Medicare in Idaho
Key Takeaways
- More than 344,000 residents are enrolled in Medicare in Idaho.
- Both Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). and Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). plans are available in Idaho.
- An estimated 83 Medicare Advantage plans are available in Idaho in 2024, an increase from 80 in 2023.
Although Idaho is known for its plentiful potatoes, there’s another attribute the state is known for: its gems. Idaho produces a whopping 72 gemstone types, including amethysts, rubies, diamonds, and star garnets. It’s no wonder then that Idaho is known as “the Gem State.”
However, Idaho’s true gems are Idahoans. With more than 1.9 million people, Idaho had 378,590 Medicare beneficiaries in 2023. Keep reading to find out more about Medicare in Idaho.
Does Idaho Have Medicare?
When you qualify for Medicare in Idaho, you can choose to participate in Original Medicare or Medicare Advantage. Original Medicare lets you see any doctor or go to any facility that accepts Medicare. Original Medicare is divided into parts that are responsible for different medical needs. Part A pays for hospital coverage and long-term skilled nursing stays. Part B pays for doctor’s visits, some immunizations, and durable medical equipment.
Another option for Medicare in Idaho is Medicare Advantage plans. Also known as Medicare Part C, these plans are when a person chooses a private insurance company to provide their Medicare coverage. Medicare Advantage provides additional benefits (such as dental or eye care coverage), and most offer prescription drug coverage.
Medicare Advantage plans in Idaho are usually region-specific. The plans will contract with doctors, hospitals, and other healthcare organizations to provide services. As a result, you will usually choose from a list of providers if you select a Medicare Advantage plan.
Still have questions? GoHealth has the answers you need.
What Is Medicare?
Medicare is a government-funded insurance program that is usually for individuals ages 65 and older and those who qualify based on disability or certain medical conditions. The Medicare and Medicaid programs were started in 1965 to provide medical coverage to those ages 65 and older.
Over the years, Medicare has expanded in its scope, specifically to increase the availability of services to those who are disabled, have been diagnosed with end stage renal disease, or have amyotrophic lateral sclerosis (ALS).
Medicaid is also a program that helps make healthcare more affordable. However, Medicaid in Idaho may vary from other states because each state administers Medicaid funds and programs.
Where Is the Medicare Number on My Card?
When you enroll in Medicare, you will receive a red, white, and blue Medicare enrollment card. This card allows healthcare providers to identify that you’re enrolled in Medicare and bill Medicare on your behalf. You will have your own Medicare number, which is like an account number.
Your Medicare number is located on your Medicare card immediately below your name. This number is actually a mixture of numbers and letters. Ideally, this protects you from identity theft because other identifying information, such as your Social Security number, is not on the card. However, your Medicare number is still personal information. You should not share the number with persons other than healthcare providers. If someone is trying to obtain this information from you, contact Medicare at 1-800-MEDICARE (1-800-633-4227).
Do You Get Free Medicare When You Turn 65?
Medicare is not completely free insurance coverage. If you paid Medicare taxes for 40 quarters of work (about 10 years), you will receive Medicare Part A premium-free. Medicare Part B or medical coverage requires you to pay a monthly premium, which Medicare sets each year.
Even if you choose a Medicare Advantage plan in Idaho, you will continue to pay a monthly Part B premium, plus a premium (if any) to your Medicare Advantage plan. Some plans offer premium-free coverage.
In addition to Medicare premiums, you will have co-payments and deductibles to pay with Medicare. However, Medicare negotiates with healthcare providers to keep these costs as low and consistent as possible.
Does Idaho Have Free Health Insurance?
While Medicare does offer reduced-cost insurance, you will still have costs under Medicare. In addition to Medicare, Idaho does offer financial assistance for healthcare through its Medicaid program. Medicaid doesn’t have the same age requirements as Medicare. Instead, most people qualify for Medicare based on their income. Idaho has income requirements to offer varying levels of financial support.
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Are Medicare Plans Required at 65?
Medicare is a benefit available to you when you turn age 65, but you don’t have to enroll if you have other insurance coverage, such as through an employer. You can defer your Medicare plan when you turn age 65 if you have other insurance. Medicare also requires you to have some form of prescription drug coverage. This is known as Medicare Part D, and it is available through private insurance companies in Idaho.
If you don’t enroll in Medicare when you turn age 65 (or notify Medicare you are delaying your coverage), you could face penalties. These are usually determined by how long you went without Medicare coverage. Penalties apply for delayed enrollment in Part B and Part D. Once you have a penalty, you must pay it for a lifetime — that’s why it is best to enroll in Medicare at the correct time.
Are There Medicare Advantage Plans in Idaho?
An estimated 83 Medicare Advantage plans are available in Idaho in 2024, with 97.8 percent of Idaho residents having access to a Medicare Advantage plan. Medicare Advantage plans are region-specific in Idaho. A GoHealth licensed insurance agent can help you search for Medicare Advantage plans in your area. As a general rule, the larger the population of the city in Idaho you live in, the more Medicare Advantage plans an insurance company likely offers.
Some insurance companies offer multiple plan types. These plans may have different attributes, such as $0 monthly premiums. An estimated 96.2 percent of people in Idaho have access to a $0 monthly premium Medicare Advantage plan. Other plans may charge a premium, but offer innovative services, such as wellness and health planning, reduced cost-sharing, and incentive programs.
Who Has the Best Medicare Advantage Plan?
The best Medicare Advantage plan in Idaho is the one that meets your distinct health needs. You must consider factors like monthly premium cost, out-of-pocket limits, network, prescription drug plan, and available services when selecting a Medicare Advantage plan.
The Centers for Medicare and Medicaid Services (CMS) also have a star rating system. The highest rating is five stars.
You can also ask friends and family about their Medicare plan, and if they would recommend it. Another way to evaluate the best Medicare Advantage plan in Idaho is to ask your preferred doctor or doctors what insurance types they accept. Doing so will help you choose a plan that allows you to continue seeing doctors you trust.
What Is the Downside to Medicare Advantage Plans?
The main downside to a Medicare Advantage plan in Idaho is that most plans limit the providers you can see. Original Medicare allows you to see any provider who accepts Medicare across the country. While Medicare Advantage plans do have an out-of-pocket limit (unlike Original Medicare), you could find you pay more for care until you meet your out-of-pocket deductible.
However, Medicare Advantage does have several benefits compared to Original Medicare. This includes that many have $0 monthly premiums and offer prescription drug or Part D coverage as part of their coverage. Many Medicare Advantage plans in Idaho offer additional services that Original Medicare does not cover, such as dental, vision, or hearing insurance coverage.
Can I bundle multiple benefits into one plan?
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 334,470 people are enrolled in Medicare Part A and B in Idaho. The total number of beneficiaries enrolled in Medicare Advantage increased from 120,658 to 136,37 year over year. Medicare Advantage participation in Idaho went from 37.76% to 40.77% year over year. If you’d like to dive deeper into how Medicare in Idaho breaks down across the state, we provide a glance at who is using Medicare and how.
334,470 Beneficiaries with Part A & Part B
136,37 Medicare Advantage Beneficiaries
40.77% Medicare Advantage Participation Rate
51.87% Female
48.13% Male
91.90% Non-Hispanic White
0.28% African American
3.75% Hispanic
4.08% Other/Unknown
15.26% Eligible for Medicaid
0.86 Average HCC Score
$8,477.35 Actual Per Capita Costs
12.98% Hospital Readmission Rate
25.38% % of Beneficiaries with an Emergency Department Visit
120,658 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
37.76% Medicare Advantage Participation Rate, Previous Year
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
Idaho Department of Insurance
https://doi.idaho.gov
What should I know about the DOI?
If you have questions about the health insurance you’ve bought, contact the Department of Insurance.
Idaho Medicaid Program
https://healthandwelfare.idaho.gov/
What should I know about Idaho Medicaid?
If you have questions about health coverage eligibility or having a hard time affording coverage, contact Idaho’s Medicaid Program.
Senior Health Benefits Advisors (SHIBA)
https://doi.idaho.gov/shiba/
What Should I Know about SHIBA?
If you are on Medicare or have a disability or end stage renal disease, contact SHIBA.
Idaho Department of Veterans’ Affairs
https://veterans.idaho.gov/
What should I know about IDVA?
If you are a veteran and have a question or concern about veterans’ health care benefits, contact IDVA.
Nationwide Resources
Speak with a GoHealth insurance agent that is licensed in Idaho about your Medicare questions.
Mon – Fri, 8 a.m. – 6 p.m. CT
Centers for Medicare and Medicaid Services
You can reach the Social Security Administration by phone for general questions. Not all questions can be answered over the phone.
Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online
1-800-722-1213
TTY 1-800-325-0778
Speak to SSA Representative, Monday – Friday, 8 AM – 7 PM ET
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
- Fact Sheet. CMS.gov.
- Fact Sheet – 2021 Part C and D Star Ratings. CMS.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.