Idaho health plan · 2025

Select Health SAHA Silver 4500 - no deductible for office visits · 26002ID0010054

Select Health offers this marketplace health insurance plan (Plan ID 26002ID0010054) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Silver Plan type: PPO CSR: Standard Silver On Exchange Plan Issuer: Select Health
Telehealth Data pending HSA eligible No Dental Not listed Vision Not listed

CMS AV Calculator output: 71.29% (28.71% member share on average). Learn about AV methodology.

2025 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 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

N/A

N/A

See deductible details

Max out-of-pocket

$9,000

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.
  • Standard Silver On Exchange Plan 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 26002ID0010054
Coverage year 2025
State Idaho
Issuer Select Health
Variant ID 26002ID0010054-01
Available variants

Standard On Exchange Plan · 26002ID0010054-01

Open to Indians below 300% FPL · 26002ID0010054-02

Open to Indians above 300% FPL · 26002ID0010054-03

73% AV Silver Plan · 26002ID0010054-04

87% AV Silver Plan · 26002ID0010054-05

94% AV Silver Plan · 26002ID0010054-06
Last plan update Wed, 26 Nov 2025 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 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, 02 Dec 2025 06:13 GMT).

All providers in Idaho 6
PCPs in Idaho 1
Telehealth support Data pending
Nationwide providers 9
6 doctors statewide 1 PCPs

Provider network(s)

Providers Idaho All US states
All 6 9
PCP 1 2
Allergy N/A N/A
OB/GYN N/A N/A
Dentists N/A N/A

Drug coverage overview

3,860 drugs tracked

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

Tier Covered drugs
NON-PREFERRED-GENERIC 2,237
NON-PREFERRED-BRAND 663
SPECIALTY-DRUGS 501
ZERO-COST-SHARE-PREVENTIVE-DRUGS 459
Prior authorization Drugs
Required 525
Not Required 3,335
Step therapy Drugs
Required 213
Not Required 3,647
Quantity limits Drugs
Has Limit 423
No Limit 3,437

Customer highlights

What stands out for members

  • Issuer: Select Health · Plan ID 26002ID0010054 · 2025 filing.
  • Disease management programs available: Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma.
  • Variant 26002ID0010054-01 (Standard On Exchange Plan) currently displayed.
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Variant attributes

Select Health SAHA Silver 4500 - no deductible for office visits · Variant 26002ID0010054-01

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2025

CSR Variation Type

Standard Silver On Exchange Plan

HIOS Product ID

26002ID001

Metal Level

Silver

Plan ID (Standard Component ID with Variant)

26002ID0010054-01

Plan Marketing Name

Select Health SAHA Silver 4500 - no deductible for office visits

Plan Variant Marketing Name

Select Health SAHA Silver 4500 - no deductible for office visits

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

26002

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

Yes

Network ID

IDN003

Out of Country Coverage

No

Out of Country Coverage Description

All covered services obtained outside of the service area, except urgent, or emergency conditions, apply to nonparticipating benefits

Out of Service Area Coverage

No

Out of Service Area Coverage Description

All covered services obtained outside of the service area, except urgent, or emergency conditions, apply to nonparticipating benefits

Service Area ID

IDS003

State Code

ID

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

AV Calculator Output Number

0.712870706

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

30.00%

Inpatient Copayment Maximum Days

5

Medical Drug Deductibles Integrated

No

Medical Drug Maximum Out of Pocket Integrated

Yes

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

30.00%

SBC Scenario, Having a Baby, Coinsurance

$0

SBC Scenario, Having a Baby, Copayment

$700

SBC Scenario, Having a Baby, Deductible

$4,500

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$500

SBC Scenario, Having Diabetes, Deductible

$800

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$400

SBC Scenario, Treatment of a Simple Fracture, Deductible

$2,100

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

per person not applicable | per group not applicable

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

Not Applicable

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

$9000 per person | $18000 per group

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

$9,000

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

$91000 per person | $182000 per group

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

$91,000

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

IDF012

SBC Scenario, Having a Baby, Limit

$60

SBC Scenario, Having Diabetes, Limit

$20

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

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

$2500 per person | per group not applicable

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

$2,500

Drug EHB Deductible, In Network (Tier 1), Family

per person not applicable | per group not applicable

Drug EHB Deductible, In Network (Tier 1), Individual

Not Applicable

Drug EHB Deductible, Out of Network, Family

per person not applicable | per group not applicable

Drug EHB Deductible, Out of Network, Individual

Not Applicable

Dental Only Plan

No

Design Type

Not Applicable

Disease Management Programs Offered

Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma

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?

No

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

per person not applicable | per group not applicable

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

Not Applicable

Medical EHB Deductible, In Network (Tier 1), Family

$4500 per person | $9000 per group

Medical EHB Deductible, In Network (Tier 1), Individual

$4,500

Medical EHB Deductible, Out of Network, Family

$18200 per person | $36400 per group

Medical EHB Deductible, Out of Network, Individual

$18,200

Plan Effective Date

1/1/2025

Plan Expiration Date

12/31/2025

Plan Level Exclusions

Abortions/Termination of Pregnancy (except to save the life of the mother or when caused by rape/incest); Acupuncture/Acupressure; Administrative Services/Charges; Certain Allergy Tests; Bariatric Surgery; Biofeedback/Neurofeedback; Certain Cancer Therapies; Certain Illegal Activities; Claims After One Year; Complementary/Alternative Medicine; Complications of a Non-Covered Service; Custodial Care; Debarred Providers; Dental Anesthesia where criteria is not met; Duplication of Coverage; Exercise Equipment/Fitness Training; Experimental/Investigational Services (except for approved clinical trials); Refractive Eye Surgery; Food Supplements; Gene Therapy; Hearing Aids where criteria is not met; Home Health Aides; Certain Immunizations; Certain Pain Management Services; Certain Prescription/Injectable Drugs and Specialty Medications; Reconstructive, Corrective, and Cosmetic Services; Respite Care; Robot-Assisted Surgery; Sexual Dysfunction; Certain Specialty Services; Travel-Related Expenses; computer-assisted interpretation of X-rays; Computer-assisted navigation for orthopedic procedures; Home A1C testing; Magnetic Source Imaging (MSI); Manipulation under anesthesia; Oncofertility; Radiofrequency ablation for lateral epicondylitis; Virtual colonoscopy screening; and certain DME items.

Plan Type

PPO

QHP/Non QHP

Both

Source Name

SERFF

Plan ID

26002ID0010054

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?

Select Health SAHA Silver 4500 - no deductible for office visits (26002ID0010054) is a Silver PPO from Select Health 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 Select Health SAHA Silver 4500 - no deductible for 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 Select Health SAHA Silver 4500 - no deductible for 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 Select Health SAHA Silver 4500 - no deductible for 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 Select Health SAHA Silver 4500 - no deductible for office visits?

The issuer lists disease management resources for: Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma.

Is there out-of-country coverage for Select Health SAHA Silver 4500 - no deductible for office visits?

No, out-of-country services are not covered for this plan. Details: All covered services obtained outside of the service area, except urgent, or emergency conditions, apply to nonparticipating benefits

Does Select Health SAHA Silver 4500 - no deductible for office visits cover care outside the service area?

No, the issuer indicates out-of-service-area care is not covered except for emergencies. Details: All covered services obtained outside of the service area, except urgent, or emergency conditions, apply to nonparticipating benefits

How do I enroll in or manage payments for Select Health SAHA Silver 4500 - no deductible for office visits?

Use HealthPorta to shortlist plans, then finish enrollment through Healthcare.gov or your state-based marketplace.

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 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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