Medicare Advantage in Idaho

Looking for Idaho Medicare Advantage Plans? Enter your ZIP below to compare affordable or $0 premium plans in your area.

Idaho state

Information about Medicare Advantage Plans in Idaho

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32 percent of Medicare beneficiaries in Idaho were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.1

There are 301 different Idaho Medicare Advantage plans in 2019.1 Not every plan is available in each county, so it's important to find out which ones are offered where you live.

A licensed insurance agent can help you compare the availability, benefits and costs of Medicare Advantage plans in your area of Idaho. Read below to learn more about Medicare in your state.

You can also learn more about other types of Medicare plans:

Average costs of Medicare Advantage in Idaho

Idaho Medicare Advantage beneficiaries paid a weighted average premium of $49 per month in 2019.

That average was affected by the 51 available plans that feature $0 monthly premiums.

  • Average monthly premium cost in 2019 (weighted): $49
  • Average in-network out-of-pocket spending limit: $5,662
  • Average deductible in 2019 (weighted): $125.941

Individual plan premiums, deductibles and out-of-pocket costs may vary greatly depending on where you live and the plan you have.

You can view the 2019 average Idaho Medicare Advantage plan monthly premiums by county listed below in this guide.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Compare Idaho Medicare Advantage plan costs

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Medicare Eligibility & Enrollment

If you want to enroll in Medicare Advantage in Idaho, you must first be enrolled in Medicare Part A and Part B, often referred to as Original Medicare.

To be eligible for Original Medicare at age 65, you must meet the following requirements:

  • You must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.

  • You or your spouse must have worked long enough to be eligible for Social Security or Railroad Retirement benefits.

  • You or your spouse must be government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes.

You may also be eligible for Medicare benefits under 65 if:

  • You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.

  • You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).

  • You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for a certain length of time.

It’s important to note that if you have ESRD, you may not qualify for most Medicare Advantage plans. If you have ESRD, you may be able to enroll in a Idaho Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs.

How to sign up for a Medicare Advantage Plan in Idaho

The first time you may be able to enroll in a Idaho Medicare Part C plan is during your Medicare Initial Enrollment Period (IEP).

Medicare Initial Enrollment Period graphic

Your Medicare IEP starts three months before your 65th birthday. It includes the month of your 65th birthday and then continues for another three months after your birthday.

Additional times at which you may sign up for a Medicare Advantage plan include:

Medicare Advantage Open Enrollment Period graphic

Medicare Advantage Open Enrollment Period: January 1 – March 31

If you're already enrolled in a Part C plan, from January 1 to March 31 every year, you may switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare.

If you return to Original Medicare during this period, you'll be able to join a Medicare standalone prescription drug plan (Medicare Part D).

Medicare AEP graphic

Medicare Annual Enrollment Period (AEP): October 15 – December 7

From October 15 to December 7 every year, you may enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another.

You may also drop your existing Medicare Advantage plan and return to Original Medicare.

During AEP, you may also join, switch or drop a Medicare Part D plan. 

Medicare Special Enrollment Periods (SEP)

You may potentially be granted a Medicare Special Enrollment Period (SEP) at any time throughout the year for qualifying circumstances.

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period.

Find a Idaho Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in Idaho 2019

Each year, the Centers for Medicare & Medicaid Services (CMS) issues Star Ratings for all Medicare Advantage plans using a system of one to five stars.2

In order for a Medicare Advantage plan to be considered a top-rated plan, it must have four or more stars out of five stars.

There are 201 top-rated 2019 Medicare Advantage plans in Idaho that are rated four stars or higher. That's more than 2 out of every 3 Medicare Advantage plans (67 percent) in Idaho in 2019.

Medicare Star Ratings
Star Ratings

★★★★★

Excellent

★★★★

Above Average

★★★

Average

★★

Below Average

Poor

Medicare Advantage plans are rated in the following five categories:

  • Preventive care and health maintenance (screenings, tests, vaccines, etc.)
  • Management of chronic conditions
  • Member experiences and ratings of the plan
  • Member complaints, problems receiving services and member retention
  • Customer service

The information for the star ratings is gathered from information that is submitted to Medicare, Medicare’s regular monitoring activities and member surveys.

List of Medicare Advantage Plans Available in Idaho in 2019

To view a list of plans offered in your area within Idaho, use our plan comparison tool.

Find a Idaho Medicare Advantage plan

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in Idaho

Multiple insurance carriers may offer Medicare Advantage plans in Idaho, depending on where you live.

Private insurance companies offer Medicare Advantage plans that may be unique to the plan area they serve.

Call to speak with a licensed insurance agent who can help you compare the Medicare Advantage plans that are sold by insurance companies in your area.

When you’re shopping for Medicare Advantage plans in Idaho, you can compare plans from several different carriers by using some of the following information:

  • The Medicare Star Ratings can give you an idea of a plan’s overall quality.

  • Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.

  • Websites such as the Better Business Bureau and Consumer Reports can teach you about a company’s reputation among its customers.

  • You can read through Medicare Advantage plan reviews and testimonials from customers.

Idaho Medicare Advantage plans by county

The chart below provides some more information about 2019 Idaho Medicare Advantage plans by county.1

  • Ada County and Canyon County had the highest number of top-rated Medicare Advantage plans (4 stars or higher) in 2019, with 18 such plans in each county.
2019 ID Medicare Advantage by County
County Total of County MA Enrollees % of Medicare Beneficiaries Enrolled in MA Number of Plans Available Number of $0 Premium Plans Available % Enrolled in a $0 Premium Plan
Ada 38663 46% 29 7 25.4%
Adams 260 18% 2 1 73.2%
Bannock 4859 31% 10 1 0.0%
Bingham 1851 22% 9 1 0.1%
Blaine 823 16% 3 1 0.2%
Boise 891 37% 16 4 38.4%
Bonner 3877 29% 15 2 0.1%
Bonneville 4476 23% 10 1 0.1%
Boundary 905 26% 8 1 0.2%
Camas 39 14% 2 1 2.9%
Canyon 19501 49% 29 7 23.6%
Cassia 924 22% 7 0 0.0%
Clark 28 20% 6 0 0.0%
Elmore 985 20% 11 2 49.2%
Franklin 297 12% 1 0 0.0%
Fremont 441 16% 6 0 0.0%
Gem 2255 44% 19 4 25.1%
Gooding 726 23% 3 1 0.2%
Jefferson 838 19% 9 1 0.2%
Jerome 1149 29% 3 1 0.1%
Kootenai 11885 30% 17 2 0.0%
Latah 736 11% 3 0 0.0%
Lincoln 179 16% 2 1 0.6%
Madison 652 20% 9 1 0.2%
Minidoka 968 25% 7 0 0.0%
Nez Perce 2304 22% 9 0 0.0%
Owyhee 926 36% 14 3 27.5%
Payette 2232 37% 18 4 2.8%
Power 297 20% 6 0 0.0%
Twin Falls 5638 34% 11 1 0.0%
Valley 803 25% 4 2 8.0%
Washington 804 25% 3 1 54.0%

ID Medicare Advantage enrollees by plan type

The chart below illustrates the percentage of 2019 Idaho Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.1

Plan type Percentage of Idaho enrollees (2019)
HMO 66.3%
Local PPO 33.65%
Other Plans <1%

The major types of Medicare Advantage plans include:

  • HMO
    Health Maintenance Organization (HMO) usually requires patients to use health care providers and pharmacies that are part of the plan’s network (except in the case of emergencies) while also typically requiring a referral from a primary care doctor in order to see a specialist.

  • PPO
    Medicare Advantage beneficiaries in a Preferred Provider Organization (PPO) are able to see providers outside of their plan’s network, often at a higher cost.

    Beneficiaries in this type of plan typically pay less out of pocket if they choose to receive medical services from providers within their plan’s network.

    PPO plans typically do not require patients to acquire a referral before visiting with a specialist.

  • PFFS
    A Private Fee-For-Service (PFFS) plan determines how much it will pay to health care providers and how much the patient will pay when care is received.

    With a PFFS plan, you can typically receive care from any doctor, hospital or health care provider that accepts your plan’s terms. Not all providers will accept these terms, however.

  • SNP
    A Special Needs Plan (SNP) is a type of Medicare Advantage plan limited to people with certain chronic conditions and other specific characteristics.

    Typically, you must receive care from health care providers and hospitals within your SNP network, except for in cases when you need emergency or urgent care and when someone who has End-Stage Renal Disease (ESRD) needs out-of-area kidney dialysis.

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 Idaho Medicare Advantage plans that are available where you live.

Local health insurance resources in Idaho

  • Senior Health Insurance Benefits Advisors is a state program offering free information, counseling and assistance for beneficiaries of Medicare and other senior health insurance programs.

    SHIBA is made up of trained volunteers and can be reached at 800-247-4422.  

  • You can also explore more information about the insurance industry in Idaho by visiting the state’s Department of Insurance website.

  • Idaho Prescription Drug Assistance Programs
    The state of Idaho has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.