Idaho Medicare Supplement Plans (Medigap)
Idaho Medicare Supplement plans were created to provide additional coverage to your traditional Medicare plan. These supplement plans cover the gaps of what is not covered by Original Medicare. A Medigap plan will cover any additional out-of-pocket costs, like coinsurance, deductibles, and copayments.
Idaho Medigap Policies are the same as Idaho Medicare Supplement plans. Purchasing Medicare coverage is typically a pretty simple process. Idaho Medicare coverage can be divided into different parts and plans.
Idaho Medicare Options Explained
- Part A & Part B (The Original Medicare)
- Part C (Medicare Advantage)
- Part D (Prescription Drug Plan)
Part A covers hospital care, nursing facility care, nursing home care (unless custodial care is required), hospice, and any additional home health services.
Part B covers clinical research, emergency medical assistance, inpatient and outpatient mental health care, and any other preventative services.
Part C, also known as Medicare Advantage, will replace your Part A and Part B. It covers most of the same medical care but may hold some limitations.
Part D, the Prescription Drug Plan, covers most of your prescribed, medically necessary, medications.
How to Qualify for Medicare in Idaho
If you are seeking Medicare coverage, there are a few qualifications you may need first. To be eligible for Idaho Medicare Supplement Plans, you must be:
- 65 years of age or older, and enrolled in Medicare Part B, or
- Disabled, under 65.
A senior, 65 years of age or older, must enroll in Medicare when they are first eligible. If you do not enroll when you are first able to, you may incur additional charges. This is caused by the Part B Late Enrollment Penalty. If you do not enroll within your first 12-month period, your Medicare Part B premium will increase by 10% each year.
If you are currently receiving disability benefits from Social Security or Railroad Retirement benefits, you qualify for Part A and Part B (the Original Medicare) Medicare coverage.
At this time, our carriers do not offer coverage for Idaho residents who are disabled, under 65. However, this does not mean there are no carriers who offer plans to those on disability.
Applying for Idaho Medicare Supplement Plans
As an Idaho resident, your Open Enrollment Period (OEP)will start on the 1st day of the month you are at least 65 years old, and when your Medicare Part B has become effective.
For example, if your 65th birthday was on August 31st of 2018, and you got Medicare Part B became effective on October 20th, your open enrollment period would begin on November 1st. Once you have determined when your OEP begins, it will be in effect for 6 months. Within these 6 months, you are granted Guaranteed Issue (GI).
Guaranteed Issue is the period of time after enrollment when insurance companies are required to allow you to enroll in an Idaho Medicare supplement plan, or Medigap policy. With guaranteed issuance, no senior can be denied a Medicare supplement plan or Medigap policy.
Idaho residents are currently granted Guaranteed Issuance if their employer-sponsored plan is primary to Medicare.
Idaho Medigap Premiums
Cost becomes a big factor when it comes to health care. You never want to be left with high medical bills, with no coverage.
Most people think cost is determined by the state. That is incorrect. The cost will be determined by your insurance carrier.
When determining the cost, the carrier will take into consideration your location, age, and sex. Medicare costs for Coeur d’Alene, Idaho, will vary from premiums in Boise, Idaho.
Medigap carriers classify costs into three different pricing methods.
- Attained Age Rated: Age attained rated Medigap is calculated by your current age. It is usually the lowest-priced option at the beginning but will increase as you get older. This increase could be anywhere from 1.5%, up to 5% each year.
- Issue Age Rated: This pricing method is based on the age you were at the time you purchased your policy. Costs will not increase because of your age. The older you are when you purchase your policy, the higher the cost.
- Community Rated: With Community Rated Medigap, everyone will pay the same amount, regardless of age. Your premium does not go up as you get older.
Additionally, there are some policies that may seem great at the beginning. However, in reality, you could end up paying more than anticipated. Be sure to do plenty of research when considering a Medicare policy provider.
The Best Medicare Supplement Plans in Idaho
When comparing Medicare plans in Idaho, remember each letter plan stays consistent from provider to provider. The only variation is the cost. The most commonly chosen Medicare plans are Plan HDF, Plan F, Plan N, and Plan G.
- Plan HDF: This plan was created specifically to work with Medicare Part A and Part B, the Original Medicare. You will receive full coverage on all out-of-pocket costs. Including co-payments, deductibles, coinsurance, and any additional charges that Original Medicare does not cover. High Deductible Plan F holds you responsible for any medical expenses up to your designated deductible amount. Because of the deductible, the premium for the HDF plan is much less than Plan F.
- Plan F: Medicare Plan F leaves minimal out-of-pocket expenses to be covered. Regardless of the provider, you receive the same coverage. This plan will cover most of the remaining hospital and doctor costs after Medicare handles their portion of the costs.
- Plan N: Medicare Plan N covers expenses not paid by Medicare health insurance coverage. This plan may not always be full coverage but is considered one of the more affordable plans available.
- Plan G: This plan is sold by private insurance companies and all providers offer the same benefits. Remember, prices vary with every provider. Plan G and Plan F are the only plans that cover any of your excess charges.
Please note, Idaho may charge excess charges for Medicare coverage. If you want coverage for your Part B deductible, it may be smart to go with Plan F or HDF.
With that said, Plan F & High-Deductible Plan F are going to be discontinued in 2020. However, as long as you’re Medicare eligible prior to 2020, you can still enroll in these plans after 2020.
The state also announced that they have something in place to prevent abnormal rate increases for first-dollar coverage plans to protect current enrollees after 2020.
“Idaho Rule 18.01.54, therefore, protects Plan F beneficiaries from seeing higher premium increases than beneficiaries in any other letter plan.“
Idaho Medicare Prescription Drug Plans
Most medical health situations require prescribed medications. Meaning, your health care bill can start to add up if you fail to plan ahead and purchase prescription drug coverage.
With Part D Prescription Drug coverage, you avoid paying most of the cost of your medically necessary, prescribed medications.
There are currently a few plans that include some drug benefits already. However, it may risky to wait and find that you do not have coverage to pay your prescription drug costs when a medical emergency arises.
If you do not purchase prescription drug coverage soon after qualifying for Original Medicare, you may be subject to a Part D penalty.
This penalty is calculated by multiplying the national base beneficiary premium of 1% times the number of months that you did not possess Part D prescription drug coverage.
Medicare Advantage Plans in Idaho
Medicare Part C, also known as Medicare Advantage is one of the better, more full coverage plans. However, if you choose a Medicare Advantage Plan, you will be required to give up your Part A and Part B coverage. Once you choose a provider for your primary coverage, you will no longer have Medicare Part A and B. Medicare Part C (Medicare Advantage) takes the place of those plans.
Medicare Advantage is a great option for many people. While it is popular, Medigap may give you a bit more freedom. If you should decide to choose Medigap, you are not limited to where you seek health care in Idaho. With Medicare Advantage, there are restrictions on where you receive health care.
Both Medicare Advantage and Medigap have their benefits. One of the biggest concerns for those seeking health care is cost. We usually find that Medigap is less expensive, and has a less out-of-pocket risk. Medigap, along with Original Medicare, gives you the best coverage opportunity during emergency medical situations.
Compare Medicare Plan Prices for Idaho
When determining which Medicare plan is best for you, we advise gathering as much information as possible. If you have any additional questions regarding Medicare plans, Medigap, Medicare Advantage, or Prescription Drug plans, please contact us today! We would be happy to set you up with one of our agents to help you get started in the right direction.
If you prefer to skip the phone call, and just get a quote, please fill out the form at the bottom of the page. If you are still in the process of conducting your independent research, you can compare rates here.
Idaho Medicare Resources
Does Medicare pay for eyeglasses in Idaho?
Unfortunately, at this time, Medicare does not cover routine eye exams for eyeglasses or contact lenses. However, Medicare Part B may cover some preventative or diagnostic eye exams.
What is the Best Medicare Supplement Plan in Idaho?
If you are looking for the best supplement plan in your area, please contact us today for more information. Each plan has its own benefits and differences. What may be the best plan for you, may not be the best fit for others.
Why isn’t Idaho expanding Medicare?
In 2012, the U.S. Supreme Court ruled that the federal government could not withhold funds from states refusing to expand Medicaid. Making Medicaid expansion optional for several states. This means Medicaid eligibility for those under 65 were included in the changes. In June of 2018, Idaho had chosen not to expand their Medicaid benefits. However, there are currently several petitioners trying to reverse this decision.