Last Updated on
October 6, 2016
If you’re enrolled in Medicare in Idaho and would like some help paying for Medicare-related costs, you may want to consider signing up for a Medicare Supplement plan (also known as a Medigap plan). In Idaho, you may have access to various Medicare Supplement plan options, depending on your zip code. Familiarize yourself with Medigap in Idaho, and learn about choosing a plan that may fit your health and budget requirements.
Medigap may help Medicare beneficiaries pay for health-care costs associated with Original Medicare, Part A and Part B, including copayments, coinsurance, deductibles, and other out-pocket expenses. In 47 states, there are 10 standardized Medigap plans available, each of which is identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N), with plans of the same letter offering the same benefits (for example, a Medigap Plan G sold by one company has the same benefits as a Plan G sold by another company). Only three states (Massachusetts, Minnesota, and Wisconsin) offer different kinds of Medigap plans. Plans E, H, I, and J are no longer sold. Note that some companies may offer additional innovative benefits.
To join Medigap in Idaho, as in all states, you must already be enrolled in Original Medicare, Part A and Part B. The Medigap Open Enrollment Period starts the first day you are age 65 or older and enrolled in Medicare Part B, and lasts for six months. This is usually the best time to sign up for a Medicare Supplement plan. During this time period, you can join any Medigap plan available in your area, and you won’t be subject to restrictions for pre-existing conditions or medical underwriting (although waiting periods may apply). If you decide to apply for Medigap in Idaho at a later date (after your Medigap Open Enrollment Period ends), you may be denied coverage or charged more for an insurance policy.
Remember that Medigap plans are meant to supplement and not to replace Original Medicare, so you have to remain enrolled in Original Medicare, Part A and Part B, and go on paying your Medicare Part B premium, in order to retain your health insurance coverage. If you want to keep your Medigap plan and add prescription drug coverage, you may want to enroll in a stand-alone Medicare Part D prescription drug plan. Medigap plans do not offer coverage for prescription drugs.
Here’s a look at the 10 standardized Medigap plans that may be available in Idaho. It may be a good idea to understand what each plan offers prior to making your final selection. In this chart, X indicates that the service (or item) is 100% covered; a percentage indicates what percent of the service/item is covered; and a blank cell indicates it is not covered.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted||X||X||X||X||X||X||X||X||X||X|
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B excess charges||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out-of-pocket limits apply.**|
*Medicare Supplement Plan F offers a high-deductible version in which beneficiaries pay a certain deductible amount before the plan begins coverage. This amount may change from year to year.
**Once you reach the out-of-pocket limits (including the Part B deductible), both Medicare Supplement Plans K and L pay 100% of covered services in the above chart for the remainder of the calendar year.
***Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, except for a copayment of up to $20 on doctor visits and up to $50 on emergency room visits that don’t result in an inpatient admission.
As explained above, Medicare Supplement plans in Idaho with the same letter designation don’t vary in coverage or benefits. However, each independent insurance company that offers Medicare Supplement plans can determine its own monthly premium structure. This means that if you live in Boise, in Ada County, you may pay more or less than a resident of Coeur d’Alene in Kootenai County for an identical Medicare Supplement plan. It may be a good idea to compare all Medicare Supplement plans available in your area, and then select a Medigap plan in Idaho based on your individual health and budget needs.
For additional information about Medicare in Idaho, view the following resources:
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.