Idaho Medicare Health Insurance Guide

Are you or a loved one who lives in Idaho nearing Medicare eligibility? Or, do you already have Medicare and have some unanswered questions? Either way, you’ve come to the right place. 

While Medicare is a federal health insurance program, each state does have its own privately owned plans that can add benefits and reduce costs. We’ll discuss the parts of Medicare in this guide and help you determine whether or not you need more coverage. If any time you’d like to speak with a licensed agent for free, send us a message or call us during business hours at 844-431-1832.  

Click below to learn more about Idaho Medicare:

• Idaho Medicare Eligibility
• What does Idaho Medicare Cost?
• What Does Medicare Cover in Idaho?
• Idaho Medicare Plan Finder
• Medicare Idaho Providers
• Idaho Medicare Resources
• Getting Both Medicare and Medicaid in Idaho
• How to Apply for Medicare in Idaho

Idaho Medicare Eligibility

There are a few ways to qualify for Medicare in Idaho. That’s right, you don’t necessarily have to be 65! You can qualify for Medicare by:

• Turning 65
• Getting diagnosed with ALS
• Getting diagnosed with ESRD

Entering your 25th month of SSDI

What Does Idaho Medicare Cost?

Medicare costs can change based on what other plans you enroll in and what savings you qualify for. In general, you can account for the federal Medicare program (parts A and B) covering 80% of your covered medical costs.

For example, Medicare Part A covers hospital stays. If you know that your total costs for your stay are $1,000, and everything that happened during your stay was a covered service, you will only owe $200. However, there are other costs to consider as well. You may have to pay a deductible before your coverage kicks in, and you may owe other copayments and coinsurance for certain services (as we’ll discuss later, you may be able to get those other costs covered through a Medicare Supplement plan).

In 2019, the Part B deductible 2019 is $185, and the premiums range from $135.50 per month to $460.50 per month (depending on your income). The Part A hospital benefit deductible is $1,364 in 2019, and the Part A premiums range from $0 to $437 per month based on how much you’ve worked and paid Medicare taxes throughout your life.

What Does Medicare Cover in Idaho?

Original Medicare includes Part A, which covers hospital-related benefits, and Part B, which covers medical benefits. Part A covers inpatient and outpatient hospital stays, hospice, and some home health services. Part B covers preventative care like your annual wellness visit, mental health, lab tests and X-rays, durable medical equipment, and ambulance travel.

If you’re looking for other benefits, like dental, vision, and prescription drugs, you’ll want to look at Medicare Advantage plans. If you’re looking for more financial coverage, you might want to consider Medicare Supplements.

Idaho Medicare Plan Finder

Our Medicare Plan Finder tool allows you to search through some of the plans available in your area so that you can make an educated decision about your healthcare. 

Even better, we have Medicare Plan Finder licensed agents who can meet with you in person to talk about all your options, the doctors you need, the prescriptions you need, and more to figure out which plan makes the most sense for you.

Once you’ve made a decision, our agents can help you complete your application for a plan.

Medicare Advantage Plans in Idaho (MA)

Depending on your zip code, you may have a few Idaho Medicare Advantage plans to choose from. Medicare Advantage plans are able to cover the benefits that Original Medicare does not. That can include fitness benefits, dental, vision, prescription drugs, and even meal delivery. Believe it or not, some people can get MA plans for a $0 premium! However, MA plans can be different not only in every state but also in every county and zip code.

Idaho Medicare Supplement Plans (Mediap)

Medicare Supplements, or Medigap plans, are different from Medicare Advantage plans. Instead of adding health benefits, Medigap plans can add financial benefits. There are several different types of Medigap plans, all of which have different costs and benefits. Benefits include coverage for costs like copayments, deductibles, etc. Use our Medicare Plan Finder tool to find out which type of Medigap plan is right for you.

Idaho Prescription Drug Plans (PDP)

There are two main ways to get Medicare prescription drug coverage in Idaho: enroll in a Medicare Advantage plan that comes with a prescription drug benefit, or enroll in a standalone prescription drug plan.

Keep in mind that you cannot have both a Medicare Advantage plan and a prescription drug plan at the same time, so you’ll have to choose between the two. Additionally, you cannot have a Medicare Advantage plan and a Medicare Supplement plan at the same time, but you CAN have a Medicare Supplement plan and a prescription drug plan at the same time.

Medicare in Idaho Providers

A great way to find Idaho doctors who accept Medicare is by visiting Medicare.gov’s provider finder tool. 

However, if you have a Medicare Advantage plan or other private insurance, you will want to see if your plan carrier has its own doctor finder tool.  Use your plan’s doctor finder or ask your agent for help to make sure that the doctor you like is in your network.

Idaho Medicare and Senior Resources

Idaho Commission on Aging: This commission has programs in the state of Idaho for helping aging adults stay at home, stay healthy, and stay informed and educated. 

Idaho Senior Services Respite Program: This program provides temporary caregiver services when primary caregivers need a break.

Medicare Plan Finder: We have licensed agents who provide free assistance with selecting Medicare plans! It doesn’t cost anything more to speak with an agent than if you had applied directly through the carrier. The difference is that an agent can offer you multiple plans, providing a bias-free approach. We also have a Medicare Plan Finder tool that you can use to compare plans before you meet with an agent.

Getting Both Medicare and Medicaid in Idaho

If you qualify for both Medicare and Idaho Medicaid and there is a plan available in your area, you may be able to enroll in a Medicare Advantage Dual-Eligible Special Needs Plan. These plans generally have very low or no costs and provide benefits for Medicare and Medicaid covered services. Medicaid qualifications are based on income and other Idaho state regulations.

For help with finding plans in your area, call 844-431-1832.

How to Apply for Medicare in Idaho

If you receive benefits from the Railroad Retirement Board or Social Security, you may be automatically enrolled in Medicare. If you are not automatically enrolled, you can enroll through the Social Security website, in-person at a Social Security office, or by calling 1-800-772-1213. 

To enroll in Part D, Medicare Advantage, or Medicare Supplements, start searching for Idaho plans here or get in touch with an agent, here. You can also call our office at 844-431-1832 from 8 AM to 4:30 PM, Monday through Friday, and we’ll get you set up with an agent in Idaho near you.