Idahoans urged to check Medicare plans

As health insurance carriers change private plans for Medicare, Idaho officials are encouraging people to review their policies during open enrollment next month.

Open enrollment for Medicare — when people can change their insurance coverage — starts Oct. 15 and ends Dec. 7. But insurers have been changing, and even pulling out of, Medicare Advantage, which are private plans for the federal health insurance program for older Americans and people with disabilities.

“Consumers should use this annual Open Enrollment Period to compare plans, confirm that their doctors and prescriptions are covered, and seek free, objective help …” Idaho Department of Insurance Director Dean Cameron said in a statement. “Taking action early ensures uninterrupted coverage and continued access to quality care. Most importantly, consumers should know they are not alone — our team is ready to help every step of the way.”

He recommended several options to get help: directly from the Idaho Department of Insurance; through the agency’s program for Senior Health Insurance Benefit Advisors, also known as SHIBA; or from a local insurance agent. 

More than half of people eligible for Medicare are enrolled in Medicare Advantage plans, which tend to cover extra benefits than traditional Medicare. 

How are Medicare Advantage plans changing?

Because of rising costs, less federal payments and new regulations, some insurers who offer Medicare Advantage Plans are reducing benefits, trimming provider networks and leaving some areas, the Department of Insurance announced in a news release last week. Last year, after many insurers pulled Medicare Advantage plans, more than a million patients needed to find new health insurance, Stateline reported. 

Idaho Department of Insurance officials expect plans to be withdrawn in 2026. But even if plans stay in Idaho, agency officials say benefits or provider networks could change. 

By Oct. 1, all people enrolled in Medicare Advantage plans should have received an explanation of any changes to their plan from the insurance carrier through a letter called an Annual Notice of Change.

Right now, seven insurance carriers offer Medicare Advantage plans in Idaho counties. 

If plans are canceled, people affected may be able to switch plans, through Medicare Advantage or traditional Medicare, if they qualify for a special enrollment period. 

How can you get help on Medicare in Idaho?

In Idaho, contact the Department of Insurance’s SHIBA program for free assistance to help compare plans, answer questions, review coverage options, help with complaints and enroll in Medicare Advantage and Part D prescription drug plans.

To contact SHIBA or enroll in the program’s monthly Medicare webinar workshops, call 1-800-247-4422.

Find more resources about misleading Medicare marketing online at the Department of Insurance’s website at doi.idaho.gov/shiba/medicare-improper-marketing.