Medicare and Medicaid resources for Idahoans.
Free guides, checklists, and tools for individuals, families, and the professionals who refer them. No jargon, no sales pitch.
Referral Partner Toolkit
Everything a caseworker, guardian, discharge planner, or facility staff member needs to send us a dual-eligible client in eastern Idaho.
Referral intake checklist
What to gather before you send us a client: contact info, Medicaid status, doctors, prescriptions, and deadline.
Fax cover sheet
A ready-to-print cover sheet with our address, phone, and a HIPAA-safe minimal disclosure line.
Quick contact card
Our phone, email, and service areas on one card you can hand to a client or pin at your desk.
How to reach us
- Phone
- (208) 521-3445
- Admin@hometownh.com
- Address
- 3729 Woodking Dr, Idaho Falls, ID 83440
We respond to every referral within one business day. We do not sell annuities or financial products, so we never compete with the professionals who refer to us.
Idaho eligibility guide: 2026
Income and resource limits for the programs that help Idahoans pay for Medicare and Medicaid. Limits change each year; always confirm with Medicare.gov or Idaho Department of Health and Welfare.
| Program | What it pays | Single income | Couple income | Resources |
|---|---|---|---|---|
| QMB | Part A & B premiums, deductibles, coinsurance, copays | Up to ~$1,255/mo | Up to ~$1,704/mo | $9,430 individual / $14,130 couple |
| SLMB | Part B premium only | Up to ~$1,506/mo | Up to ~$2,044/mo | $9,430 individual / $14,130 couple |
| QI | Part B premium only | Up to ~$1,694/mo | Up to ~$2,300/mo | $9,430 individual / $14,130 couple |
| Extra Help (LIS) | Part D premiums, deductibles, and copays | Up to ~$21,870/yr | Up to ~$29,580/yr | $17,200 individual / $34,360 couple |
| Idaho Medicaid expansion | Full Medicaid benefits | Up to ~$1,732/mo | Up to ~$2,351/mo | No asset test |
Enrollment checklists by life event
Medicare and Medicaid deadlines are not forgiving. Use the right checklist so nothing slips.
Turning 65
- Confirm if employer coverage is creditable
- Enroll in Part A and Part B 3 months before your birthday month
- Compare Advantage, Supplement, and Part D plans
- Apply for MSP/Extra Help if income is limited
Losing employer coverage
- Get your termination date in writing
- Confirm if your SEP is 60 days before or after loss of coverage
- Compare COBRA, Marketplace, and Medicare options
- Enroll before the SEP closes
Moving to or within Idaho
- Update your address with Medicare and Medicaid
- Confirm your current plan is available in your new county
- Check if your doctors are in the new network
- Use your SEP to switch if needed
Medicaid or dual-eligible status change
- Verify your new eligibility category
- Confirm if you can enroll in MMCP or a D-SNP
- Check doctor and prescription networks
- Submit the change during the Integrated SEP
Medicare and Medicaid terms, plain English
The words insurance companies love to abbreviate, explained the way we would explain them to a neighbor.
- D-SNP
- Dual Eligible Special Needs Plan. A Medicare Advantage plan designed for people with both Medicare and Medicaid.
- MMCP
- Medicare Medicaid Coordinated Plan. Idaho's integrated program with one plan, one card, and one care coordinator for both programs.
- MSP
- Medicare Savings Program. State-run programs (QMB, SLMB, QI) that help pay Medicare premiums and cost-sharing.
- QMB
- Qualified Medicare Beneficiary. The most generous MSP: pays Part A and Part B premiums, deductibles, coinsurance, and copays.
- SLMB
- Specified Low-Income Medicare Beneficiary. Pays the Part B premium for people with slightly higher income than QMB.
- QI
- Qualifying Individual. Pays the Part B premium at a higher income limit than SLMB.
- LIS / Extra Help
- Low-Income Subsidy. Federal program that lowers Part D prescription drug costs. Automatic if you have any MSP.
- IEP
- Initial Enrollment Period. Your first 7-month window to sign up for Medicare around your 65th birthday.
- AEP
- Annual Enrollment Period. October 15 to December 7, when anyone with Medicare can change Advantage or Part D plans.
- SEP
- Special Enrollment Period. A window outside AEP triggered by life events like moving, losing coverage, or Medicaid changes.
- Original Medicare
- Medicare Part A and Part B run directly by the federal government. You can add a Supplement and Part D plan.
- Medicare Advantage
- Part C. Private plans that bundle Part A, Part B, and usually Part D, with network rules and extra benefits.
- Part D
- Prescription drug coverage. Available as a stand-alone plan or bundled in a Medicare Advantage plan.
- Formulary
- The list of drugs a plan covers and what tier each drug is on. Tiers determine your copay.
- Prior authorization
- Approval your plan must grant before it will cover certain drugs, procedures, or specialist visits.
- Care coordinator
- A nurse or social worker assigned to help you schedule care, find services, and navigate your plan.
Deeper guides on Medicare, Medicaid, and dual-eligible coverage
Written for Idahoans and the professionals who serve them.
Medicare Annual Enrollment in Idaho: What to Do October 15 to December 7
Your Idaho-specific guide to Medicare's Annual Enrollment Period, what you can change, what to compare, and the deadlines that actually matter.
Read postSNAP and Medicare in Idaho: Stacking Benefits for Dual-Eligibles
How SNAP food benefits stack with Medicare and Idaho Medicaid for dual-eligible Idahoans, eligibility, application, and what your D-SNP grocery card covers.
Read postExtra Help (Low Income Subsidy) for Part D in Idaho
How the federal Extra Help program lowers Medicare Part D costs for Idahoans, who qualifies, what it pays, and why dual-eligibles get it automatically.
Read postStill have questions?
Call (208) 521-3445 or book a free 30-minute consultation. We can pre-screen you for eligibility and walk you through your options.