Summary: If you’re on Medicare in Idaho, you may want to know all of your health care options. Beyond Original Medicare in Idaho, you may be able to enroll in a Medicare Advantage plan. You also may be able to get a stand-alone Medicare Part D prescription drug plan or a Medigap plan.

An overview of Medicare in Idaho

The federal Medicare program is sometimes called Original Medicare. This includes Medicare Part A, which is hospital coverage, and Part B, which is medical coverage.

Your other choices may include:

  • A Medicare Advantage plan (Medicare Part C)
  • A stand-alone Medicare Part D prescription drug plan
  • A Medigap (Medicare Supplement insurance) plan

Original Medicare in Idaho

Medicare Part A covers inpatient hospital stays. Part B covers doctor visits and preventive services. These include annual wellness exams.

Did you know that you might not have to do anything to get enrolled in Medicare? You’re typically enrolled in Medicare Part A and Part B automatically at age 65. This happens if you receive retirement benefits through either the Social Security Administration (SSA) or the Railroad Retirement Board (RRB).

You might be eligible for Medicare under the age of 65 if you have a qualifying disability. You’re usually enrolled automatically in Medicare when you’ve received SSA or certain RRB disability benefits for 24 months in a row.

What if you’re not automatically enrolled in Medicare in Idaho? You need to apply as soon as you’re eligible. If you decide to delay enrollment, you’ll still need to apply for Medicare when your other coverage ends. Learn about Medicare late enrollment penalties.

To enroll, call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. Phone hours are Monday through Friday, from 7AM to 7PM.

  • If you worked for a railroad, call the RRB at 1-877-772-5772. TTY users can call 1-312-751-4701. Phone hours are Monday through Friday, from 9AM to 3:30PM.

You’ll get your Medicare card in the mail about three months before the start of your coverage.

Medicare in Idaho Plan Options

There are several kinds of plans to consider.

  • The federal government administers Original Medicare Part A and Part B.
  • Private insurance companies, contracted with Medicare, provide other plan options.

Listed below are choices for Medicare in Idaho. 

Medicare Advantage Plans

Medicare Advantage plans (Medicare Part C) are offered by private insurance companies that contract with Medicare to provide Part A and Part B coverage. Medicare Advantage plans are required to give the same coverage as Original Medicare. This includes the maximum out of pocket spending limit.

What happens once your out-of-pocket expenses have been reached, including the deductible? The Medicare Advantage plan pays 100% of covered health-care costs for the rest of the year. Medicare Advantage plans may also cover extra benefits. These may include dental, vision care, hearing, or wellness benefits.

Medicare Advantage prescription drug plans

Some plans, known as Medicare Advantage prescription drug plans, also include prescription drug coverage.

To get Medicare Part C, you must:

  • Be entitled to Medicare Part A,
  • Be enrolled in Medicare Part B, and
  • Live in the plan’s service area

In 2020, some Idaho Medicare Advantage plans have $0 monthly premiums. You’ll need to keep paying your Medicare Part B premium. You’ll also need to pay any premium required by your Medicare Advantage plan.

Medicare Supplement (Medigap) insurance plan

If you decide to stay with Original Medicare, you may have the option to buy a Medicare Supplement (Medigap) insurance plan to help pay for Medicare’s out-of-pocket costs.

Different Medigap plans pay for different amounts of those costs. These costs include copayments, coinsurance, and deductibles.

Medicare Part D prescription drug plan

Original Medicare does not include prescription drug coverage. Many people choose to get Medicare Part D prescription drug benefits from either:

  • A Medicare Advantage prescription drug plan, or
  • A stand-alone Part D prescription drug plan

Every Medicare prescription drug plan has a formulary. This is a list of prescriptions covered by that plan and separated into cost tiers.

Medicare in Idaho Resources

Here are a few resources for Medicare in Idaho and related health care topics.

  • State Health Insurance Assistance Program (SHIP): Toll-free number 1-800-247-4422, Monday through Friday, 8:30AM to 4:30PM MT.
  • National Institute on Aging Information Center: Toll-free number 1-800-222-2225. Phone hours are Monday through Friday, 8:30AM to 5:00PM ET.

Learn more about how Medicare in Idaho works:

Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.

The product and service descriptions, if any, provided on these PlanPrescriber web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.