Welcome to Medicare in Idaho

Idaho Medicare Advantage plans are offered by private insurance companies that have a contract with the Centers for Medicare and Medicaid Services (CMS). 

They are required by law to cover all Medicare services included in Medicare Part A, B, and many plans also include a Part D plan. 

Note the Part D plan has it’s separate premium which is added to the premium of the health side of the plan. For simplicity sakes, the total of these two premiums are added together and presented to you as your ‘plans premium’.

 Some plans may include non-Medicare benefits like:

Dental, vision, and hearing;

Fitness benefits;

Gym memberships.

If you’re new to Medicare, new to Idaho, or moving from one Idaho County to another, this guide will help you understand your options. 

We are an Idaho based brokerage firm which specializes in Medicare insurance.  Idaho residents have benefited from our no-cost services since 2012. 

Be aware the details of each plan’s coverage can change from year to year.

 Idaho Medicare Advantage Options Vary by County

Each insurance company decides which counties it will serve. That means:

• Some counties have only a few plan options
• Others have 20 or more
• Insurance companies can tailor plans to specific Idaho Counties
• Your available choices depend on your County of residence.

Some Counties have HMO, PPO, HMO-POS, D-DNP, C-SNP and/or I-SNP available.  Multiple insurance companies may offer their own ‘mix’ of plan’s in your County.

This is why it’s important to compare Medicare Advantage plans in Idaho based on where you live, not just the plan type or insurance company name.

2026 Market Changes to Idaho Medicare Advantage Coverage

The Idaho Medicare Advantage market is changing rapidly. Several insurers have reduced, changed or terminated their offerings for 2026.  These include:

• Blue Cross of Idaho replaced its 2025 plans with a handful of new 2026 plans AND reduced which Counties their plans are available
• Regence Blue Shield of Idaho exited the Idaho market on 12/31/2025
• Select Health exited the remaining Idaho Counties on the same date
• PacificSource, UnitedHealthcare, and Humana have made plan changes, left some Counties, and added specific plans to specific Counties. 

Over 70,000 Idaho residents had their Medicare Advantage plans cancelled on 12/31/2025.  

These shifts mean that some Idaho Medicare Advantage programs which were available in 2025 are not be available in 2026.  

 Monthly Premiums Don’t Tell the Whole Story

2026 Idaho Medicare Advantage plan premiums range from $0 to $153 per month*.
More than 30 of Idaho’s 44 counties have plans with premiums above $59*.

But premium is only one cost to pay attention to. Some plans include:

• Medical deductibles…look closely at plan documents to see if you will be exposed to this seldom seen new cost 
• Daily hospital copays…this figure can a key item when selecting which plan for 2026. Ignoring this may help you hit the plan’s Maximum Out of Pocket Limit (MOOP).

A higher premium does not always mean better coverage.  For many people, the real cost is what happens when they use plan covered health care services.

• The quoted figures above were found using the ‘Plan Finder tool on the Medicare.gov AND q1medicare.com websites.

 Provider Networks: What “Strong” Really Means

Medicare Advantage provider networks may be smaller than most people realize.

Medicare provides a free provider search tool on Medicare.gov that helps put provider access into perspective.

Anyone can enter a ZIP code, adjust the travel radius, and see all doctors and hospitals that accept Medicare in that area. 

This same resource shows you the figures by specialty (internists, cardiologists, neurologists, neurologists, oncologists, and more).

We encourage you to visit the website of any Idaho Medicare Advantage plan you are considering and review their plan’s ‘provider directory’. Compare the figures by type of physician available to that plan’s members vs what is available to people staying with traditional Medicare. 

Given the physician shortage in Idaho, you may want access to all/most all of the providers near you. 

Perhaps opening up access to facilities in Seattle or Salt Lake City may be nice too. 

Why should you do this? 

Because a recent publication ((10/27/2025) by the Kaiser Family Foundation, found that Medicare Advantage enrollees, on average, had access to just under half (48%) of the physicians in their area who accept Medicare insurance.  The remaining 52% are typically outside the Medicare Advantage plan’s network. 

Idaho residents with a Medigap plans have access to both the 48% commonly found in Medicare Advantage networks and the remaining 52%.  This includes all physicians/hospitals/other providers in the US too.    

This also means the top hospitals (Mayo Clinics, Cleveland Clinic, Cedars Sinai Medical Center, etc.) in the US (provided they continue to ‘accept Medicare’) are available to people that stay with traditional Medicare with or without a Medigap plan.

That difference is not academic — it directly affects who can treat you, where you can receive care, and how much flexibility you have if your health needs change.

 What the proposed 2027 Federal Subsidy Cut Means

Medicare Advantage plans receive federal subsidies to help cover the cost of members’ care. Historically, these subsidies increased by about 4–6% per year.

For 2027, that growth rate was reduced to about 0.9%.  We understand the politics behind setting these figures and recognize there may be a ‘last minute’ adjustment.  We will have to wait and see what really happens here.  

When funding grows more slowly than the cost of providing health care, insurance companies must adjust to avoid losing money. They can respond by:

• Reducing benefits
• Increasing premiums
• Raising deductibles and copays
• Narrowing provider networks
• Increasing prior authorization requirements
• Reducing plan availability in certain counties

This makes it even more important to understand what a plan actually costs when you use care, not just what the premium is.

Key Difference

Medicare Advantage cost sharing is set by the insurance company and can change each year. The monthly subsidy they get from the government may not keep up with the cost of health care.

Medigap cost sharing is tied to Original Medicare and is more predictable.  Check out 2026 figures here.  

 Why People Choose Medigap 

We recognize Medigap plans are not right for everyone. 

People which prefer this solution may place emphasis on the points below: 

• Freedom to choose any doctor or hospital that accepts Medicare
• Minimal prior authorizations
• Stable coverage year after year
• Nationwide access
• More predictable costs when you use care.

 With the rising cost of Medicare Advantage plans, Medigap Plan G High-Deductible (HD-G) is looking attractive.

Medigap HD-G is tied directly to Original Medicare’s cost structure.

• 2025 deductible: $2,870
• 2026 deductible: $2,950

Remember Medicare care pays for most of your cost of health care (for Part A and B covered services AND if you are enrolled in Part A and B).

There is cost sharing for Idaho residents enrolled in traditional Medicare as well as those enrolled in a Medicare Advantage plan.

If an HD-G plan is chosen to supplement traditional Medicare, your out of pocket cost for Part A and B services (for 2026)  is capped at $2,950.   

This is different from Medicare Advantage, where the plan sets the out-of-pocket cost maximum and can change them annually.  Medicare sets the maximum figure a plan can have.  The insurance company sets their own figure, as long as it does not exceed the permitted maximum for the year.

 Premium Comparison (for Idaho)

Medigap HD-G often costs less than $85 per month in Idaho (rates vary by insurance company and can go up annually).

More comprehensive Medigap plans (Plan F, Plan G, Plan N) have higher premiums, but they require less cost sharing when you use care.

Plan Type	Monthly Premium	Out-of-Pocket When You Use Care
HD-G	Lower (often < $85)	$2950 deductible, then full coverage
Plan G	Higher; varies by insurance company.	Cost sharing is less than $290/year
Plan N	Less than Plan G	Some additional copays and cost sharing
Plan F*	More than Plan G	$0 cost sharing for Part A&B services.

*Plan F is only available to people who became eligible for Medicare before January 1, 2020.

 Why Some Insurers Are Tightening Benefits

Several Medicare Advantage insurers have reported financial pressure in 2024. Some lost money.  The 2025 figures will be out the end of the first quarter/early 2nd quarter of 2026. 

To stay sustainable, many adjusted their 2026 plan designs, including:

• higher premiums in many counties
• higher cost sharing
• adding a health care ‘deductible’
• fewer extra benefits (many not covering/limiting comprehensive dental)
• narrower networks
• more prior authorization requirements

Even when plans still offer $0 monthly premiums, out-of-pocket costs can be higher and the quality of “extras” has often declined.

In Idaho, several 2026 plans show higher premiums, increased deductibles, and reduced extras compared to 2025. 

You always need to check the depth of the provider network no matter which plan you are interested in. 

Ask yourself if you are diagnosed with a serious health issue, where would you want to be treated.  A top hospital with physicians specializing in that issue, or a different resource which may treat the same issue less than 25 times a year?   

This is why it’s important to look beyond the monthly premium when choosing a plan.

 How to Get Help Choosing

If you want help comparing Idaho Medicare Advantage plans or exploring Medigap options like Plan G High-Deductible,  Plan N or Plan G, we’re here for you. 

We’ve helped Idaho residents with Medicare since 2012 and will be accepting a few more new customers in 2026. 

There are other Idaho based brokers which specialize in Medicare too.  Just be sure they represent all of the plans available to you (Medicare Advantage AND Medigap), and have been in this business helping Idaho residents for at least 5-years.. 

We also suggest all Idaho Medicare beneficiaries review the  Medicare authored/published document titled “Medicare & You.” This is available here. 

The Idaho Department of Insurance SHIBA group also offers unbiased help with Medicare.  View their information here. 

Below are links to each of Idaho’s 44 Counties.  Each has specific information about that County’s Medicare insurance choices.   We have not completed updating each Counties information and hope to have this completed soon..   

Call if you have questions on this content.

If you would like us to contact you, complete the ‘contact us’ form found here.  

Thank you for visiting.

Southwestern Idaho Medicare Advantage Plans

Ada County plans are reviewed here.

Adams County Plans are reviewed here. 

Boise County plans are reviewed  here. 

Canyon County plans are reviewed here.

Elmore County plans are reviewed here. 

Gem County plans are reviewed here. 

Owyhee County plans are reviewed here. 

Payette County plans are reviewed here.

Washington County plans are reviewed here.

Valley County plans are reviewed here. 

Medicare Advantage Plans in Northern Idaho Counties

Benewah County plans are reviewed here. 

Bonner County plans are reviewed here. 

Boundary County plans are reviewed here.

Clearwater County plans are reviewed here.

Idaho County plans are reviewed here. 

Kootenai County plans are reviewed here.

Latah County plans are reviewed here. 

Lemhi County plans are reviewed here.

Lewis County plans are reviewed here. 

Nez Perce County – plans are reviewed here.

Shoshone County – plans are reviewed here. 

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Medicare Advantage Plans in Central Idaho Counties

Blaine County plans are reviewed here.

Butte County plans are reviewed here. 

Camas County plans are reviewed here. 

Custer County plans are reviewed here.

Medicare Advantage Plans in South Central Idaho Counties 

Cassia County plans are reviewed here. 

Gooding County plans reviewed here.

Jerome County plans are reviewed here. 

Lincoln County plans are reviewed here. 

Minidoka County plans are reviewed here. 

Twin Falls County plans are reviewed here. 

Medicare Advantage Plans in Eastern Idaho Counties

Bannock County plans are reviewed here. 

Bear Lake County plans are reviewed here.

Bingham County plans are reviewed here. 

Bonneville County plans are reviewed here. 

Caribou County are reviewed here. 

Clark County plans are reviewed here.

Franklin County plans are reviewed here. 

Fremont County plans are reviewed here. 

Jefferson County plans are reviewed here. 

Madison County plans are reviewed here. 

Oneida County are available here. 

Power County plans are reviewed here. 

Teton County plans are available here. 

We are here to help you think through your choices of Idaho Medicare Advantage plans.

Thank you for reading the article. 

Contact us.  We will answer your questions, help you think through your plan choices and enroll in the plan you choose.  

*Statistics on Medicare Advantage plans available in Idaho and other facts stated above came from this resource and this resource.