Idaho Medicare Supplement Plans
We help you pick which of the 12 Idaho Medicare supplement plans fit your needs and budget.
Some residents call Idaho Medicare Supplement plans Idaho Medigap plans. We use the terms interchangeably.
If you want the flexibility of:
- using any doctor(s)/hospital(s) in the US that accepts Medicare, all of these 12 plans should be considered. Top facilities like the Mayo Clinics are available to you no matter which of these 12 plans you choose.
- seeing a specialist without getting permission from your insurance company.
- ‘Eliminating insurance company imposed Prior authorizations’ before services can be used.
- Having a plan that travels with you anywhere in the US (move permanently or just visiting). This flexibility means you do not need permission from an insurance company to use ‘out of network’ services.
- Avoiding issues where your preferred doctor or hospital will not accept your insurance company because they don’t pay their bills and/or respond to ‘prior authorizations’ in a timely manner.
- To skip an ‘annual notices of change’, Summary of Benefits, the Evidence of Coverage, and provider directory plan documents each fall to learn how the plan is changing for next year. We do recommend you review the annual publication from Medicare titled ‘Medicare and You’. This explains how Medicare works and any changes Medicare may have made. You can review this document here.
If the above are irritants to you, consider one of the twelve Idaho Medigap plans.
All of the 12 Idaho Medicare Supplement plans use the same provider directory.
All providers (physicians/hospitals/etc.) in the US that ‘accept Medicare’ are in this data base. They are all available to you.
You just make the appointment AND you do not need permission from an insurance company to use their services. They may not accept your appointment because they are not accepting new patients or if they are a specialist, they may not be able to treat your issue.
Check this out here.
Enter your zip code and adjust the search radius around the zip code.
Medicare Advantage plans typically have a sub-set of these same physicians in their plan’s network.
You do not have to compare next year’s version of your current plan to your other choices.
Why? Because any cost sharing your plan has will be the same as other companies which offer your same plan. They all have the same provider directory too.
Each company offering your plan may have a different monthly premium.
If, after one or more annual premium increase(s), your plan’s premium is uncomfortably higher than another, switch companies, get the same plan, and pocket the savings. You can do this without going through underwriting if you make the change during your annual ‘birthday window’.
The same benefits of your plan remain in place year after year AND you do not have a 200+ page document (like the ‘Evidence of Coverage’ which comes with Medicare Advantage plans) to learn about an insurance company’s self-imposed additional rules about each specific coverage.
Medicare continues paying the majority of cost sharing for the servicers you use. Your Idaho Medicare supplement plan continues to pay its share, and it does this year after year, even though Medicare bumps these figures annually.
Medicare cost sharing for this year is available here.
When these figures go up (check around November 10th or so annually), your Medigap plan continues to operate in the same manner as it did last year.
This concept is the same for most all health insurance.
Idaho is different than most states in the US with respect to the rules in place for both Medigap plans and the insurance companies offering these plans. This is important; be sure you understand this.
Effective March 1, 2022, the changes made by the 2021 Idaho Legislature (and signed by the Governor) were implemented. Each state can supplement Medicare’s rules on Medigap plans if they choose to do so.
On this date and going forward, ‘community rating’ and ‘birthday window’ rules were put into place. Plan holders with a ‘issue age’ policy are not required to switch to a ‘community rated policy’. Please read the information found here as it further describes the rules/regulations that are now in place.
The highlights of this change include:
- If an Idaho resident is currently enrolled in a Medigap plan and they want to lower their plans monthly premium, they can switch to a company which offers the same plan with a lower premium. They avoid ‘underwriting’ if they do this during their ‘annual birthday window’. If their plan was ‘issue age’ prior to the change, their new plan will follow ‘community rating’ rules for setting the plan premium. Issue age policies can no longer be written in Idaho after 2/28/2022.
- A person’s ‘birthday window’ begins on their birth date (month/day) and ends 63-days later.
- If a person holding an ‘issue age’ policy makes a switch to get a lower premium, their new plan will be ‘community rated’.
- A policy holder can make a ‘lateral move’ (get the same plan), move to a less comprehensive plan (Plan G to Plan N for example), or move up to a more comprehensive plan (Plan N to Plan G). If the policy holder wishes to move to a more comprehensive plan, they will have to answer the health history questions on the new application. Based on your answers, your application can either be accepted or denied. If it is denied, you can apply to a different company or just keep your present plan.
Call if you have questions.
There are twelve different Idaho Medigap plans.
Each plan covers a different combination of your share of the cost for Part A and B covered services. This reference provides a good visual of what each of the 12 Idaho Medicare Supplement plans cover. Take a few moments to digest what this information means. Reading this reference should tie these two concepts together (the service which is covered and the current Medicare cost share for that service).
Having a variety of plan options means you can find the plan that meets your needs and retirement budget.
Call us if you want help interpreting this chart.
Two of these plans have a ‘deductible’ feature in place (Plan G hi-deductible AND Plan F hi-deductible).
Forget the negatives about ‘hi-deductible’ plans you may have had before you were eligible for Medicare.
These plans have the same features as the other 10 plans, except they operate with a ‘deductible concept’.
The deductible? Less than $3,000 for 2026…remember Medicare is paying the ‘lion’s share of Medicare covered services you use’.
This means your share is the leftover copays/coinsurance/deductibles that Medicare does not completely pay for. Your total cost share for the calendar year is capped at less than $3,000.
You can get these plans with a monthly premium less than $100.
Also, these plans typically have a lower premium than the other ten Medicare Supplement plans.
Why would a person want one of the other Medigap plans?
They have lower cost sharing. Plan G, for example, limits your annual cost share to $0 – $283.50 for Medicare covered health care.
Five plans offer more comprehensive coverage (C, D, F, G, and N).
Plan C and F are restricted to people enrolled (or eligible) for Medicare prior to January 1, 2020. We prefer Plan F over C. Their monthly premiums are similar.
Plan D is offered by less than 5 of the 20+ companies offering Medigap plans to Idaho residents. Coverage is like Plan G. We don’t see the need for a Plan D anymore.
Plan N often has a lower premium than Plan G, but policy holders have a few more copays when compared to Plan G. These additional copays may be a financial burden as the Plan N policy holder ages (and starts to use more health care services).
Remember, if you choose a Medigap plan with less comprehensive coverage and later in life, want to move up to a plan with more comprehensive coverage, you will have to answer the underwriting questions. This means the insurance company can deny your application (based on your answers and prescription medication take).
We do not recommend Idaho residents consider Idaho Mediap plans K, L, and M.
Why? Because of low national enrollment in these plans.
If you add the number of active policies for all three plans together, they are less than 2% of all active Medicare Supplement plans in the US. These figures came from the 2024 Medicare Supplement Loss Ratio report found here.
We are cautious about the remaining 2 Idaho Medicare Supplement plans (A and B).
Why? Skilled nursing care isn’t covered by either plan. Should a person need this service, the out-of-pocket cost can be a financial burden. People may be better off with a hi-deductible Plan G or a Plan G or N.
You have a good choice of national and regional companies offering these plans.
We prefer doing business with companies with the lower plan premium, an AM Best rating of A- (or better), have been in the health insurance business at least 4-years, and have at least 10,000 active policy holders. These companies are typically on our ‘recommendation’ list (provided they have competitive premiums).
A few insurance companies include a gym membership with their plan. The depth and variety of participating exercise facilities can differ noticeably. Usage rules can vary too.
Household discounts are offered by a few companies too.
Some plans either include discounts on dental, vision and other services, or offer these plans separately and come with their own premium.
Be aware many insurance companies offer dental/vision/hearing insurance plans, and they are easy to find by using internet tools to find them. We encourage you to shop around.
Unless you are a frequent user of dental services, we have found just paying cash for the services you use may be a more economical solution.
Keep in mind when a company includes ‘services not covered by Medicare’, the actual cost of these is factored into the calculation of their plan’s premium. Also, the insurance company offering ‘extras’ can drop these services (or change the details of these extra features) at their discretion.
Idaho Medicare Supplement plan reference materials you should read.
There are two key resources you should read.
The first is the ‘Choosing a Medicare Supplement Policy’ document published by the Centers for Medicare and Medicaid Services (CMS).
We prefer this document as it is well written, has a concise table of contents, and is easy to understand. We suggest you use this as your primary reference on this subject. Another source of this same information can be found here.
Additional information about current demographics of Medigap enrollment/customer satisfaction is available here. This offers a thorough analysis of the Medigap market. Enrollment by plan for Idaho is also included in this report.
What else you need to know.
If you have a Medicare Supplement plan and are moving to Idaho.
- Call us to switch your Part D (prescription drug plan) to one that is available to Idaho residents. You have 63-days from your move date to get this done.
- Get a quote on your Idaho Medicare Supplement plan. Idaho premiums may be lower than your current premium. Remember a Medicare Supplement plan has the same coverage no matter which insurance company you buy it from.
We can help you with both items above.
Idaho Medicare Supplement plan enrollment rules.
Medicare Supplement plans have different enrollment rules (when compared to Medicare Advantage and Prescription drug plans). If you have an interest in a Medicare Supplement policy, please be sure you understand these rules. We can help you with this.
How much do Idaho Medicare Supplement plans cost?
Current premiums and new regulations the Idaho Legislature added to Federal rules for Medicare Supplement insurers is available here.
Notice the monthly premium difference between the insurance companies offering these plans varies by up to 250%+. I have guidelines on initial company selection and when to switch companies.
I do not recommend plans/companies I would not enroll in myself.
The Idaho Department of Insurance regulates insurance companies offering Medicare Supplement plans to Idaho residents. This responsibility includes reviewing the annual reports each insurance company is required to file and approve/disapproving annual premium increases.
Which plan(s) should you consider?
The plan which fits your needs and budget.
If the budget is not a concern, consider the plan that offers you the best coverage if you are diagnosed with a serious health issue.
Remember, as we age, we may want to turn over health care decisions to a younger family member of someone else we trust. Having health insurance with no copays/coinsurance/other details should make for an easy transition of this responsibility to them.
What is the difference between Medicare Agents and Medicare brokers?
The discussion found here and will help you understand this. Let me answer your questions on this document.
A few of the insurance companies offering Idaho Medicare Supplement plans only use ‘captive agents’. This means each company has their own agents which only represent their plans.
Check out our license with the State of Idaho.
We are licensed to sell Medicare products in the State of Idaho.
We only help Idaho residents with their Medicare insurance choices (Medicare Supplement, Medicare Advantage, and Medicare prescription drug plans).
The above link points you regarding our license with the State of Idaho. Be sure and scroll down to the bottom of the page and click on the word ‘search’. Let me answer your questions on this content.
Closing Comments
Are Medicare Supplement plans right for everyone? No. Medicare Advantage plans aren’t either. People are unique in their needs, retirement budget, and preferences on where they get their health care.
If you plan to work with a broker and are considering an Idaho Medicare Supplement plan or a Medicare Advantage plan, contact us. We have been helping Idaho residents with their choices since 2012.
Read the information found here to learn which plans we are licensed with.
We are here to help. Call us when you are ready.
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