What Are Medicare Supplement Plans in Idaho?
Medicare offers health insurance to people age 65 and older as well as some younger people with disabilities and those with end-stage renal disease (ESRD).1 Like most health insurance plans, Medicare coverage has copayments, deductibles and coinsurance. Idaho Medicare Supplement plans (also known as Medigap policies) help pay for those out-of-pocket expenses.
These plans are sold by Medicare-approved insurance carriers. They are standardized by letter (A-N). That means that Medicare Supplement Plan A provides the same benefits regardless of which insurance company you purchase it from.
What You Need to Know
The best time to enroll in an Idaho Medicare Supplement plan is during your Medigap Open Enrollment period.
The most popular Medicare Supplement plans are Plans F, G, and N. Over 50% of people enrolled in a Medigap policy have Plan F.
Medicare Supplement plans do not offer prescription coverage, but Medicare prescription drug plans (also known as Part D) are available.
When Can You Enroll in a Medigap Policy?
You can apply for a Medicare Supplement plan at any time. However, the best time to enroll is during your Medigap Open Enrollment period. This period starts the month when you are 65 or older and enrolled in Medicare Part B and lasts for six months.
During your Medigap Open Enrollment period, insurance companies can’t decline your application or charge you more for any health conditions you may have.2
If you apply for a Medigap policy outside of open enrollment, an insurance company can decline your application or charge you more unless you have guaranteed issue rights. Several situations entitle you to guaranteed issue rights, including:
- Moving out of a Medicare Advantage (MA) plan’s service area.
- An MA plan no longer servicing your area.
- Having Original Medicare and an employer or union plan, and the employer or union plan is ending.
- Joining a Medicare Advantage plan when you first turn 65 and deciding within the first year of joining that you no longer want the plan.
- Dropping a Medicare Supplement plan to join an MA plan for the first time, and within the first year deciding to switch back to a Medicare Supplement plan.
- Leaving a Medigap policy or MA plan because the plan misled you.3
Changing Your Policy
You can change your Medigap policy outside of your Medigap Open Enrollment period, but insurers can decline coverage or charge you more based on medical underwriting — unless you have guaranteed issue rights.
What Are the Most Popular Medicare Supplement Plans?
Plan F covers:
- Medicare Part A coinsurance.
- Medicare Part B coinsurance or copayments.
- The first three pints of blood.
- Medicare Part A hospice care coinsurance or copayments.
- Skilled nursing facility care coinsurance.
- Medicare Parts A and B deductibles.
- Part B excess charges.*
- 80% of foreign travel emergency costs up to plan limits.
*If you see a doctor who doesn’t accept Medicare assignment, the doctor can charge you up to 15% more than the Medicare-approved amount for your service. These are called Part B excess charges.5
Plan F is not available to anyone who started Medicare on or after January 1, 2020.
Plan G covers everything Plan F does except for the Medicare Part B deductible.
Plan N covers everything Plan F does except for the Part B deductible and Part B excess charges. Plan N also has a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in an inpatient admission.6
How Do You Choose a Medicare Supplement Plan?
The first step in choosing an Idaho Medicare Supplement plan is deciding which lettered plan(s) meet your healthcare needs. Next, visit the Medicare Plan Finder to find insurance companies selling the plan in Idaho. Contact at least two or three insurance companies to determine which plans they sell and how much those policies cost.
Be sure you’re comparing the same plan across insurance companies. For example, compare prices for Medigap Plan A from one company to Plan A from another. That way, you’re making an apples-to-apples comparison.
Medigap plans are standardized, which means they offer the same benefits regardless of which company you purchase it from. Why do plan prices vary even though the benefits are the same? The reason is that insurance companies can choose how they price their plans. They have three options:
- Attained age ratings: With this option, insurance companies base the plan premiums (the amount you pay for the plan each month) on your current age. That means premiums increase as you get older. These plans are typically the cheapest when you’re younger in comparison to other plans, but they become the most expensive as you age.
- Issue age ratings: Insurance companies that use this pricing method base the plan premiums on your age when you buy the policy. They don’t increase policy premiums due to age, but they might due to other factors like inflation.
- Community age ratings: Insurance companies using this option charge the same premium to everyone regardless of their age or gender. They don’t increase premiums due to age, but they may increase them due to inflation and other factors.7
When you’re shopping for a Medigap policy, ask the insurance company how they price their plans and consider that information when you’re choosing a plan.
Do Medicare Supplement Plans Offer Prescription Coverage?
How Much Do Medigap Policies Cost?
Here’s how much Medicare Supplement plans cost in Idaho.
A 65-year-old man or woman who doesn’t use tobacco would pay:
Understanding Plan Costs
Medicare Supplement plan costs vary from one insurer to the next, depending on the method they use to price their plan, so it pays to comparison shops.
- Between $146 and $364 for Plan F.
- Between $120 and $301 for Plan G.
- Between $97 and $250 for Plan N.
What If You Want to Change Your Medigap Policy?
You can apply for a new Medigap policy at any time. Keep in mind that unless you have guaranteed issue rights, the insurance company can decline your application or charge you more based on medical underwriting.9
What Are Alternatives to Medicare Supplement Plans?
Medicare Advantage (MA) plans are a bundled alternative to Medigap policies. Also known as Medicare Part C, MA plans provide your Original Medicare benefits (Parts A and B). Most plans include Medicare Part D, which helps to cover prescription medications, and other benefits like hearing, vision and dental care.10
MA plans may be an HMO (health maintenance organization), PPO (preferred provider organization) or PFFS (private fee-for-service) plan.11
What Are Medicare Resources in Idaho?
Idaho residents have access to several Medicare resources:
- The Senior Health Insurance Benefits Advisors (SHIBA) provide Medicare beneficiaries with free, unbiased advice. Call SHIBA at 1-800-247-4422.
- If you have a complaint about a Medicare Supplement plan, contact the Idaho Department of Insurance online or by calling 208-334-4319.
- Medicaid offers free and low-cost healthcare to people with limited incomes and assets. Apply for Medicaid online.
If you’re ready to apply for a Medicare Supplement plan, start by deciding on your preferred lettered plans. Contact insurance companies so you can compare quotes, and consider buying a Part D prescription plan. Keep in mind that you still need to pay your Medicare Part B premium. If you need help, SHIBA can provide you with advice tailored to your situation.