Idaho: Start Here
Beginner guide for Idaho—Your Health Idaho, DOI external review, managed-care PA rules, and what to open next.
Read guideState playbook
Idaho
State insurers, legislation, and appeal resources for patients and advocates in Idaho.
4 guides
Idaho Prior Authorization Law
2-business-day MCO PA responses, emergency PA ban, binding approvals, and federal Marketplace UR timelines.
Read guideIdaho Health Insurance Appeals and Grievances
Internal grievances—35-day and 3-day exhaustion rules, adverse benefit determinations, path to DOI review.
Read guideIdaho External Review (DOI)
Binding IRO review—4-month filing, 42-day standard, 72-hour expedited, fully insured Idaho plans.
Read guidePrior auth & internal appeals
Match the plan on the member ID card. Use the denial letter for where to file appeals.
- Blue Cross of Idaho
- SelectHealth
- Regence BlueShield of Idaho
- PacificSource
- Idaho Medicaid
External appeals
After internal appeal, for eligible Idaho fully insured plans only.
- Idaho DOI — External Review
- Medicaid — State fair hearing