Idaho health plan · 2025

PREF Bronze Essential 9000 With 4 Copay No Deductible Office Visits · 44648ID1290028

Regence BlueShield of Idaho offers this marketplace plan (Plan ID 44648ID1290028). Use the modules below to compare premiums, coverage structure, provider access, and formulary context against alternative options in the same market.

Metal level: Expanded Bronze Plan type: PPO CSR: Limited Cost Sharing Plan Variation Issuer: Regence BlueShield of Idaho
Telehealth Data pending HSA eligible No Dental Not listed Vision Not listed
View issuer site

CMS AV Calculator output: 61.18% (38.82% member share on average). Learn about AV methodology.

2025 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 10 Mar 2026 06:40 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

See plan search for live pricing

Before subsidies

Estimate after subsidies

Deductible

$8,500

N/A

See deductible details

Max out-of-pocket

$9,200

N/A

Review MOOP rules

Office visits

Primary care See benefits
Specialist See benefits
HSA Not eligible

Drug tiers

Generic See drug coverage
Preferred brand See drug coverage

View formulary tiers

Issuer profile See benefits
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Enrollment guidance

Stay on top of 2025 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Idaho). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Limited Cost Sharing Plan Variation plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 44648ID1290028
Coverage year 2025
State Idaho
Issuer Regence BlueShield of Idaho
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 44648ID1290028-03
Available variants

Standard On Exchange Plan · 44648ID1290028-01

Open to Indians below 300% FPL · 44648ID1290028-02

Open to Indians above 300% FPL · 44648ID1290028-03
Last plan update Thu, 19 Jun 2025 00:00 GMT
Last HealthPorta import Tue, 10 Mar 2026 06:40 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 10 Mar 2026 06:40 GMT).

All providers in Idaho N/A
PCPs in Idaho N/A
Telehealth support Data pending
Nationwide providers N/A
N/A doctors statewide N/A PCPs N/A OB/GYN

Provider network(s)

['PREFERRED']

Providers Idaho All US states
All N/A N/A
PCP N/A N/A
Allergy N/A N/A
OB/GYN N/A N/A
Dentists N/A N/A

Drug coverage overview

3,676 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
GENERIC 2,445
NON-PREFERRED-BRAND 716
SPECIALTY 514
PREFERRED-GENERIC 1
Prior authorization Drugs
Required 391
Not Required 3,285
Step therapy Drugs
Required 0
Not Required 3,676
Quantity limits Drugs
Has Limit 941
No Limit 2,735

Customer highlights

What stands out for members

  • Issuer: Regence BlueShield of Idaho · Plan ID 44648ID1290028 · 2025 filing.
  • Disease management programs available: Pregnancy, Pain Management, Depression, Low Back Pain, Heart Disease.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 44648ID1290028-03 (Open to Indians above 300% FPL) currently displayed.
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Variant attributes

PREF Bronze Essential 9000 With 4 Copay No Deductible Office Visits · Variant 44648ID1290028-03

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2025

CSR Variation Type

Limited Cost Sharing Plan Variation

HIOS Product ID

44648ID129

Metal Level

Expanded Bronze

Plan ID (Standard Component ID with Variant)

44648ID1290028-03

Plan Marketing Name

PREF Bronze Essential 8500 With 4 Copay No Deductible Office Visits

Plan Variant Marketing Name

PREF Bronze Essential 8500 With 4 Copay No Deductible Office Visits

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

44648

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

Yes

Network ID

IDN002

Out of Country Coverage

Yes

Out of Country Coverage Description

Members traveling outside the United States receive coverage for the same benefits as inside the United States. Members who do not seek inpatient care at a BlueCross BlueShield Global Hospital may have to pay a provider upfront for care and submit an international claim form to be reimbursed.

Out of Service Area Coverage

Yes

Out of Service Area Coverage Description

Out of Area benefits are covered on Blue Card which provides access to the largest network of doctors in the United States

Service Area ID

IDS002

State Code

ID

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

AV Calculator Output Number

0.611773803

Begin Primary Care Deductible Coinsurance After Number Of Copays

4

Medical Drug Deductibles Integrated

Yes

Medical Drug Maximum Out of Pocket Integrated

Yes

SBC Scenario, Having a Baby, Coinsurance

$400

SBC Scenario, Having a Baby, Copayment

$10

SBC Scenario, Having a Baby, Deductible

$8,500

SBC Scenario, Having Diabetes, Coinsurance

$900

SBC Scenario, Having Diabetes, Copayment

$500

SBC Scenario, Having Diabetes, Deductible

$900

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$200

SBC Scenario, Treatment of a Simple Fracture, Deductible

$2,500

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family

$90700 per person | $181400 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

$90,700

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

10.00%

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family

$9200 per person | $18400 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$9,200

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family

$81500 per person | $163000 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

$81,500

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

IDF008

SBC Scenario, Having a Baby, Limit

$60

SBC Scenario, Having Diabetes, Limit

$200

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

Additional attributes

Issuer-provided metadata for this variant.

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Dental Only Plan

No

Design Type

Not Applicable

Disease Management Programs Offered

Pregnancy, Pain Management, Depression, Low Back Pain, Heart Disease

EHB Percent of Total Premium

100%

First Tier Utilization

100%

Import Date

1/13/2025

HSA Eligible

No

IsItANewPlan

New

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

Yes

Plan Effective Date

1/1/2025

Plan Type

PPO

QHP/Non QHP

Both

Source Name

SERFF

Specialist Requiring a Referral

A provider focusing on a specific area of medicine or a group of patients to diagnose, manage, prevent, or treat certain types of symptoms and conditions.

Plan ID

44648ID1290028

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family

$24800 per person | $49600 per group

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual

$24,800

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family

$8500 per person | $17000 per group

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual

$8,500

TEHBDedOutofNetFamily

$16300 per person | $32600 per group

Combined Medical and Drug EHB Deductible, Out of Network, Individual

$16,300

Unique Plan Design

No

Version Number

1

Wellness Program Offered

No

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Idaho?

PREF Bronze Essential 9000 With 4 Copay No Deductible Office Visits (44648ID1290028) is a Expanded Bronze PPO from Regence BlueShield of Idaho in Idaho for the 2025 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does PREF Bronze Essential 9000 With 4 Copay No Deductible Office Visits support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is PREF Bronze Essential 9000 With 4 Copay No Deductible Office Visits HSA-eligible and does it include dental or vision coverage?

It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.

Dental coverage is not listed for this plan.

Vision coverage is not listed for this plan.

Does PREF Bronze Essential 9000 With 4 Copay No Deductible Office Visits support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Which disease management programs come with PREF Bronze Essential 9000 With 4 Copay No Deductible Office Visits?

The issuer lists disease management resources for: Pregnancy, Pain Management, Depression, Low Back Pain, Heart Disease.

Is there out-of-country coverage for PREF Bronze Essential 9000 With 4 Copay No Deductible Office Visits?

Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Members traveling outside the United States receive coverage for the same benefits as inside the United States. Members who do not seek inpatient care at a BlueCross BlueShield Global Hospital may have to pay a provider upfront for care and submit an international claim form to be reimbursed.

Does PREF Bronze Essential 9000 With 4 Copay No Deductible Office Visits cover care outside the service area?

Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Out of Area benefits are covered on Blue Card which provides access to the largest network of doctors in the United States

How do I enroll in or manage payments for PREF Bronze Essential 9000 With 4 Copay No Deductible Office Visits?

Use the issuer portal https://regence.com to pay premiums or start enrollment, then return to HealthPorta for benefit comparisons.

Disclaimer: Based on the Tue, 10 Mar 2026 06:40 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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