Medicare plans in Idaho provide health insurance for people age 65 and older and for some people under age 65 who meet certain medial qualifications.
Original Medicare is provided through the federalgovernment. Medicare Advantage, prescription drug plans, and Medigap insuranceare all offered through private insurance carriers.
Read on to learn more about your Medicare options in Idaho.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Idaho for the 2021 plan year:
- A total of 346,684 residents of Idaho are enrolled in Medicare.
- The average Medicare Advantage monthly premium decreased in Idaho compared to last year — from $42.62 in 2020 to $35.65 in 2021.
- There are 75 Medicare Advantage plans available in Idaho for 2021, compared to 68 plans in 2020.
- About 94 percent of Idaho residents with Medicare have access to buy a Medicare Advantage plan, and 93 percent can purchase plans with $0 premiums.
- There are 12 different Medigap plans offered in Idaho for 2021.
Everyone who enrolls in Medicare, including Medicare Advantage plans, must first sign up for Part A and Part B coverage, also known as original Medicare.
Original Medicare is also called traditional Medicare. It’s offered through the federal government and funded through payroll taxes and taxes on Social Security income. It’s made up of two parts: Part A and Part B.
Part A covers:
Part B covers:
- outpatient medical care
- doctor’s appointments
- preventive care, such as screenings and annual wellness visits
- lab tests and imaging, such as X-rays
- durable medical equipment
Medicare Advantage in Idaho
In 2021, you can choose Medicare Advantage plans in Idaho from:
- Aetna Medicare
- Blue Cross of Idaho
- Molina Healthcare of Utah & Idaho
- PacificSource Medicare
- Regence BlueCross BlueShield of Idaho
Available plans will vary depending on your county of residence.
Medicare supplement plans in Idaho
Medigap plans are available through private insurance carriers to help cover some costs of your care, since original Medicare does not have an out-of-pocket limit. These plans are only available with original Medicare.
Many companies offer Medigap plans in Idaho. In 2021, some of the companies offering Medigap plans throughout the state include:
Medicare in Idaho is available to U.S. citizens (or legal residents for 5 or more years) who are 65 years old and over. If you are under 65 years old, you may still be able to get Medicare if you:
- received Social Security or Railroad Retirement Board disability payments for 24 months
- have end stage renal disease (ESRD)
- have amyotrophic lateral sclerosis (ALS)
When can I enroll in Medicare Idaho plans?
There are certain times of the year when you can enroll in or change Medicare and Medicare Advantage plans.
- Initial enrollment period (IEP). Three months before you turn 65, you can enroll in Medicare for coverage that begins during your birthday month. If you miss that window, you can still enroll during your birthday month or 3 months after, but there is a delay before coverage starts.
- General enrollment (January 1–March 31). You can sign up for parts A, B, or D during general enrollment if you missed IEP and don’t qualify for a special enrollment period. If you don’t have other coverage and didn’t sign up during your IEP, you may pay a late sign-up penalty for Part B and Part D.
- Open enrollment (October 15–December 7). If you’re already signed up for Medicare, you can change plan options during the annual enrollment period.
- Medicare Advantage open enrollment (January 1–March 31). During open enrollment, you can change Medicare Advantage plans or switch to original Medicare.
- Special enrollment period (SEP). You can sign up for Medicare during an SEP if you’ve lost coverage for a qualifying reason, such as moving out of your plan’s network area or losing an employer-sponsored plan after retirement. You don’t have to wait for annual enrollment.
Tips for enrolling in Medicare in Idaho
With so many options available, it’s important to carefully consider your own personal healthcare needs to determine if original Medicare or Medicare Advantage is the best choice as well as whether you might need supplemental coverage.
Choose a plan that:
- has doctors you like and facilities that are convenient to your location
- covers the services you need
- provides affordable coverage
- has a high star rating for quality and patient satisfaction from CMS
Find answers to questions and get help with Medicare Idaho plans from the following resources:
- Senior Health Insurance Benefits Advisors (SHIBA) (800-247-4422). SHIBA provides free help for Idaho seniors with questions about Medicare.
- Idaho Department of Insurance (800-247-4422). This resource offers information on Extra Help and Medicare Savings Programs for assistance paying for Medicare if you cannot afford it.
- Live Better Idaho (877-456-1233). This is a public-private partnership with information and resources about Medicare and other services for Idaho residents.
- Idaho AIDS Drug Assistance Program (IDAGAP) (800-926-2588). This organization offers financial assistance for Medicare Part D coverage if you are HIV-positive.
- Medicare (800-633-4227). You can also contact Medicare if you have additional questions.
- More than 300,000 Idaho residents are enrolled in Medicare.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state.
- Overall, monthly premium costs have decreased for 2021 Medicare Advantage plans in Idaho.
- There are also several Medigap plan options if you live in Idaho and are looking for additional coverage.