Best Medicare Advantage Plans in Idaho (2026)

Key Takeaways

Idaho has 27 Medicare Advantage plans available from five providers across HMO, HMO-POS and PPO network structures with premiums from $0 to $153 per month.

UnitedHealthcare is the best Medicare Advantage provider in Idaho for PPO and HMO-POS plans, while Saint Alphonsus Health Plan ranks best for HMO plans.

When choosing a Medicare Advantage plan in Idaho, consider which doctors and specialists you want to use, the prescription medications you take and how much you’re willing to spend on monthly premiums and out-of-pocket costs.

Best Medicare Advantage Providers in Idaho

We evaluated the best Medicare Advantage plans in Idaho based on CMS star ratings, monthly premiums, and maximum out-of-pocket limits to identify top-performing providers offering the best combination of value and coverage.

Saint Alphonsus Health Plan leads the Idaho market for HMO coverage, offering $0 monthly premiums and a strong 4.0-star rating. UnitedHealthcare provides the top HMO-POS and PPO options in the state, combining affordable premiums with competitive out-of-pocket limits and access to a broader network of providers.


HMO	Saint Alphonsus Health Plan	4.00	$0	$6,700	Saint Alphonsus Health Plan No Premium (HMO)
HMO-POS	UnitedHealthcare	4.00	$39	$6,247	AARP Medicare Advantage from UHC ID-0005 (HMO-POS)
PPO	UnitedHealthcare	4.00	$22	$6,983	AARP Medicare Advantage from UHC ID-0003 (PPO)

Medicare Advantage Plans Explained

Medicare Advantage plans offer an alternative to Original Medicare by bundling hospital and medical coverage through private insurance companies. These plans include extra benefits like dental, vision, and prescription drug coverage that traditional Medicare doesn't provide.

CMS Star Ratings: Medicare scores these plans from 1 to 5 stars based on care quality and member satisfaction. Plans with 4 or 5 stars show they deliver better overall service and health outcomes.
Monthly premiums: You'll pay your regular Part B premium plus any extra costs your specific plan charges. Many Medicare Advantage plans in the Gem State offer $0 additional monthly premiums.
Maximum out-of-pocket (MOOP) limits: This yearly cap protects you from endless medical bills. Once you hit this amount, your plan pays 100% of covered services for the rest of the year.
Prescription drug coverage: Most Medicare Advantage plans include Part D medication benefits automatically. Check that your current prescriptions appear on the plan's approved drug list before enrolling.

Saint Alphonsus Health Plan

Best HMO

MoneyGeek Rating

4.3/ 5

4/5Affordability

5/5Quality

2.5/5Availability

CMS Star Rating
4.0
Plan Types
HMO

pros
- All plans earn 4.0-star CMS rating
- All plans have $0 monthly premium
- Enhanced Part D drug coverage in all plans
cons
- Does not offer PPO or HMO-POS options
- Out-of-pocket maximums up to $7,900
Saint Alphonsus Health Plan's two HMO options both earn a 4-star CMS rating and charge $0 monthly premiums in Idaho. The provider's network focuses on strong local relationships, averaging $6,700 in out-of-pocket maximums. Both plans include enhanced Part D drug coverage, giving members comprehensive prescription benefits.

UnitedHealthcare

Best HMO-POS

MoneyGeek Rating

5/ 5

5/5Affordability

5/5Quality

5/5Availability

CMS Star Rating
4.0
Plan Types
HMO-POS, PPO

pros
- Three plans with $0 monthly premium
- All plans have 4.0 CMS star rating
- Out-of-network provider access
cons
- No HMO plans
- Higher costs for out-of-network care
- Higher MOOP limits
UnitedHealthcare is a top Medicare Advantage provider, offering nine AARP-branded plans with 4-star CMS ratings across its HMO-POS and PPO options. The company's four PPO plans have premiums from $0 to $44 and MOOP limits between $5,900 and $7,900, with the ID-0003 PPO standing out at $0 monthly and a $6,700 MOOP.

Its five HMO-POS plans range from $0 to $74 monthly, with three plans capping MOOP at $5,900. The $0 premium HMO-POS options ID-0009 and ID-0008 match the top PPOs’ $6,700 out-of-pocket limit. All plans include enhanced Part D prescription coverage with no deductible.

Best Idaho HMO Medicare Advantage Providers

Most of Idaho’s 10 HMO Medicare Advantage plans charge monthly premiums, though four options are available at $0 per month. Seniors can choose from three providers, with out-of-pocket maximums ranging from $5,500 to $7,900 and averaging $6,160 annually. Plan quality is moderate, averaging 3.5 stars, with two plans earning 4 stars or higher. All 10 plans include enhanced Part D prescription drug coverage.

Saint Alphonsus Health Plan leads Idaho’s HMO market with a 4.0-star rating, offering two $0 premium plans with an average $6,700 MOOP.
Humana has two plans with $0 monthly premiums and $6,400 MOOP, though the CMS rating is 3.0 stars.
Blue Cross Blue Shield delivers the greatest variety with six plans averaging $99 per month, 3.5-star ratings, and $5,900 MOOP limits.


Saint Alphonsus Health Plan	4.00	$0	$6,700	2	4.25
Humana	3.00	$0	$6,400	2	4.11
Blue Cross Blue Shield	3.50	$99	$5,900	6	4.09

HMO PROS AND CONS

HMO Medicare Advantage plans require you to stay within a provider network and get referrals for specialists. You'll pay lower premiums and out-of-pocket costs while getting coordinated care through your primary doctor. These plans suit Idaho residents who want predictable health care expenses.

Best Idaho HMO-POS Medicare Advantage Providers

HMO-POS plans in Idaho are attractive for seniors who want out-of-network access, with seven plans available from two providers. Only two plans offer $0 monthly premiums, while the average premium is $39. Out-of-pocket maximums range from $5,900 to $6,700, averaging $6,342 annually, providing extra protection for members who occasionally need care outside the network. All plans include enhanced Part D prescription coverage and feature an average 3.86-star CMS rating.

UnitedHealthcare leads Idaho’s HMO-POS market with five plans averaging $6,247 MOOP and 4.0-star ratings.
PacificSource Medicare offers two plans with $52 monthly premiums, $6,687 MOOP, and a 3.5-star CMS rating.


UnitedHealthcare	4.00	$39	$6,247	5	5.00
PacificSource Medicare	3.50	$52	$6,687	2	3.25

HMO-POS PROS AND CONS

If you want affordable Medicare coverage but need to see doctors outside your network, HMO-POS plans might work for you. These plans keep most HMO cost benefits while letting you visit out-of-network providers when necessary, though you'll pay higher costs.

Best Idaho PPO Medicare Advantage Providers

Idaho has 10 PPO options from just two providers, averaging $27 per month, with four plans offering $0 premiums. Out-of-pocket maximums are higher than other plan types, averaging $6,915 and ranging from $5,900 to $8,800. Star ratings average 3.9, with most plans earning 3.5 stars. All plans include enhanced Part D prescription coverage and waive deductibles on select medication tiers.

UnitedHealthcare has the best Medicare Advantage PPO plans in Idaho, with four plans averaging $22 per month and featuring $6,983 MOOP limits and 4.0-star CMS ratings.
Humana offers six plans at $48 monthly with an average 3.7-star rating and $6,984 average MOOP.


UnitedHealthcare	4.00	$22	$6,983	4	5.00
Humana	3.70	$48	$6,984	6	3.50

PPO PROS AND CONS

PPO Medicare Advantage plans provide maximum flexibility, letting you visit any Medicare-approved doctor without referrals and giving you access to both in-network and out-of-network care. You'll pay higher monthly premiums and out-of-pocket maximums than more restrictive plan types, but you get complete freedom to manage your health care.

How to Find the Best Idaho Medicare Advantage Plans

When shopping for the best Medicare Advantage plan in Idaho, consider your health care needs, medication coverage and total costs.

1
Check Your Doctor and Hospital Network
Verify that your current doctors, specialists and hospitals are part of the plan's network. HMO plans require referrals for specialists, while PPOs offer more flexibility in choosing providers. Learn more about health insurance network types.
2
Compare Maximum Out-of-Pocket Costs
Look beyond the monthly premium to understand the maximum out-of-pocket costs. This is the total amount you could pay for covered services in a year. A plan with a $0 premium but $7,833 MOOP could cost more than one with a $29 premium and $6,750 MOOP if you need frequent medical care.
3
Review Prescription Drug Coverage
Review the plan's prescription drug coverage to see if your medications are included. Pay attention to the tier placement of your drugs, as this can affect your out-of-pocket costs for prescriptions. Most Medicare Advantage plans include Part D drug coverage, though some require separate enrollment.
4
Evaluate Additional Benefits
Evaluate any additional benefits, such as dental, vision, hearing, fitness programs or transportation services.
5
Consider CMS Star Ratings
Consider the CMS star ratings when selecting a Medicare Advantage plan, as they reflect the quality of care and customer satisfaction. Plans are rated on a scale of one to five stars, with higher ratings indicating better performance.

Average Idaho Medicare Advantage Cost

Network structure determines costs in Idaho's Medicare Advantage market. Plans with restricted networks keep monthly premiums and out-of-pocket expenses lower than plans offering broader provider access.

PPO plans offer the most affordable monthly costs at $24 median premium but carry the highest risk with $6,915 average maximum out-of-pocket expenses. HMO plans cost $38 monthly but provide better financial protection with $6,160 average MOOP limits. HMO-POS plans sit in the middle at $57 median monthly premium and $6,343 MOOP, adding some out-of-network flexibility for the extra cost.


HMO	$38	$50	$6,160
HMO-POS	$57	$39	$6,343
PPO	$24	$27	$6,915

Best Idaho Medicare Advantage: FAQ

Get answers about Idaho Medicare Advantage plans:

When can I enroll in a Medicare Advantage plan in Idaho?

In Idaho, you can enroll during the Annual Enrollment Period from Oct. 15 to Dec. 7, or during the Open Enrollment Period from Jan. 1 to March 31. You may also qualify for a Special Enrollment Period if you experience qualifying life events like relocating or losing other coverage.

Does Medicare Advantage cover prescription drugs in Idaho?

Yes, most Medicare Advantage plans in Idaho provide prescription drug coverage as part of their benefits package. Before enrolling, confirm your medications appear on the plan's formulary and review their tier levels, which directly impact your out-of-pocket costs at the pharmacy.

Do I need to change Medicare Advantage plans if I move to a different county in Idaho?

You may need to switch plans since Medicare Advantage networks differ by county. Notify your current insurer within 30 days of relocating to understand your coverage options. You'll qualify for a Special Enrollment Period, allowing you to select a new plan that serves your new area.

Our Methodology: How We Chose the Best Idaho Medicare Advantage Plans

We analyzed Medicare Advantage plans in Idaho using three core criteria:

Affordability (50%): Costs represent half the total score due to their immediate effect on your spending. We analyzed combined monthly premiums for Part C and Part D coverage (weighted at 30%) and in-network maximum out-of-pocket limits (weighted at 20%). Plans with lower premiums and MOOP thresholds score higher by reducing annual health care expenses.
Star Ratings (40%): CMS star ratings evaluate plan performance in care quality, customer service and member experience. The Overall Star Rating merges Part C (medical benefits) and Part D (prescription drug coverage) scores into one rating on a 1 to 5-star scale. Higher-rated plans score better in our evaluation.
Availability (10%): We consider each insurer's geographic presence across the United States. Providers serving more states score higher, as broader availability indicates more robust infrastructure, better support and better continuity if you relocate.

These factors create a fair comparison of Medicare Advantage plans, weighing costs against care quality and service.

About Mark Fitzpatrick

Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. He has analyzed the insurance market for over five years, conducting original research for insurance shoppers. His insights have been featured in CNBC, NBC News and Mashable.

Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!

He writes about economics and insurance, breaking down complex topics so people know what they're buying.

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