Paul Sanchez
Medicare is a government-funded insurance program that is usually for individuals aged 65 and older and those who qualify based on disability or certain medical conditions. In Idaho, residents can choose from Original Medicare (parts A and B) and Medicare Advantage (Part C) plans. Original Medicare does not limit out-of-pocket costs, so most enrollees maintain some form of supplemental healthcare coverage. This is where Medicare Supplement Insurance, often called Medigap Insurance, comes in. Medigap policies help cover the out-of-pocket costs of Original Medicare and are sold by Medicare-approved private insurance companies. As of 2021, there were 94,149 Idaho Medicare beneficiaries with Medigap coverage, and 29 companies offering Medicare supplement policies in the state.
| Characteristics | Values |
|---|---|
| Number of residents enrolled in Medicare | Over 344,000 |
| Number of residents enrolled in Medicare Advantage | About 49% of total enrollees |
| Number of Medigap insurers | 24 |
| Number of Medigap plans | 12 |
| Average premium cost for a Medicare supplement plan | $204 (2023) |
| Percentage of enrollees with a Medicare supplement plan | 45% (2023) |
| Most popular plans | Plan G and Plan F |
| Number of companies offering Plan G and Plan F | 29 |
| Number of standardized Medigap plans | 10 |
| Number of companies offering all 10 plans | 29 |
| Number of companies offering high-deductible versions of plans F and G | 29 |
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What You'll Learn
- Medigap plans are Medicare Supplement Insurance offered by private insurance companies
- Medigap plans help cover out-of-pocket costs
- Medigap plans are standardised, with 10 types available to Idaho residents
- Idaho has extensive consumer protections for Medigap
- Medicare Advantage plans are available through private insurance carriers
Medigap plans are Medicare Supplement Insurance offered by private insurance companies
In Idaho, residents aged 65 and over, as well as some individuals under 65 with disabilities, can enrol in Medicare. The state offers both Original Medicare (Parts A and B) and Medicare Advantage (Part C) plans. Original Medicare is provided by the federal government, while Medicare Advantage blends Medicare benefits with private health insurance.
Medigap plans, also known as Medicare Supplement Insurance, are extra insurance offered by private insurance companies to fill the "gaps" in Original Medicare coverage. These plans help pay some of the out-of-pocket healthcare costs that Original Medicare does not cover. Medigap policies are standardized, meaning policies with the same letter offer the same basic benefits regardless of the insurance company. While the benefits are the same, the cost of the plans may vary.
As of 2025, there are 12 different Medigap plans offered in Idaho, with 24 insurers providing these plans. Medigap plans are only available with Original Medicare, and residents must be enrolled in Part A and Part B coverage to be eligible for Medigap. During the six-month "Medigap Open Enrollment" period, which begins the first month a resident has Medicare Part B and is 65 or older, insurance companies cannot deny coverage due to pre-existing health conditions. After this period, residents may face difficulties purchasing a Medigap policy, or it may cost more.
Medigap plans are a useful option for Idaho residents with Original Medicare who want to limit their out-of-pocket expenses. By purchasing a Medigap plan, residents can gain peace of mind knowing that their healthcare costs are more comprehensively covered.
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Medigap plans help cover out-of-pocket costs
In the United States, Medicare is a government-funded insurance program generally for individuals aged 65 and older and those who qualify based on disability or certain medical conditions. Idaho residents can choose from Original Medicare (parts A and B) and Medicare Advantage (Part C) plans.
Original Medicare does not limit out-of-pocket costs, so most enrollees maintain some form of supplemental healthcare coverage. Medigap plans, also known as Medicare supplement plans or MedSupp, will pay some or all of the out-of-pocket costs that Original Medicare enrollees would otherwise have to pay. These plans are only available with Original Medicare and are offered through private insurance carriers.
Medigap plans can help offset any out-of-pocket costs that an enrollee may be responsible for paying. Each Medigap plan is different, and out-of-pocket costs may vary by plan. For example, some plans have a maximum out-of-pocket (MOOP) limit, which caps the amount that enrollees have to spend out-of-pocket. In 2025, Medigap plans K and L will have MOOPs of $7,220 and $3,610, respectively.
As of 2021, there were 94,149 Idaho Medicare beneficiaries with Medigap coverage, which is about 42% of the state's Original Medicare enrollees. Medigap plans are sold by private insurers, but the plans are standardized under federal rules, with ten different plan designs (differentiated by the letters A through N). Idaho has extensive consumer protections for Medigap, including guaranteed issue for beneficiaries under 65, a "birthday rule" annual plan change window, and a community rating requirement.
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Medigap plans are standardised, with 10 types available to Idaho residents
Idaho residents can choose from Original Medicare (Parts A and B) and Medicare Advantage (Part C) plans. Medicare Advantage plans include all the benefits of Medicare Parts A and B, and they often provide additional benefits such as prescription drug coverage, dental and vision coverage, and gym memberships.
Medicare Advantage plans are available through private insurance carriers, who bundle Parts A and B and often include prescription drug benefits and additional types of coverage. However, Original Medicare does not limit out-of-pocket costs, so most enrollees maintain some form of supplemental healthcare coverage. For those without supplemental coverage, Medigap plans (also known as Medicare supplement plans, or MedSupp) will pay some or all of the out-of-pocket costs that Original Medicare does not cover.
Medigap plans are standardised under federal rules, with 10 different plan designs (differentiated by the letters A through N). In 2025, 24 insurers offered Medigap plans in Idaho. Medigap plans sold to new enrollees to Medicare are not allowed to cover the Part B deductible, so Plans C and F are not available to people who are newly eligible for Medicare on or after 1 January 2020. People who are new to Medicare on or after this date have the right to buy Plans D and G instead.
Medigap insurers can impose a pre-existing condition waiting period of up to six months if you didn’t have at least six months of continuous coverage before enrolling. If you apply for a Medigap plan after your initial enrollment window closes, the insurer can consider your medical history in determining whether to accept your application.
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Idaho has extensive consumer protections for Medigap
Idaho residents have a range of options when it comes to Medicare plans. Original Medicare (Parts A and B) is provided by the federal government and is available to Americans aged 65 and older, as well as some individuals with disabilities. Medicare Advantage (Part C) is offered through private insurance carriers and typically includes Parts A and B, along with additional benefits.
Medicare Supplement Insurance, also known as Medigap, is a form of insurance that fills the gaps in Original Medicare coverage. Medigap plans are sold by Medicare-approved private insurance companies and help cover the out-of-pocket costs, deductibles, copays, and coinsurance associated with Original Medicare. Idaho has 24 insurers offering Medigap plans in 2025, with 12 different plans available.
Idaho has extensive consumer protections in place for Medigap. These protections include guaranteed issue for beneficiaries under 65, meaning that insurance companies cannot use medical underwriting to deny applications or change prices during the open enrollment period. There is also a “birthday rule” annual plan change window, allowing beneficiaries to make changes to their plan each year around their birthday. Additionally, Medigap plans in Idaho are priced based on a community rating, ensuring that the premium cost is the same for all enrollees of the same age.
It is important to note that Medigap plans cannot be used in conjunction with Medicare Advantage plans. As such, Idaho residents must carefully consider their healthcare needs and determine whether Original Medicare or Medicare Advantage is the best choice, and whether supplemental coverage through Medigap is necessary. Resources such as Idaho's Senior Health Insurance Benefits Advisors (SHIBA) can provide free help and information to seniors with questions about Medicare and Medigap plans.
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Medicare Advantage plans are available through private insurance carriers
In Idaho, residents can choose from Original Medicare (Parts A and B) and Medicare Advantage (Part C) plans. Medicare Advantage plans are available through private insurance carriers. These plans are typically offered by private companies that contract with Medicare and must follow the rules set by Medicare.
Medicare Advantage plans bundle Parts A and B of Original Medicare and often include additional benefits, such as prescription drug coverage (Part D), dental and vision coverage, a 24-hour nurse hotline, gym memberships, and assistance with transportation and in-home safety. These plans are usually region-specific and contract with doctors, hospitals, and other healthcare organisations to provide services.
The availability of Medicare Advantage plans depends on the county of residence, and insurance companies can decide whether a plan will be available statewide or only in specific counties. In Idaho, there were an estimated 83 Medicare Advantage plans available in 2024, with over 49% of the state's Medicare beneficiaries enrolled in these plans.
Medicare Advantage plans can provide a comprehensive alternative to Original Medicare, offering additional benefits and coordinated care to help manage costs and reduce hospitalizations. However, it is important to carefully consider your healthcare needs and review your options to ensure you have the coverage that best suits your requirements.
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Frequently asked questions
Medigap, or Medicare Supplement Insurance, is a form of insurance that helps cover gaps in Original Medicare (parts A and B). Medigap policies help cover the out-of-pocket costs of Original Medicare, such as deductibles and coinsurance.
There are 10 plan types, labelled A, B, C, D, F, G, K, L, M, and N. The benefits of each plan are standardized across the country, except in Massachusetts, Minnesota, and Wisconsin, which have unique standardization rules. In 2025, there were 12 different Medigap plans offered in Idaho.
You can purchase a Medigap plan from a Medicare-approved private insurance company. You must have Medicare Part A and Part B to buy a Medigap plan. In Idaho, you can contact Senior Health Insurance Benefits Advisors (SHIBA) for free help with questions about Medicare and Medigap.
