Question 1

Does Idaho have a birthday rule for switching Medigap plans?

Accepted Answer

Yes. Since March 1, 2022, anyone in Idaho who already has a Medicare Supplement (Medigap) policy gets a 63-day window each year, starting on their birthday, to switch to a policy with similar or lesser coverage. You can stay with your company or move to a different one, and the new company can't ask health questions or turn you down for your health. The rule only moves you sideways or down in coverage, never up, and it applies only to people who already have Medigap. In practice it's a yearly chance to compare what other companies charge for the same plan letter you already have.

Question 2

Can I use Idaho's birthday rule to leave Medicare Advantage for a Medigap plan?

Accepted Answer

No. The birthday rule is only for people who already hold a Medigap policy. Moving from Medicare Advantage to Medigap generally means answering health questions, unless another guaranteed-issue right applies, such as leaving a Medicare Advantage plan within the first 12 months after joining Medicare at 65 or your plan leaving your area. If you're thinking about this switch, check whether one of those rights applies to you before you drop your current plan.

Question 3

I'm under 65 and on Medicare because of a disability. Can I buy a Medigap plan in Idaho?

Accepted Answer

Yes, with a timing catch. Idaho requires Medigap policies to be offered to people under 65 during their Medicare Initial Enrollment Period, or during a guaranteed-issue period if one applies. Insurers may charge under-65 enrollees up to 150% of the premium they charge someone who is 65. Miss those windows and a company can generally ask health questions. When you turn 65, you get a new six-month Medigap Open Enrollment Period, and the age-65 rate applies from then on.

Question 4

Is there free, unbiased Medicare help in Idaho?

Accepted Answer

Yes. SHIBA (Senior Health Insurance Benefits Advisors), run by the Idaho Department of Insurance, gives free Medicare counseling at 1-800-247-4422. SHIBA doesn't sell insurance or recommend specific products, and it helps by phone, by appointment and at community events around the state. Many people use SHIBA and a licensed agent together: SHIBA for neutral education, an agent for comparing the specific plans available at their address. Neither costs you anything.

Question 5

Are Medicare enrollment dates different in Idaho?

Accepted Answer

No. Medicare is a federal program, so the dates are the same in Idaho as everywhere: the seven-month Initial Enrollment Period around your 65th birthday, Open Enrollment from October 15 to December 7 with changes starting January 1, the Medicare Advantage Open Enrollment Period from January 1 to March 31, and Special Enrollment Periods after events like moving or losing job-based coverage. What does differ is which plans are offered, because Medicare Advantage and Part D plans are approved county by county.

Question 6

Who helps Idaho residents through this site?

Accepted Answer

Eric Jenkins, who is licensed in Idaho. Eric has advised Medicare clients since 2009 and lives in Mapleton, Utah; Idaho appointments are by phone or video. Call or text him at (702) 249-0514 or email ejenkins@crsgadvisors.com. Jordan Jenkins, who runs this site, is licensed in Wyoming and Utah only, so he can't help with an Idaho policy.

Question 7

When is open enrollment for Your Health Idaho?

Accepted Answer

Idaho runs its own marketplace, Your Health Idaho, instead of HealthCare.gov. Open enrollment for 2027 coverage runs October 15 through December 15, 2026, for plans starting January 1, 2027. That's a month earlier than HealthCare.gov's January 15 deadline, so dates you see in national news may not apply in Idaho. If you don't choose a plan by December 15 you may be automatically re-enrolled in your current one. Outside open enrollment you need a qualifying life event, which usually gives you 60 days (90 days after losing Medicaid). Your Health Idaho's call center is 1-855-944-3246.

Question 8

What is changing with Idaho Medicaid in 2027?

Accepted Answer

Idaho Medicaid expansion covers adults 19 to 64 with income up to 138% of the federal poverty level. The Idaho Department of Health and Welfare has announced that starting January 1, 2027, most adults in the expansion group will need to show 80 hours a month of work, community service, or approved school or job training, with eligibility checked twice a year. Some people are exempt. Medicaid has no enrollment season, so you can apply any time at idalink.idaho.gov or 1-877-456-1233. Check your own situation with Health and Welfare, since the details are still being put in place.

Question 9

I live in Wyoming or Utah but see doctors in Idaho Falls, Pocatello or Preston. Does my coverage work there?

Accepted Answer

Original Medicare works with any provider in any state that accepts Medicare, so a Medigap setup crosses the state line without a problem. Medicare Advantage plans are built on networks, and how they treat care in Idaho varies plan by plan: some include Idaho providers in network, some pay them at out-of-network rates, and some HMOs cover little beyond emergencies. Tell your agent about your Idaho doctors at the start of any plan comparison. Your agent is the one licensed in the state where you live: Jordan for Wyoming and Utah residents, Eric for Idaho residents.

Question 10

Are Medigap premiums in Idaho based on my age?

Accepted Answer

Not for new policies. Medigap policies sold in Idaho after February 28, 2022 are community-rated, which means a company charges the same premium for the same plan regardless of age. Your premium can still rise for inflation and claims costs, but not just because you got a year older. Older policies may be priced differently, so check your policy documents if you bought before March 2022.

Idaho-Specific Medicare and Insurance Questions, Answered