Table of Contents

Medicare Plans by State

STATE -Select-
  • Alabama
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Page Reviewed / Updated – September 29, 2022
Reviewed by Dr. Brindusa Vanta, MD

Older adults who are looking for health insurance can choose coverage through Medicare, the federal program for adults aged 65 and older. Some younger adults with disabilities are eligible as well. As of 2022, there are 358,996 individuals enrolled in Medicare in Idaho. This is about 19% of the 1.9 million people who live in the state. Each year the state spends over $1.8 billion on Medicare, around $5,762 per beneficiary.

Original Medicare is the more common type of Medicare in the state, and it has two basic parts. With Part A, seniors receive coverage for inpatient care in a hospital, nursing homes, hospice care and some home health care services as well. This part of Medicare is available at no cost, provided the senior paid enough Medicare payroll taxes while working or they’re married to someone who did. Part B covers preventative care, regular outpatient doctor visits and medical supplies. In 2022, the standard premium for Part B was $170.10 a month

For seniors who want a different type of coverage, privately run plans offer the chance to get personalized coverage. Part C, also known as Medicare Advantage, is the choice of about 40% of the total Medicare users in Idaho. These Medicare-compliant plans come from private health insurance providers and have the coverage of both Part A and Part B, and often include drug coverage (Part D), as well. The Advantage plans may also include dental, vision care and various wellness services. s. For prescription drug coverage (Part D), seniors have to enroll separately if they are Original Medicare users or if their Medicare plan does not include it. Medigap is the Medicare supplement plan that reimburses out-of-pocket costs not covered through Original Medicare.

This guide outlines these coverage options in detail for Idaho residents. It also provides resources to help seniors in the state make the best decisions about their Medicare health care coverage. 

Options for Medicare Coverage in Idaho

Medicare coverage for seniors in Idaho is available in multiple ways. While many choose Original Medicare, which the federal government operates, options through private health insurance providers have the same benefits but with additional coverage options. These coverage choices allow seniors to get the best possible plan for their personal needs. 

Original Medicare (Parts A & B)

Original Medicare is administered by the Centers for Medicare & Medicaid Services (CMS) and is open to seniors aged 65 and over, along with those under 65 years old, but with certain disabilities or end-stage kidney disease. It includes two parts. Part A covers inpatient hospital care, nursing home and skilled nursing care, hospice and home health care. Part B, or medical coverage, pays for medically necessary goods and services such as durable medical equipment, mental health services and emergency medical transportation. 

Unlike most private Medicare plans, Original Medicare’s provider network isn’t limited to the beneficiary’s geographic region, making it easier to obtain services while traveling within the country. In most cases, Medicare doesn’t pay for health services the individual receives outside the United States. 

Under this program, seniors pay for services as they receive them. They must pay an annual deductible, which is $1,556 for Part A and $233 for Part B in 2022. After they’ve paid this amount, Medicare covers all eligible services at 80%. Beneficiaries pay the remaining 20% out of pocket.

Who Should Consider Original Medicare

Original Medicare may be a good option for those who:

  • Travel frequently within the United States
  • Don’t need extra benefits such as home-delivered meals and coverage for over-the-counter medication
  • Want to choose their own prescription drug coverage

Medicare Advantage (Part C)

Medicare Advantage plans are another option to get Medicare coverage in Idaho. Also known as Medicare Part C, these plans come from private health insurance providers. They have the same coverage as Original Medicare except for hospice coverage, which only Part A provides, but they can also have additional coverage options like prescription drugs, dental care or over-the-counter medications based on the plan’s coverage choices.

Medicare Advantage plans come in four basic forms. Seniors can choose from Preferred Provider Organization, Health Maintenance Organization, Special Needs Plans and Private Fee-for-Service plans. Each has its own rules for eligibility and out-of-pocket costs based on the insurance provider’s decisions. Older adults should shop carefully because of the differences between plans.

Who Should Consider Medicare Advantage

Seniors may find Medicare Advantage to be a good choice if the following apply:

  • They need to control out-of-pocket expenses.
  • They like the idea of shopping for a managed care plan.
  • They have good overall health that could lower premiums.
  • They want the additional coverage options not available through Original Medicare .

The Top 10 Medicare Advantage Plans in Idaho

The table below outlines the top Medicare Advantage plans for Idaho residents. As of April 2022, these were the top plans based on the number of people enrolled. The table shows a range of how much beneficiaries pay for coverage and the types of plans offered. The Medicare Advantage Plans in Idaho page has more information about these options.


Total Enrollment

Star Rating

Min Cost

Max Cost

Plan Types

Blue Cross of Idaho












PacificSource Medicare












Regence BlueShield Of Idaho












Aetna Medicare






Molina Healthcare of Utah & Idaho












Anthem Blue Cross and Blue Shield






Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t pay for most prescription drugs through Part A or B coverage. Instead, seniors purchase separate prescription drug policies, also called Part D coverage. Medicare contracts with private health insurance companies to provide this coverage. There are multiple plans to choose from with varying monthly premiums, which beneficiaries pay in addition to their Original Medicare premiums. While seniors don’t have to purchase prescription drug coverage when they’re first eligible for Medicare, not obtaining this coverage at this time may result in late enrollment penalties they pay for as long as they have Medicare if they enroll later.

Each prescription drug plan has its own formulary, or list of covered drugs. Formularies are typically split up into tiers. The tier a medication is in determines how much the insurance company pays and how much the beneficiary pays for it. Lower-level tiers are usually made up of generic and low-cost brand name drugs, while higher tiers are composed of more expensive brand name and specialty drugs. In most cases, the lower the tier, the lower the policyholder’s cost-sharing responsibility.

Who Should Consider Medicare Prescription Drug Coverage

Seniors who may benefit from prescription drug coverage include those who:

  • Currently take prescription medication or expect to in the future
  • Want to avoid late enrollment penalties
  • Want to reduce out-of-pocket prescription drug expenses

Medicare Supplement Insurance (Medigap)

While Original Medicare provides coverage for many medical costs, seniors may still have significant out-of-pocket expenses. These may include copays, coinsurance and deductibles. Seniors may be able to reduce their cost-sharing obligations by purchasing a Medigap plan. These plans can only be used with Original Medicare. It’s illegal for private insurance companies to sell Medigap plans to those with Medicare Advantage plans.

For more information on Medigap plans, seniors can refer to the Best Medicare Supplement Companies of 2022 page.

Who Should Consider Medicare Supplement Insurance

Good candidates for Medigap may be those who:

  • Have ongoing health issues and expenses
  • Travel overseas often
  • Want to access an expanded network of health care providers
  • Expect to need health services not covered by Original Medicare

Medicare Resources in Idaho

Navigating the world of Medicare, applications and appeals can feel overwhelming. In Idaho, older adults and their caregivers have a number of resources available to them to help with this process. These resources are available free of charge, and their primary goal is to help seniors navigate Medicare, choose the best plan for their needs and utilize their benefits effectively. 

Senior Health Insurance Benefits Advisors

Senior Health Insurance Benefits Advisors (SHIBA) is a free service for Medicare beneficiaries in Idaho. It provides counseling via email, phone and remote communication to help seniors understand their Medicare benefits or choose the right program. Volunteer counselors receive specialized training to assist them in helping seniors with their Medicare needs. SHIBA also provides educational programming to help older adults understand all of their Medicare options. 

Contact Info

Medicare beneficiaries who want help from SHIBA can call (800) 247-4422 or use an online contact form to start the conversation.

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Idaho Department of Insurance

The Idaho Department of Insurance (DOI) provides help for insurance customers, including Medicare beneficiaries, throughout the state. In addition to running SHIBA, the DOI takes complaints of insurance fraud and other problems with insurance providers in the state. It also provides education about laws and rules surrounding insurance and Medicare, so older adults can understand their rights. 

Contact Info

Medicare beneficiaries can call the consumer hotline at (800) 721-3272 to get answers to their questions. They can also call the fraud hotline to report suspected fraud at (866) 939-7226.

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Idaho Legal Aid

Idaho Legal Aid provides older adults with free legal services that include help with understanding and fighting for their health benefits. Seniors can call the Senior Legal Hotline to get advice from volunteer attorneys and can also contact their local office to learn more about their Medicare rights. 

Contact Info

Seniors can get help from the Senior Legal Hotline between 10:00 a.m. and 4:30 p.m. Mondays through Thursdays. Call (208) 746-7541 to talk to a legal advisor.

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Idaho Senior Medicare Patrol

Medicare fraud is on the rise, and the Idaho Senior Medicare Patrol (SMP)program helps seniors detect and report health care fraud, including Medicare fraud. It provides educational resources older adults can use to identify fraud and provides a reporting process they can use to report suspected fraud. 

Contact Info

Older adults who are concerned about fraud can contact SMP through their local Area Agency on Aging. They can also call (208) 736-2122 to report fraud. 

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Social Security Administration

The Social Security Administration is the federal department that oversees the Medicare program. Seniors can contact their local SSA office in Idaho to inquire about replacement Medicare cards or to get help with the application process. The online portal helps seniors understand if they qualify for Medicare benefits and how they can apply on time to avoid penalties. 

Contact Info

Seniors can contact the SSA by calling (800) 772-1213 or reaching out to their local SSA office. The federal website has a database to help seniors find their local office location. 

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Idaho Area Agencies on Aging

Idaho has six Area Agencies on Aging (AAA)that provide advocacy and support to seniors in the different coverage areas. These are the contact points for seniors looking for Medicare help, and most of the AAAs manage the SHIBA and SMP programs. Seniors can reach out to their local AAA to find help with their Medicare coverage questions.

Contact Info

Seniors need to contact their individual AAA via phone or in person. AAAs are located in Idaho Falls, Lewiston, Coeur d’Alene, Twin Falls, Pocatello and Meridian. They can also contact the Idaho Commission on Aging at (877) 471-2777.

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