All Medicare found 23 Medicare Part D prescription drug plans available in Idaho for 2023. See Plans
Idaho Part D Plans By The Numbers
- Average premium: $48.92 per month.
- Lowest premium: $5.10 per month.
- Average deductible: $388 per year.
- Plans with no deductible: 4.
- Plans rated 4-stars or better: 0%.
- Basic benefit plans: 9.
- Enhanced benefit plans: 14.
- Full Low-Income Subsidy plans: 6.
- Plans with extra gap coverage: 5.
All Plans Have Four Cost Phases
A Medicare prescription drug plan is extra coverage you can get in Idaho to help you pay for your prescriptions. Part D plans, or PDPs, don't cover all costs, but they do cover a lot. But, how these plans work can be confusing, so let's go over the four phases of cost-sharing.
Phase 1: The Plan's Deductible
Before a Part D plan will pay any of your prescription costs, you must first pay full cost of your prescriptions until the annual deductible is met. So, for instance, if you enroll in a Idaho plan with a $400 deductible, you will pay $400 out-of-pocket to pick up your prescriptions before the plan kicks in to pay its share.
IMPORTANT: Here's a cost-savings tip. A few plans in Idaho exclude Tier 1 drugs from the annual deductible. If you use mostly Tier 1 generic drugs, this can add up to a significant cost savings.
Phase 2: Initial Coverage Limit
The Initial Coverage Limit starts once the deductible is paid. It is the same for all plans. The amount this year is $4,660. In this phase, you and your plan split all costs up until your total retail spend on prescriptions exceeds $4,660. You pay the formulary amount. The plan will pay the rest. If your medication costs $50, and the formulary calls for a 10% copay, your share will be $5.
CRITICAL: When the total cost of your prescriptions exceeds $4,660, you go into the next please, the Coverage Gap (aka, "donut hole").
Phase 3: The Medicare Part D Coverage Gap
Your share on all brand-name drugs will be 25% in the Coverage Gap phase. The manufacturer is required to give a 70% discount, while your Medicare Part D plan will take the remaining 5%. This continues until you reach $7,400 in True Out Of Pocket Costs (TrOOP). Your TrOOP includes the 25% that you pay and the 70% discount received from the manufacturer.
TIP: Some plans offer additional gap coverage, so look for it on the plan information pages.
Generic drugs have a different situation. The 25% you pay yourself counts towards your TrOOP. However, your Part D pays the other 75%., which does not count towards tour TrOOP.
Phase 4: Catastrophic Coverage
After you have spent $7,400 in 2023, you get out of the coverage gap phase and you automatically receive "catastrophic coverage". In this phase, you will only have to pay a small percentage of coinsurance or payment on covered drugs for the rest of the year. All Idaho Part D plans include this coverage.
Costs That Help You Get Catastrophic Coverage
- Your plan's deductible;
- What you paid during the initial coverage limit period;
- Most of the full cost of brand-name drugs (and the manufacturer’s discount) purchased in the coverage gap;
- The amount paid by others, including family members, most charities, and other persons on your behalf; and
- The amount paid by State Pharmaceutical Assistance Programs (SPAPs), AIDS Drug Assistance Programs, and the Indian Health Service.
Most Idaho Medicare Advantage Plans Include Part D Benefits
There are two ways can you get Part D prescription drug benefits. All Medicare prescription drug plans sold in Idaho work with Original Medicare. But, there's a second way to get coverage. Perhaps you would like more benefits that Original Medicare provides. In this case, a Medicare Advantage health plan might be exactly what you're looking for. Most Medicare Advantage in Idaho and Medicare SNP Plans in Idaho include Part D coverage.
Cover Your Original Medicare Gaps with a Medicare Supplement
You already know that Original Medicare does not cover your outpatient medications. That's why you're looking at Part D plans, right? Are also thinking about supplemental Medicare insurance to cover the 20% of Medicare Part A and Part B that come out of your pocket? It's a smart move because major medical bills add up fast. The All Medicare makes it easy to find the lowest rates on Idaho Medicare supplements with our free quoting service. The choice is yours because all Idaho Part D plans are compatible with the full range of Medicare supplement plans.
Medicaid and Your Idaho Medicare Part D Plan
If you are eligible for Medicare and Medicaid (aka "dual eligible", or "Medi-Medi") you may be automatically enrolled in a pre-selected Idaho Medicare Prescription Drug plan and Social Security’s Extra Help program. You must meet strict eligibility requirements to receive Extra Help, which will pay most of your prescription costs. Contact your local Medicaid office for more information.
The 2023 Medicare Part D Plan information for Idaho was last updated by the All Medicare team on