For anyone who lives in Idaho age 65 and older, you can start receiving health care benefits from the federal government through Idaho Medicare plans. The benefits you are eligible for fall under Part A and Part B of Medicare. These benefits include hospital stays and most hospital services, in addition to outpatient care. There are many more services too, and they are outlined in the table below.

Medicare Plans in Idaho

There are some base costs associated with receiving Medicare benefits. Depending on your history of employment, you may have to pay for both Parts A and B, or only Part B. Those who have a lengthy work history (10 years/40 quarters) will only have to pay for Part B. However, those who have worked less than 10 years in their lifetime will also be required to pay a premium in order to have access to Part A benefits.

Medicare Part A (Hospital Coverage)

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care
Medicare Part B (Medical Insurance)

  • Services from doctors and health providers
  • Outpatient care
  • Home health care
  • Durable medical equipment
  • Some preventive services
Medicare Part C (Medicare Advantage)

  • Includes all benefits and services covered under Part A and Part B
  • Usually includes Medicare prescription drug coverage (Part D) as part of the plan
  • Offered by Medicare-approved private insurance companies
  • May include extra benefits and services for an extra cost
Medicare Part D (Drug Coverage)

  • Helps cover the cost of prescription drugs
  • Run by Medicare-approved private insurance companies
  • May help lower your prescription drug costs and help protect against higher costs in the future

The Scope of Idaho Medicare Insurance Programs

In Idaho, there are 242,889 retirement-age citizens currently enrolled in Medicare. Of those, one-third (33%) are getting Medicare Benefits through a Medicare Advantage policy. There is also another group of beneficiaries – 22% of the nearly quarter million number mentioned above – who supplement Traditional Medicare with one of ten available Medigap policies. The remaining 45% may be relying on Medicare alone to cover their health costs, or they may be receiving some other sort of benefits (such as through an employer).

All qualified seniors who are currently enrolled in Medicare should be looking into a supplemental insurance policy. If you are not yet enrolled, or if you are unsure, click the link above and learn how to get yourself enrolled today.

Should You Supplement Your Medicare if You Live in Idaho?

Costs will inevitably vary by state, but this is only one of many, many factors which will influence your decision to supplement your Traditional Medicare benefits. Your age is another factor; the older you are, the more coverage you will need to protect yourself from expensive and/or unexpected medical bills. The table below illustrates only some of the costs you might be stuck paying if you don’t protect yourself from the gaps in Medicare coverage:

Medicare Part A Costs in 2022 Medicare Part B Costs in 2022
  • Part A is premium-free for most
  • Part A deductible is $1,556 per benefit period
  • Inpatient hospital stay days 61-90 is $389
  • The standard Part B premium is $170.10
  • The annual deductible for Part B is $233
  • Medicare pays 80%, you pay 20% out-of-pocket

You have several options when it comes to supplementing your Original Medicare package. It can be hard to pick the right supplement, especially if you are on a tight budget. The two simplest and most affordable options are Medicare Advantage and Medigap. We’ll discuss each option, and give you plenty of information to help you decide.

Medigap Policies for Idaho Residents

As mentioned earlier, Medigap supplement policies are designed to protect you from the coverage gaps associated with Medicare Parts A & B. There are 10 government-approved policies to choose from. They are listed alphabetically for simplicity’s sake: A, B, C, D, F, G, K, L, M, and N. There also used to be a Plan E, H, I, and J. In order to reform and enhance the Medicare system, however, they were eliminated back in 2010.

Federal laws demand that Medigap policy providers offer the exact same benefits in each plan, and in every state. This means that Medigap Plan A in Idaho is the exact same policy as a Medigap Plan A in Iowa or Alaska. They will differ in price, however, as well as in which companies are able to provide them to you. The table below can tell you more:

Medicare Advantage in Idaho

Medicare Part C, Medicare Advantage, and Medicare Replacement are all essentially the same thing, regardless of the name you call them by (but most prefer the term Medicare Advantage). As you may imagine, signing up for a Medicare Advantage policy will, essentially, replace your traditional Medicare benefits. There are some small benefits to this. Government laws ensure that your Advantage policy will provide “equal or greater” benefits than Traditional Medicare alone. And you only have to deal with one (private) company through Medicare Advantage, which helps keep things simple.

While the benefits provided through Medicare Advantage may cost the same or less compared to Original Medicare, keep in mind that most of their HMO and PPO networks are fairly restricted. Therefore, switching to Medicare Part C may require you to switch doctors as well. And you’ll be dealing with a private health insurance company instead of the government, which may or may not be a benefit depending on your personal experience with either entity.

HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) networks are carefully selected groups of doctors and medical facilities which must be utilized if you want your Medicare Advantage provider to pay out claims.

by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
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