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H0529

Idaho House Bill 529: Rules for Paying Cash for Health Care

Last scannedAug 24, 2026, 7:59 AM

In one sentence

This bill stops insurance companies from blocking patients who want to pay a lower cash price directly to their doctor, and it requires insurers to count those payments toward the patient's yearly spending limits if specific conditions are met.

Requires health carriers to allow providers to offer discounted cash prices without filing an insurance claim.
Allows covered persons to choose paying out of pocket for services instead of using their insurance plan.
Mandates that insurers count negotiated cash payments toward a patient's deductible and annual maximum if the service is medically necessary, covered by the plan, and costs less than the average allowed amount.
Requires patients to send electronic proof of payment and confirmation that no claim was filed to get credit on their insurance account.
Prohibits providers from billing for any balance after accepting a discounted cash price as full payment.

Health carriers (insurance companies) operating in Idaho
Health care providers such as doctors and hospitals
Covered persons who have health benefit plans that pay out of pocket for services

This law does not apply to limited benefit plans like dental-only or vision-only insurance.
The rules do not cover government programs such as Medicaid or Medicare supplemental policies.
Credit for cash payments only counts toward the current contract period and does not carry over to a new year.

Plain language

Discounted cash price: The charge a provider gives to someone paying with cash without filing an insurance claim.
Out-of-pocket deductible: The amount of money a person must pay for health care before their insurance plan starts covering costs.
Annual maximum out-of-pocket expense: The most money a person has to pay in one year for covered services, after which the insurer pays 100% of allowed amounts.

Official record

Source attached

Health care cash payments

Official activity