Understand Medicare in Idaho
Medicare, the United States federal medical insurance program, provides coverage for more than 200,000 people in Idaho who qualify for Medicare. You can get Medicare if you’re 65 or older or have a qualifying disability.
Your disability typically qualifies if you’ve received at least 24 Social Security or Railroad Retirement Board (RRB) disability insurance payments. You can also enroll in Medicare Advantage Plans if you have End-Stage Renal Disease (ESRD) or amyotrophic lateral sclerosis (ALS).
Most people have premium-free Part A but, if you have to buy it, the cost can reach up to $499 per month in 2022. Part B costs $170.10 per month but can be more if you have higher income. There are 44 Medicare Advantage Plans in the state that are an alternative to Original Medicare. Learn more about your Medicare options in Idaho.
Medicare Plans in Idaho
|Compare ratings of Idaho’s Medicare plan providers:|
|Insurance company||Medicare rating||A.M. Best rating||BBB rating||NCQA rating||J.D. Power ranking|
|Aetna||4 stars||A||A+||2.5 to 4.5 stars||Fifth out of 10|
|Blue Cross Blue Shield||4.5 stars||A||A+||Not rated||Sixth out of 10|
|Humana||4 stars||A-||A+||1.5 to 4.5 stars||Third out of ten|
|UnitedHealthcare||3.5 stars||A-||A-||4 stars||Fourth out of 10|
Medicare Plan Options in Idaho
Residents of Idaho have multiple Medicare plans to choose from. Many are tiered to help Idahoans find the plan that is best suited to your lifestyle and medical needs. For example, seniors and individuals with disabilities who don’t need much coverage can apply for Original Medicare. Idaho’sMedicare Advantage program might be a better option if you need more comprehensive insurance. Some Medicare policies offer additional prescription drug add-ons or supplementary coverage.
|Original Medicare (Parts A and B)||Original Medicare is the basic Medicare plan, which is a fee-for-service form of insurance. It has two parts: Part A hospital insurance and Part B medical insurance. Part A covers hospital stays and periods spent at skilled nursing facilities, lab tests an individual has performed, and hospice care. Part B covers doctor’s office visits and home health care services. It may also cover some preventive care, such as screenings for cancers and mental illnesses, including depression. With Original Medicare, you’ll pay a deductible along with your share of the fees incurred during an inpatient or outpatient visit:
|Medicare Advantage Plans (Part C)||Medicare Advantage plans, also known as Part C, are an alternative to Original Medicare offered by private insurance companies. These plans include both Part A and Part B coverage, except for hospice care. Most services are provided by network providers, and you may need primary care physicians, referrals for specialists, and prior authorizations for treatment and medications. Medicare Advantage offers additional coverage for essential needs, such as prescription drugs, dental and vision care. Some Medicare Advantage Plans also cover gym memberships and transportation to and from medical appointments. Part C may also pay for adult day care services:
|Medicare Prescription Drug Coverage Plans (Part D)||Many Medicare Advantage policies add Part D drug coverage automatically to their package, but you can also add Medicare prescription drug coverage to Original Medicare. Medicare prescription drug coverage is offered to all Medicare enrollees, but you may have to pay a penalty if you wait to enroll after being initially eligible. Medicare Part D plans may not all cover the same drugs or have the same costs as Medicare Advantage policies. Standalone Part D coverage is provided by Medicare-approved private insurers. Most plans require a deductible and a copay for each prescription drug:
|Medicare Supplement Insurance Plans (Medigap)||Some Idaho seniors purchase a Medicare Supplement Insurance policy, also known as Medigap. These plans are intended to fill in the gaps Original Medicare doesn’t cover. Some of these gaps include medical coverage while overseas, Part A and Part B copays, and excess Part B charges. Medigap doesn’t pay for anything related to Medicare Advantage. You cannot have a Medigap plan and a Medicare Advantage Plan at the same time.
Medicare in Idaho by the Numbers
|People enrolled in Original Medicare||Average plan cost||Annual state spending per beneficiary||Spending per beneficiary compared to the national average|
|218,557||Plan A: $0 to $499 per month*
Plan B: $170.10 per month**
*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.
Medicare Resources in Idaho
Getting support can help when you’re making Medicare decisions. Idaho has numerous locations where enrollees can receive help through the State Health Insurance Program (SHIP), also known as Senior Health Insurance Benefits Advisors (SHIBA). SHIBA has counselors throughout the state that work with local nonprofits and public health agencies, as well as Area Agencies on Aging (AAAs), to provide seniors with Medicare information.
Idaho Commission on Aging
The Idaho Commission on Aging can connect you with one of its regional agencies, all of which provide a comprehensive selection of services for the region’s older adults. The agencies have programs designed to help seniors 60 and older maintain their health and independence, including resources to guide you through the Medicare enrollment process, and the counselors will help you understand the available benefits fully.ble.
Contact information: Website | (208) 334-3833
Idaho Department on Insurance
The Idaho Department of Insurance provides education and resources to help you understand Medicare and Medicare Advantage plans so you can make informed decisions.
Contact information: Website | (208) 334-4250
Idaho Department of Health and Welfare
The Idaho Department of Health and Welfare provides healthcare services if you qualify based on income.
Contact information: Website | (877) 456-1233
Learn More from Our Sources
- Medicare | How do Medicare Advantage plans work? | Last accessed November 2022
- Medicare | How to get prescription drug coverage | Last accessed November 2022
- Medicare | Medicare Advantage Plans cover all Medicare services | Last accessed November 2022
- Medicare | What Medicare covers | Last accessed November 2022
- Medicare | What’s Medicare Supplement Insurance (Medigap)? | Last accessed November 2022