Medicare Advantage plans in Idaho rural Counties
What you need to know about your choices for Medicare Advantage plans in Idaho rural Counties
Your choices of Medicare Advantage plans in Idaho rural Counties can be varied.
What can vary? Availability of plans, access to doctors and hospitals you want to use, medication cost and plan quality.
Residents of a rural Idaho County may have access to the same plans as people in the adjacent urban County.
This may sound reassuring at first. Be aware plans in a major population center can specialize in one hospital and the physicians employed at that hospital. Some plans may include other independent doctor groups in their network too. Other plans may include all hospitals in the population center and most of the physicians in the area too.
Kaiser Family Foundation did research on this subject. We encourage you to review their report (found here).
Do you want access to the top 250 Hospitals in the US? They have consistently better surgical outcomes!
Learn more about this topic here.
“The results of the Healthgrades analysis have some startling ramifications. For example, from 2019-2021:
- patients receiving Pulmonary care at a top 100 hospital lower their risk of dying by 58% when compared to getting care at a non-top 100 hospital;
- patients receiving Stroke care at a 5-star hospital in Stroke care lower their risk of dying by 52% when compared to getting care elsewhere;
- patients having joint replacement at hospitals that did-not receive the ‘Joint Replacement Excellence award’ were 2.74 times more likely to experience complications.
If you skipped reading the above noted report, we hope these quotes taken from the report will convince you it is worth your time.
When you have either a PPO plan or a network sharing Medicare Advantage plan some of these hospitals may be available to you.
Are you counting having access to the Mayo clinic with your PPO (or network sharing plan)? Read this recent new release on this subject here. If you stay with Original Medicare, with or without a Medigap plan, this resource is available to you.
You can find the top 250 hospitals by State and type of surgery they excel at here. Learn about the methodology and data used to create this report here.
If you have one of the 10 Medigap plans, all of these hospitals (provided they accept Medicare insurance) are available to you.
The Details of Medicare Advantage plans in Idaho rural Counties can change annually
Plan availability and their details occur at the County level.
This means details of specific plans can change, plans may be dropped and new plans may be available. You can change plans starting on 10/15 and through 12/7 annually.
If you miss this date, you have a 2nd chance to do the same between January 1 and March 31. Learn the specifics of this 2nd time period people already enrolled in a Medicare Advantage plan can switch again. These details are available here.
If you wish to evaluate your plan options annually on your own, you are taking on a time consuming. We recommend you work with a broker that is licensed with all plans available to you. Call us if you want help with this.
Learn what hospitals and doctors (by specialty) that accept Medicare are available in any Idaho County
You can do your own research to learn what hospitals are present in each of Idaho’s 44 Counties by using these resource mentioned below. This same tool will provide similar information for Skilled Nursing facilities, physicians by specialty, etc.
This tool is available here.
Just because providers are listed with this tool does not mean they are included in any or all of the Medicare Advantage plans available in the County. The insurance companies behind each Medicare Advantage plan have to put their own plan’s networks together. Providers can be added/removed during the calendar year.
Another handy reference lists the 2020 estimated population of each of the 44 Idaho Counties. This is available here.
Be aware of your alternative
If you are surprised to learn all doctors/hospitals in your area you may not be available to you, stay with Original Medicare (Part A and B). Doing so gives you access to all physicians/hospitals/other providers in the US that accept Medicare.
A bit more than 90% of the physicians in the US accept Medicare insurance.
If you stay with Original Medicare, you can add one of the 10 Medigap plans available to Idaho residents. Some of the Medigap plans pay all or most all of the left over costs that Medicare Part A and B do not completely cover. You can learn what Medicare pays for Part A and B services you use and your share of these left over costs by clicking here.
If you want to learn more about Medigap plans, you should find the information here a good investment of your time. If you have not reviewed the CMS document titled ‘Choosing a Medigap Policy’ we recommend you doing so. At a minimum, review pages 7 – 24 of the document found here. This reviews the enrollment periods, the differences between the 10 plans, and the important topic of ‘guaranteed issues’. Enrollment periods are different than Medicare Advantage plans and is important to understand.
If you are moving to Idaho understand your ‘Guaranteed Issue rights’
If you have a Medicare Advantage plan and are moving to Idaho (or a different County in Idaho) you should understand these. That is if your existing Medicare Advantage plan is not available in the Idaho County you are moving to, you have a ‘guaranteed issue’. This means you can enroll in a Medigap plan without answering the health history (underwriting) questions on the application. Review these rights on pages 21-24 of the document found here.
These are the Idaho Counties with no Medicare Advantage plans available
These Counties are:
Bear Lake Benewah Butte Caribou Clearwater
Custer Idaho Lemhi
Lewis Oneida Teton
If you live in one of these Counties, adding a Medigap plan can be advantageous. For example you may be able to eliminate some to all of the left over costs for Medicare covered services. In addition you have access to all physicians/hospitals/other providers that accept Medicare insurance. If is up to you to get the appointment with the provider(s) to want to use.
Be aware if you stay with Original Medicare, there is no ‘out of pocket’ limit on your share of the left over costs. Adding a Medigap Plan F Hi-deductible or one of the other Medigap plans could eliminate this issue.
Closing comments
Call us if you want help thinking through your options. We are licensed with all Medigap, Medicare Advantage, and many of the prescription drug plans available to Idaho residents.
We are here to help.
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