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Medicare in Idaho

Medicare beneficiaries in Idaho should take note of every possible Medicare option. The federal Medicare program, sometimes referred to as Original Medicare, includes both Medicare Part A and Part B. It is available to anyone in the country who is eligible for Medicare.

Beyond Original Medicare, there are private types of insurance called Medicare Advantage plans, also called Medicare Part C. These include the same amount of coverage as Medicare Part A and Part B, but may add other benefits. Part C plans are not administered by the federal government; they are managed by the private provider selling the policy. Many Medicare Advantage plans also include prescription drug coverage.

Other plans may be added to Original Medicare for more robust coverage. Because Original Medicare doesn’t cover prescription medications, you may wish to enroll in a Medicare Part D Prescription Drug Plan (PDP) to get this benefit. Medicare Supplement Insurance, on the other hand, covers Original Medicare’s out-of-pocket costs and other gaps in its coverage.

Original Medicare for Idaho beneficiaries

Medicare Part A covers inpatient hospital stays, while Part B covers doctor’s visits and preventive services such as annual wellness exams.

Beneficiaries in Idaho can be enrolled in Medicare automatically at age 65, provided they receive retirement benefits through either the Social Security Administration (SSA) or the Railroad Retirement Board (RRB). Disabled persons under the age of 65, who receive SSA disability benefits, or certain RRB disability benefits, for 24 consecutive months are enrolled automatically as well.

Residents in Idaho who are not eligible for automatic enrollment can apply manually by visiting their local SSA office. Online registration is also available, as is enrollment by phone:

  • Call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. SSA representatives are available 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. RRB representatives are available Monday through Friday, from 9AM to 3:30PM.

Once enrolled, your Medicare card is mailed about three months before the start of your coverage.

Medicare private insurance in Idaho

There are private types of Medicare insurance that a beneficiary in Idaho may wish to consider before making a final decision with respect to their coverage.

Medicare Part C, also called Medicare Advantage, is private Medicare insurance that takes the place of your Original Medicare coverage. Joining a Medicare Advantage plan doesn’t mean that you leave Original Medicare. You must continue paying your Part B premium even if you join a Part C plan.

These plans must equal the coverage of Original Medicare (save for hospice care, which remains covered through Medicare Part A), but some provide additional benefits, such as vision, hearing, and dental. Plans that include prescription drug coverage are called Medicare Advantage Prescription Drug plans (MA-PDs).

Medicare Supplement Insurance plans, also called Medigap policies, are available to beneficiaries in Idaho who receive their benefits through Original Medicare, but would like more out-of-pocket costs covered. Most states, with the exception of Massachusetts, Minnesota, and Idaho, can offer up to ten standardized policy options, each of them marked with a letter. Plans of the same letter offer the same benefits no matter which carrier offers the plan. A Medicare Supplement provider must at least offer Plan A. If the plan would like to sell additional policies, they must next offer Plan C or Plan F before offering other plans.

Because Original Medicare does not include prescription drug coverage, it may be necessary for beneficiaries to purchase a Medicare Part D stand-alone drug plan. A Medicare beneficiary must have Medicare Part A and/or Medicare Part B to be eligible for this type of plan. Every Part D plan has a formulary, which is a list of prescription medications covered by that plan, and formulary details can vary by plan.

Idaho resources for Medicare beneficiaries offers a list of available resources that can help educate you on health resources in Idaho. Medicare-specific resources are included below:

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

Learn more about how Medicare plans work in Idaho, including: