Latah County Medicare Advantage Plans

There are 10 Medicare Advantage plans for you to consider.  

These plans are broken down into three categories. 

Some of these have specific qualification rules for enrollment.  This means these may or may not be available to you.

When you review your Latah County Medicare options, we encourage you to consider the low premium Medigap plans too. 

Why? 

Because the premiums and cost sharing of Medicare Advantage plans have increased to the point where these Medigap plans are attractive. 

There are many positive benefits that come with these two plans.

A few of these are:

the doctors/hospitals in Boise, Canyon County, Kootenai County, Salt Lake City, Seattle, and the rest of the US are available to you; you just make the appointment

referrals are not needed to see a specialist  

the limit on your share of the cost for your Medicare covered services is $2,950, which is about half of the ‘Maximum out of Pocket Cost’ for most Medicare Advantage plans available to you.                                                    

The ten plans available in Latah County are broken down into different categories.  These are: 

                 Plans without prescription drug coverage

There is one plan in this category. 

According to the plan details found on the Medicare.gov website (plan finder tool), the monthly Premium is  $0.

 Medicare Part B ‘credit’ (also called ‘giveback) is $90.

If the ‘giveback’ is important to the Veteran and they plan to get health care through the plan, they need to pay close attention to plan cost sharing differences. We can help you with this.

Aso, veterans, who will be using covered health care services from a plan, need to pay attention to the plan’s network (what doctors/hospitals are available), and cost sharing.  Not all physicians in the area which ‘accept Medicare’ are available to plan members.   

Do you qualify for one of the six Special Needs plans (C-SNP and D-SNP)?

These include:           

      C-SNP  (Chronic health care Special Needs plans)

C-SNPs are designed to provide benefits tailored to people with specific chronic health issues . Qualifying conditions include Diabetes mellitus; and/or Chronic heart failure; and/or Cardiovascular disorder (cardiac arrhythmias, coronary artery disease, peripheral vascular disease, chronic venous thromboembolic disorder).  

The plan qualification process includes:                      

• Doctor Verification: The plan provider will work with your doctor to verify your chronic condition before you are fully approved for the plan.
• Special Enrollment Period: You can use a one-time special enrollment period to join a C-SNP at any time of the year, not just during the annual fall enrollment period. 

If you have one of these health issues and feel it you are not making progress getting it managed, one of these plans might help. 

D-SNP (Dual eligible Special Needs plans).

If the Idaho Department of Health and Welfare has classified you as having ‘Enhanced Status’ you have Medicaid/Medicare coordinated (MMCP) plans to consider.

Individuals awarded with QMB status have their own unique plans available.

If you have a different Medicaid status, the plans discussed below are available to you. 

All other Latah County Medicare beneficiaries have three HMO and three  PPO plans to consider.

HMO Plans.

There are two plans to consider.

Monthly premiums range from $0 to $59.

Plan MOOP’s range from $5900 to $6700.

 PPO Plans.

There is one plan available and it’s monthly premium is $19. 

Plan MOOP’s range is $7,900 for in-network usage and $13,900 when out of network resources are used.

If you have an interest in this plan, be sure and consider the two plans mentioned below.

With the rising cost of Medicare Advantage plan premiums AND cost share, the  High-Deductible version of Plan G (HD-G) or the High-Deductible (HD-F…if you qualify for enrolling) are attractive alternatives.  

Why one of the Medigap High-Deductible plans?   You have:

• Freedom to choose any physician/hospital which ‘accepts Medicare insurance’ (most do)
• Few ‘prior authorizations; you do not have an insurance company standing between you and your physician to get to the next step in your health care;
• Few/no referrals are needed; you just make the appointment
• Stable coverage year after year
• Nationwide access to health care; this means you minimize the growing issue of hospitals not accepting Medicare Advantage plans 
• More predictable costs when you use care
• The potential issue of recurring cancellation of an insurance company’s Idaho Medicare Advantage plans is eliminated; in 2025 over 70,000 Idaho residents had their Idaho Medicare Advantage plan cancelled by their insurance company.  This issue forced these policyholders to find a new plan for 2026.Premium Comparison (for Idaho)
• Both Medigap HD-G and HD-F 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.

The chart below profiles the differences between the Medigap plan choices. 

• *Plan F is only available to people who became eligible for Medicare before January 1, 2020.
• Call us if you have questions about this choice.

Call us if you have questions.

Other issues to consider when selecting a plan.

If your doctor ran tests on you to diagnose the reason you are visiting them, and unfortunately the diagnosis came back as a serious health issue.  Would you start thinking about where you want to be treated and by whom? 

The decision about getting treatment outside of your plan’s network may come to mind.   

Remember, if you choose an HMO plan, you have access to the plan’s network of facilities.   This typically means a sub-set of the ‘providers’ which ‘accept Medicare insurance’

If you choose a PPO plan, you can use the plan’s in-network facilities or go out of network. 

If you choose the ‘out of network’ option, be aware some hospitals in the US do not accept appointments from people insured with Medicare Advantage plans.  The information found here is an up-to-date report on this subject.  There are other reports for 2023 and 2024. 

Also be aware of the phrase in section 2 of the plan’s ‘Evidence of Coverage’.    It reads: “However, providers that don’t contract with us are under no obligation to treat you, except in emergency situations.”

If you are diagnosed with Cancer…

Proton Therapy is an example of newer technology for treating cancer.  

Why consider this?  If may produce better results than traditional approaches.

Read this article if you are unfamiliar with this technology.  At this point, forty six hospitals (out of over 4500) offer this solution.  One of them is in Northern Utah.   This video does a good job of describing how this works.  A map of facilities that offer this resource is available here.

How to find hospitals in and around  Latah County.

Click here to find hospitals in a 50 mile radius around Moscow.

Notice that none of the hospitals listed have a 4 or 5 ‘star rating’ by Medicare AND five of the nine hospitals are in Washington.  This means they may not be in the provider directory of the Medicare Advantage plans available to you.  

The nearest 4 star hospital in Idaho is Kootenai Health in Coeur D’ Alene.

We recommend people consider hospitals with this rating if they will be treated with more serious health issues. 

You can bump up the search radius around zip code 83843 to find more hospitals.  Be sure and look to see if the new hospitals are still in Latah County and in the provider directory of any Latah County Medicare Advantage plan you are considering; if they are ‘out of state’, they may not be in the provider directory. 

Resources are available to help you find the top hospitals in the US.

The top 250 hospitals in the US may have the latest technologies to treat different health issue(s)…and the physicians that know how to use them.

These resources may be available to you if you have the right Idaho Medicare insurance (Original Medicare with or without a Medigap plan or a PPO plan, if they will accept your PPO plan).

Some of these hospitals may not accept Medicare Advantage plans.   If you have a Medigap most will accept your insurance.

Medicare assigns Hospitals a ‘star rating’.  We recommend you focus on four and five-star rated hospitals AND skilled nursing facilities.

There are several organizations which rate hospitals too.  Each of these services may use different metrics to rank hospitals.  We favor the Health Grades resource as it focuses on results of services performed in the surgical suite.  

Learn more about this subject here.

Medications covered by each plan.

Dot your I’s and cross your T’s.

We recommend you not enroll in any Medicare Advantage plan until you understand your cost for your prescription medications. 

If you are working with a broker/agent that just tells you your medications are covered, we suggest you work with someone else that will share the whole picture. Reports can be produced which show you your fill/refill cost for your specific prescription medications and if each of the plans available to you cover all your medications.  They will also show you the refill cost of up to five pharmacies you select.  

Are medications that treat serious health issues (cancer, etc.) covered by my plan?

The Centers for Medicare and Medicaid Services (CMS) have requirements insurance companies(s) offering Medicare plan(s) must meet when they put together their list of covered medications.

Below is a cut/paste from (Section 30.2.5) the current Medicare Prescription Drug Benefit Manual.

“Part D sponsor formularies must include all or substantially all drugs in the immunosuppressant(for prophylaxis of organ transplant rejection), antidepressant, antipsychotic, anticonvulsant, antiretroviral, and antineoplastic classes. CMS instituted this policy because it was necessary to ensure that Medicare beneficiaries reliant upon these drugs would not be discouraged from enrolling in certain Part D plans, as well as to mitigate the risks and complications associated with an interruption of therapy for these vulnerable populations.“

We feel this is an important statement everyone enrolled/wishing to enroll in a Medicare prescription drug plan should be aware of.

What insurance companies offer Medicare Advantage plans in Latah County?

Molina Healthcare of Idaho

United Healthcare.

Would a Medicare coach be helpful?

A coach can firm up your understanding of Medicare, explain differences between your choices, and help you with enrollment.  They will also be there year after year to help you.   

Will the people behind the TV ads include this service for you?

Call us if you are interested. Our hours are 8am to 8pm Monday through Saturday. 

Would a Medicare coach be helpful?

A coach can answer your question(s), help firm up your understanding of Medicare, explain the differences between your choices, and

help you through the enrollment process.  They will also be there year after year to help you.   

Will the people behind the TV ad’s include this service for you?

Call us if you are interested. Our hours are 8am to 8pm Monday through Saturday. 

We started this business in 2012 explicitly to help Idaho residents work their way through this maze. 

There is no fee when you use our services.

This page was last modified on Feb 20, 2026 @ 7:27 PM