coverage, with different levels of out-of-pocket expenses and premium contribution rates. A Vision Benefit and Prescription Drug Coverage are included with medical plan enrollment. All benefit eligible employees also have access to an Employee Assistance Program (EAP) and Wellness Resources. Deductibles and benefits for all plans are provided on a fiscal year, from July 1 through June 30.

Beginning July 1, 2024, the medical coverage for the State Health Plan will be serviced by Regence BlueShield of Idaho. Please refer to the Summaries of Benefits and Coverage (SBCs) and plan documents below for specific plan details. You can also visit the FY2025 Benefits Information webpage for other program flyers and resources.

• Active Employee Regence PPO SBC
• FY25 Regence PPO Medical and Vision Contract
• Active Employee Regence Traditional SBC
• FY25 Regence Traditional Medical and Vision Contract
• Active Employee Regence HDHP SBC
• FY25 Regence HDHP Medical and Vision Contract




If you have specific questions about your medical or pharmacy benefits for FY2025, Regence Customer Service is available to help. Contact Customer Service by phone at 1-800-854-5585.

 

 

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PPO Highlights

• You save money when you use In-Network Regence Blue Shield of Idaho providers
• Most employees choose this plan

High Deductible (HDHP) Highlights

• HSA compatible. All services and prescriptions that are not preventive in nature are subject to the deductible before the plan begins to pay.

FY25 Medical Plan Comparison & Plan Contracts (Start July 1, 2024)

Feature Name	PPO In-Network	PPO Out-of-Network	Traditional	High Deductible
Deductible - Individual	$350	$600	$500	$2000
Deductible - Family	$950	$1,700	$1,400	$4,000
Out-of-Pocket Limit - Individual	$3,250	$6,500	$4,350	In Network: $5,000 Out-of-Network: $6,500
Out-of-Pocket Limit -Family	$6,750	$13,500	$8,700	In Network: $10,000 Out-of-Network: $13,000
Plan Payment (% of allowable charges after deductible)	$20 copay, $40 Specialist copay / 80%	60%	70%	In Network: 80% Out-of-Network: 60%
Wellness/Preventive Care	No copay for listed services	60%	100%	In Network: 100% Out-of-Network: 50% after deductible

For details about premiums, please see Premium Rates.
Please keep in mind that deductibles and benefit payments are based on allowable charges.
Details about the medical plans, exclusions and waiting periods, can be found in each medical plan document and Summary of Benefits & Coverage (SBC).

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I’m traveling out of the country, what should I know?

As an enrolled member in the State’s health plan, you have the ability to take your healthcare benefits with you when you go abroad. Through the Regence Blue Shield Global Core program, you have access to doctors, hospitals, support tools, and resources around the world.

Here is what you need to know:

• Always carry your insurance card.
• Contact the plan before you travel for questions about using services.
• If direct payment has not been arranged or your local plan is unable to verify your benefit coverage at time of service, you may need to pay upfront and submit a claim for reimbursement.

To learn more, review these resources available from the Global Core program:

BlueCard® Program
BCBS Global® Core