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2027 plans · CMS data

Medicare Special Needs Plans in Idaho

Every Special Needs Plan in Idaho for 2027, from the CMS plan landscape file. You can join one only if you fit its group: Medicare and Medicaid (D-SNP), a qualifying chronic condition (C-SNP) or nursing-home-level care (I-SNP). Pick your county to see the plans sold there.

5D-SNPs for Medicare and Medicaid
4C-SNPs for chronic conditions
2I-SNPs for institutional care
5rated 4+ stars by CMS

Showing all 11 plans.

D-SNPs: Medicare and Medicaid

Sorted by CMS star rating, then by how closely the plan is integrated with Idaho Medicaid, then by worst-case year. If Medicaid or the QMB program pays your Medicare cost sharing, the out-of-pocket maximum matters less than the network and how well the plan works with Medicaid.

#PlanPremium / monthIn-network max out-of-pocketWorst-case yearStars
1 Molina Medicare Complete Care (HMO D-SNP)Molina Healthcare of Utah & Idaho · HMO D-SNPFully integrated (FIDE) · $0 Medicare cost sharing5 of 44 counties $45.50 $9,850 $10,396 3★
2 Molina Medicare Complete Care (HMO D-SNP)Molina Healthcare of Utah & Idaho · HMO D-SNPFully integrated (FIDE) · $0 Medicare cost sharing38 of 44 counties $45.50 $9,850 $10,396 3★
3 UHC Dual Complete ID-YL (HMO-POS D-SNP)UnitedHealthcare · HMO-POS D-SNPFully integrated (FIDE) · $0 Medicare cost sharingAll 44 counties $21.20 $9,850 $10,104 Too new to rate
4 UHC Dual Complete ID-Y1 (HMO-POS D-SNP)UnitedHealthcare · HMO-POS D-SNPFully integrated (FIDE) · $0 Medicare cost sharingAll 44 counties $26.40 $9,850 $10,167 Too new to rate
5 UHC Dual Complete ID-QV1 (HMO-POS D-SNP)UnitedHealthcare · HMO-POS D-SNPCoordination-onlyAll 44 counties $0 $9,850 $9,850 Too new to rate

C-SNPs: chronic conditions

Sorted by worst-case year: 12 months of premiums plus the in-network out-of-pocket maximum. Each plan lists the conditions it serves; you need one of them, confirmed by your doctor or another clinician, to join.

#PlanPremium / monthIn-network max out-of-pocketWorst-case yearStars
1 UHC Complete Care ID-12 (HMO-POS C-SNP)UnitedHealthcare · HMO-POS C-SNPCardiovascular disorders, Chronic heart failure, Diabetes7 of 44 counties $0 $7,150 $7,150 4★
2 UHC Complete Care ID-13 (HMO-POS C-SNP)UnitedHealthcare · HMO-POS C-SNPCardiovascular disorders, Chronic heart failure, Diabetes17 of 44 counties $0 $7,150 $7,150 4★
3 HumanaChoice - Diabetes and Heart (PPO C-SNP)Humana · PPO C-SNPCardiovascular disorders, Chronic heart failure, Diabetes7 of 44 counties $0 $9,850 $9,850 4.5★
4 UHC Complete Care Support ID-1A (PPO C-SNP)UnitedHealthcare · PPO C-SNPCardiovascular disorders, Chronic heart failure, Diabetes42 of 44 counties $45.40 $9,850 $10,395 4.5★

I-SNPs: institutional care

For people who live, or are expected to live, at least 90 days in a nursing home or similar facility, or who need that level of care at home. Sorted by worst-case year.

#PlanPremium / monthIn-network max out-of-pocketWorst-case yearStars
1 American Health Advantage of Idaho (HMO I-SNP)American Health Advantage of Utah · HMO I-SNPHybrid (at home or in a facility)10 of 44 counties $45.50 $7,250 $7,796 Not rated
2 UHC Nursing Home Plan ID-F1 (PPO I-SNP)UnitedHealthcare · PPO I-SNPFacility-based1 of 44 counties $21.60 $9,850 $10,109 5★

Worst-case year = 12 × monthly plan premium + in-network maximum out-of-pocket, for covered Part A and B services. Many D-SNP members pay $0 in premiums with Extra Help. Star ratings are CMS’s 2027 overall ratings for the contract behind each plan. Plans under CMS sanction aren’t listed. How we sort

Before you enroll: check the plan’s network and drug list in the official Medicare Plan Finder, and ask the plan whether you qualify. Free one-on-one help: your State Health Insurance Assistance Program.

Questions

How many Special Needs Plans are in Idaho for 2027?

CMS lists 11: 5 D-SNPs (Medicare and Medicaid), 4 C-SNPs (chronic conditions) and 2 I-SNPs (institutional), from 4 parent companies. Not every plan is sold in every county; use the county filter.

Which D-SNPs in Idaho are integrated with Medicaid?

4 of the 5 D-SNPs are fully integrated, highly integrated or applicable integrated plans, which cover or coordinate Medicaid benefits more closely. The rest are coordination-only plans. Integrated plans are listed first among plans with the same star rating.

Do Special Needs Plans include drug coverage?

Yes. Every Special Needs Plan must include Part D drug coverage.

Can I stay in a Special Needs Plan if I no longer qualify?

Only while you still meet the plan's rules. If you lose eligibility, you may get a Special Enrollment Period to join another plan.

Sources

  1. CMS, CY 2027 Medicare Advantage and Prescription Drug Plan Landscape (CY2027_Landscape_202609.csv), Special Needs Plan rows — cms.gov; star ratings from the CMS 2027 Star Ratings Data Tables — cms.gov.
  2. Medicare.gov, “Special Needs Plans” — medicare.gov.

Educational information, not a recommendation to join any plan. We are not an insurance agent or broker, and we are not connected with or endorsed by the U.S. government or the federal Medicare program. Plan details can change; confirm with the plan or Medicare.gov. · Advertiser disclosure

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