It is true that the average cost of health insurance in Idaho is among the lowest in the country at only $415 per month. But the state ranks 14th among the poorest as well. This is why so many residents are thankful for their Medicare coverage.
Medicare is a federal health insurance plan designed primarily for senior citizens over 65. However, it also offers benefits to workers with certain disabilities. The state government of Idaho also offers various types of assistance for Medicare beneficiaries.
Medicare in its basic form consists of Part A and Part B coverage. Medicare Part A pays for the cost of hospital services which include inpatient care. Medicare Part B deals with various medical treatments and supplies that are considered medically necessary.
Both Medicare Part A and Part B may require beneficiaries to pay premiums, although in most cases premiums are not required for Medicare Part A. Both Parts A and B may also involve deductibles and copayments.
Many who wish for Medicare coverage may opt for even more covered services than what the Original Medicare (Part A and Part B) provides. These Medicare plans may be purchased from private carriers that have been already approved by Medicare. These plans can replace or add to the coverage provided by Original Medicare.
The main replacement for Original Medicare is the Medicare Advantage Plans. Their coverage includes paying for all the services that are covered by both Medicare Part A and Part B. This option also normally includes coverage for other medical services that are not covered by Original Medicare. Advantage Plans are also commonly called Medicare Part C.
Another option is a supplemental plan for coverage of the costs of prescription medication. This is also known as Medicare Part D. It is often added to the coverage of Part A and Part B so that the Medicare coverage is much more comprehensive.
Other supplemental plans may offer additional coverage for medical services not covered by Original Medicare. These plans may also cover the deductibles and copayments required in Original Medicare.
If you receive Medicare as a resident of Idaho, you can apply to the Live Better Idaho program for financial assistance in paying for Medicare expenses. You will have to comply with certain guidelines regarding your income.
The Qualified Medicare Beneficiary (QMB) program covers the payment for Part A and Part B premiums, and it also pays for deductibles and copayments. To qualify, QMBs must earn a monthly income of no more than $1,032. An applicant who lives with a spouse can be eligible with a combined monthly income of $1,392.
The Specified Low-Income Medicare Beneficiary (SLMB) program pays for just the Part B premium. To qualify, SLMB individuals must have a monthly income that is less than $1,234. As part of a married couple, the income ceiling is $1,666.
Another program similar to the SLMB program is the Qualified Individual (QI) program, which also pays for Medicare Part B premiums. But receiving the benefits is not always a certainty because of funding issues. To qualify, the QI must have a monthly income of not more than $1,386. A married couple’s income ceiling is $1,872.
Acceptance to any of these programs can qualify beneficiaries for the Extra Help Program, which offers low-income subsidies to cover the cost of prescription medication. The guidelines place annual income ceilings at $18,090 for individuals and $24,360 for couples. There is a resource limit as well, with $13,820 for individuals and $27,600 for married couples.
Finally, there is a Qualified Disabled and Working Individual (QDWI) program for applicants who are disabled and working. The program covers the payment for Medicare Part A premiums. The monthly income limit for an individual is $4,105 with a limit of $5,499 for married couples.
In Idaho, the State Health Insurance Assistance Program is called SHIBA. This offers free and unbiased information and counseling regarding Medicare in Idaho. It is staffed with volunteers and professionals with no ties to the private health insurance industry. Idaho residents with questions about Medicare can call SHIBA at 1-800-247-4422.