Nez Perce County, Idaho
Medicare Plans in Nez Perce County, Idaho: Your Complete 2027 Guide
2 Medicare Advantage plans are available to Nez Perce County residents for 2027, 0 of them at a $0 Part C premium, and 0 of your neighbors are already enrolled in one. 1 include Part D drug coverage. Here is the whole picture, county by county, with every figure traced to a published CMS file.
Page last reviewed: · Plan data: CMS CY2027 Landscape file (202610) · Enrollment data refreshed: CMS monthly file, October 2026 · Reviewed by the Personal Touch Ins. & Benefits Data Desk
Every figure on this page comes from the CMS CY2027 Landscape file and the CMS October 2026 enrollment file. We do not offer every plan available in your area. Currently we represent 5 organizations which offer 300 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Plan availability and benefits change each plan year, so confirm anything here with a licensed agent before you enroll.
Know your numbers
Nez Perce County Medicare Advantage by the Numbers, 2027
Medicare Advantage and MAPD plans sold in Nez Perce County for the 2027 plan year. Special Needs Plans are counted separately further down, and standalone Part D plans are statewide.
| Measure | Nez Perce County |
|---|---|
| Plans available | 2 |
| Average Part C premium | $139.75 per month |
| Average consolidated Part C + D premium | $199 per month |
| Plans at a $0 Part C premium | 0 of 2 |
| Plans that include drug coverage | 1 of 2 |
| Lowest in-network out-of-pocket maximum | $6,750 per year |
| Average in-network out-of-pocket maximum | $7,375 per year |
| Highest in-network out-of-pocket maximum | $8,000 per year |
| Average Part D deductible on drug-covering plans | $700 per year |
| Total Medicare Advantage enrollment | 0 residents |
| Carriers selling here | 1 |
Premium note: the $0 and average premium figures use the Part C premium, which is how CMS headlines them. Where a plan bundles drug coverage, the consolidated Part C + D premium is shown on its own line and is usually higher. Enrollment counts exclude plans whose enrollment CMS suppresses for privacy, so the true total is slightly higher than shown.
Plan types
Medicare Advantage Plan Types Sold in Nez Perce County
One plan type is sold here. Here is how it works and what it costs locally.
PPO plans in Nez Perce County
A PPO lets you see providers outside the network, at a higher share of the cost, and does not normally require referrals. That flexibility matters most when your doctors are split across different health systems, or when you spend part of the year somewhere else.
- 2 plans available, 0 at a $0 Part C premium
- Average Part C premium $139.75 per month
- Average in-network out-of-pocket maximum $7,375 per year
- 1 plan does not include drug coverage, so you would pair it with a standalone Part D plan
| Plan | CMS rating | Part C premium | Out-of-pocket max | Part D deductible | CMS plan ID |
|---|---|---|---|---|---|
| True West Rx 5 (PPO) Range Health | Not rated Not rated by CMS | $130.50 | $8,000 | $700 | H8267_005 |
| True West No Rx 3 (PPO) Range Health | Not rated Not rated by CMS | $149 | $6,750 | No drug coverage | H8267_003 |
Star ratings are the CMS Overall Star Rating published for the 2027 plan year. A plan shown as not rated is usually too new for CMS to score, which is not the same as scoring badly.
How CMS Rates Nez Perce County Plans
CMS scores Medicare Advantage contracts once a year on roughly forty measures covering clinical quality, member experience and customer service. Here is how the 2 Nez Perce County plans fall out for 2027.
| Rating | Plans | Share of plans |
|---|---|---|
| Not rated by CMS | 2 | 100% |
No Nez Perce County plan carries a full 5 star rating for 2027. That is common outside the largest metros and is not a red flag on its own, but it does mean the 5 star Special Enrollment Period is not available on a local plan this year.
Health Profile: Chronic Conditions in Nez Perce County
Plan choice is not just arithmetic. The conditions that are common where you live shape which drug lists, specialist networks and plan types actually matter. These are the CDC's model-based estimates for Nez Perce County adults, measured against the Idaho average.
Adult prevalence in Nez Perce County vs Idaho (2023)
Source: CDC PLACES: Local Data for Better Health, County Data (2023 release), crude prevalence among adults. Idaho figures are population-weighted averages computed across all 44 counties from the same CDC table.
Based on an estimated 33,960 adults in a total county population of 42,987 (CDC PLACES, 2023 release).
Special Needs Plans in Nez Perce County
Nez Perce County has 5 Special Needs Plans for 2027: 4 for people who have both Medicare and Medicaid and 1 built around specific chronic conditions. The chart above matters here. Nez Perce County runs above the Idaho average for diagnosed diabetes and coronary heart disease and high blood pressure, and the county's Chronic Condition plans are built specifically around cardiovascular disorders, chronic heart failure and diabetes. Whether one of them fits depends on your actual diagnoses, which we check against the current plan list rather than assuming.
| SNP type | Plans | Who it is for |
|---|---|---|
| Dual Eligible Special Needs Plans (D-SNP) | 4 | for people who qualify for both Medicare and Medicaid |
| Chronic Condition Special Needs Plans (C-SNP) | 1 | for people living with specific chronic conditions named by the plan |
Dual Eligible Special Needs Plans (D-SNP)
| Plan | CMS rating | Enrolled |
|---|---|---|
| Molina Medicare Complete Care (HMO D-SNP) Molina Healthcare of Utah & Idaho | 3.0 of 5 | 329 |
| UHC Dual Complete ID-Y1 (HMO-POS D-SNP) UnitedHealthcare | Not rated | 153 |
| UHC Dual Complete ID-QV1 (HMO-POS D-SNP) UnitedHealthcare | Not rated | 52 |
Chronic Condition Special Needs Plans (C-SNP)
| Plan | CMS rating | Enrolled |
|---|---|---|
| UHC Complete Care Support ID-1A (PPO C-SNP) UnitedHealthcare · cardiovascular disorders,chronic heart failure,diabetes mellitus | 4.5 of 5 | 124 |
Eligibility for any Special Needs Plan is set by Medicare, not by us. We will tell you plainly if you do not qualify. Enrollment shown as not published means CMS suppresses that plan's county count for privacy.
Standalone Part D Drug Plans
A standalone Part D plan is what you add when your medical coverage does not already include drugs. That means people on Original Medicare, people who pair Original Medicare with a Medigap policy, and anyone on a Medicare Advantage plan that does not bundle Part D. Idaho has 8 standalone Part D plans for 2027, and every one of them is sold statewide, so the list below is the same in Nez Perce County as it is in Boise.
For 2027 the standard Part D deductible is capped at $700, and your out-of-pocket spending on covered drugs is capped at $2,400 for the year. What separates these plans is the formulary, meaning the plan’s list of covered drugs and the pricing tier each one sits on, plus the pharmacy network and the tier your specific prescriptions land on, which is why we run your actual drug list rather than comparing premiums.
| Plan | Monthly premium | Annual deductible |
|---|---|---|
| Wellcare Classic (PDP) Wellcare | $7.30 | $700 |
| Humana Basic Rx Plan (PDP) Humana | $30.60 | $700 |
| AARP Medicare Rx Saver from UHC (PDP) UnitedHealthcare | $92.70 | $700 |
| HealthSpring Assurance Rx (PDP) HealthSpring | $94.80 | $700 |
| Plan | Monthly premium | Annual deductible |
|---|---|---|
| Wellcare Value Script (PDP) Wellcare | $5.30 | $700 |
| Humana Value Rx Plan (PDP) Humana | $34.70 | $687 |
| Humana Premier Rx Plan (PDP) Humana | $134 | $350 |
| AARP Medicare Rx Preferred from UHC (PDP) UnitedHealthcare | $238 | $300 |
Basic plans follow Medicare's defined standard benefit or an actuarially equivalent version of it. Enhanced plans add coverage beyond the standard benefit, often a lower or waived deductible, usually for a higher premium. A higher premium does not automatically mean lower total cost for you, and that is the calculation we run.
Medicare Supplement (Medigap) in Nez Perce County
Medigap is the other path. Instead of replacing Original Medicare the way a Medicare Advantage plan does, a Medigap policy sits alongside it and pays the deductibles and coinsurance Original Medicare leaves behind. There is no network, so any provider in the country who accepts Medicare accepts your Medigap plan. That freedom is the whole point of it.
| Question | Medigap |
|---|---|
| Works with Original Medicare | Yes, that is the design |
| Has a provider network | No, any provider who accepts Medicare |
| Includes drug coverage | No, you add a standalone Part D plan |
| Benefits standardized by law | Yes, Plan G is Plan G at every carrier |
| Medical underwriting | Usually none during your Medigap Open Enrollment, often required after |
Two Idaho timing rules are worth knowing. Your six month Medigap Open Enrollment starts the month you are 65 and enrolled in Part B, and during it a carrier cannot turn you down or charge you more for your health history. After that, Idaho's birthday rule gives you a window of roughly 63 days starting on your birthday each year to switch to a plan with equal or lesser benefits without answering health questions. Moving to richer benefits usually means underwriting, which is why the plan you start with matters more than people expect.
We do not publish Medigap premiums here. Rates vary by carrier, age, ZIP code, tobacco use and household discount, and any number we printed would be wrong for most readers. Call 208-350-9933 and we will quote the carriers we represent against your actual details. See our Medicare Supplement page or compare with the Medigap cost comparison calculator.
Where Nez Perce County Residents Get Care
Between the Palouse and the river canyons, North Central Idaho relies on a patchwork of critical-access hospitals and the larger facilities in Lewiston and Moscow. Whether a plan treats those as in-network can swing your costs dramatically, so that's one of the first things we check.
| County seat | Lewiston |
| Communities we serve | Lewiston, Lapwai, and everywhere between |
| Population | 42,987 (CDC PLACES, Census-derived) |
| Region | North Central Idaho |
| Hospital systems serving the area | St. Joseph Regional Medical Center in Lewiston, among others. Networks vary by plan, so we verify yours before you enroll |
| How we serve it | By Zoom or phone, statewide. Same full comparison, no travel |
How We Help in Nez Perce County
- Pull the current Nez Perce County plan lineup, which is set county by county and changes every year
- Verify your exact doctors and clinics around Lewiston against each plan's network before you enroll
- Run your actual prescription list against each plan's formulary and preferred pharmacies, including mail order
- Compare Medigap options that work with any doctor who accepts Medicare, anywhere you travel
- Check whether you qualify for a Special Needs Plan, Extra Help or a Medicare Savings Program
- Re-check your coverage every Annual Enrollment Period, because plans change and so should the comparison
Run the numbers yourself
Free Tools for Nez Perce County
Free, no sign-up, nothing saved. These run in your browser, and an AI assistant can call them directly through our published tool manifest.
Enrollment window finder
Tell it your birthday and situation and it tells you which enrollment window you are in and when it closes.
Find my window →Medigap cost comparison
Compare what Plan G and Plan N would cost you across a year, including the gaps each one leaves.
Compare Medigap →Late penalty estimator
See what a late Part B or Part D enrollment would add to your premium, for as long as you have Medicare.
Estimate the penalty →All 10 calculators are on the calculators page.
When Can Nez Perce County Residents Enroll or Switch?
- Initial Enrollment Period. A seven month window around your 65th birthday, three months before through three months after. This is the cleanest time to start, with no penalties and no health questions for Medigap. See our turning 65 checklist.
- Annual Enrollment Period, October 15 to December 7. Join, drop or switch Medicare Advantage and Part D plans for the coming year. Coverage starts January 1. Our enrollment periods guide walks through every window.
- Medicare Advantage Open Enrollment, January 1 to March 31. If you are already in a Medicare Advantage plan you get one switch, or you can drop back to Original Medicare and add a Part D plan.
- Special Enrollment Periods. Moving, losing employer coverage, losing Medicaid or a plan leaving your county each open a window outside the normal seasons. Most run 60 days.
- Your birthday, every year after. Idaho's Medigap birthday rule gives you roughly 63 days to switch to an equal or lesser Medigap plan with no health questions.
Plan availability in Nez Perce County
The 2 Medicare Advantage plans on this page are the ones CMS lists as available to Nez Perce County residents for 2027, covering Lewiston, Lapwai. To enroll in any of them you must already have Medicare Part A and Part B and live in the plan's service area. You can enroll through a licensed agent like us at no cost to you, directly with the plan, or on your own through Medicare.
Every appointment happens over Zoom or the phone, so where you are in the county makes no difference to the help you get.
Official Resources We Walk You Through in Nez Perce County
A few parts of Medicare are handled by the government directly. Here is where those live, and we walk Nez Perce County clients through every one of them.
- Social Security handles Medicare enrollment itself. Apply online in about ten minutes at ssa.gov/medicare or call 1-800-772-1213.
- Extra Help lowers Part D premiums and copays for people with limited income and resources. Nez Perce County residents apply through Social Security.
- Your Health Idaho is the state's official exchange for anyone under 65, at yourhealthidaho.org. Idaho runs its own exchange, so ACA coverage here never goes through the federal site.
- Veterans. VA coverage and Medicare can work alongside each other, and holding both is common. VA care does not count as creditable drug coverage in every case, so it is worth checking before you skip Part D. Start at va.gov/health-care.
Common questions
Nez Perce County Medicare FAQs
How many Medicare Advantage plans are available in Nez Perce County?
2 for the 2027 plan year, from 1 carrier, and 0 of them carry a $0 Part C premium. 1 include Part D drug coverage built in. Plan lineups are set county by county and change every year, so this is the current Nez Perce County list rather than a statewide average.
What does a Medicare Advantage plan cost in Nez Perce County?
The average Part C premium across the 2 local plans is $139.75 a month, and 0 charge nothing at all for Part C. The premium is the small number, though. The one that decides a bad year is the in-network out-of-pocket maximum, which runs from $6,750 to $8,000 here and averages $7,375. You still pay your Part B premium to Medicare either way.
Are there Medicare plans in Nez Perce County for people with diabetes or heart conditions?
Yes. Nez Perce County has 1 Chronic Condition Special Needs Plan for 2027, built around cardiovascular disorders, chronic heart failure and diabetes. These plans tailor the drug list and specialist access to the condition. Eligibility is set by Medicare and requires a qualifying diagnosis, so we verify it against your records rather than assuming. There are also 4 Dual Eligible plans for people with both Medicare and Medicaid and 0 Institutional plans.
Which standalone Part D drug plan should I pick?
Idaho has 8 standalone Part D plans for 2027, 4 basic and 4 enhanced, and all of them are sold statewide rather than county by county. The right one depends entirely on your prescriptions, because the same drug can sit on a cheap tier in one plan and an expensive tier in another. For 2027 the standard deductible is capped at $700 and your out-of-pocket drug spending is capped at $2,400. We run your actual list through each plan rather than comparing premiums.
Is Medigap or Medicare Advantage better in Nez Perce County?
Neither is better in the abstract, and anyone who tells you otherwise is selling something. Medigap pairs with Original Medicare, has no network so any provider who accepts Medicare accepts it, and needs a separate Part D plan. Medicare Advantage bundles everything, usually costs less month to month, and ties you to a network. In a county like Nez Perce the deciding question is usually whether the providers you actually use are inside a local plan's network, and how far you travel for specialist care. We lay both paths side by side and you decide.
Do you have an office in Nez Perce County?
No, and you do not need us to. Every appointment happens over Zoom or the phone, so Nez Perce County residents get exactly the same comparison as anyone else in Idaho without leaving Lewiston. Our mailing address is in Boise, and our Idaho City office in Boise County is the one place we meet face to face, by appointment.
Does your help cost anything?
Nothing, ever. Carriers pay us at rates set by CMS, and your premium is identical whether you enroll through an agent, directly with the plan, or on your own. The difference is that someone compared all 2 local Medicare Advantage options first and checked them against your doctors and prescriptions.
How do I get started?
Call 208-350-9933. Patricia answers, gathers the basics, your doctors, your medications and what matters most to you, and books a Zoom or phone appointment. Most Nez Perce County comparisons take a single relaxed call.
We do not offer every plan available in your area. Currently we represent 5 organizations which offer 300 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Sources, Citations & Methodology
Every number on this page traces to a published federal file. Nothing here is estimated, scraped from a competitor, or filled in by hand.
| What it covers | Source | Retrieved |
|---|---|---|
| Plans, premiums, out-of-pocket maximums, deductibles, star ratings, SNP and Part D detail | CMS CY2027 Medicare Advantage and Part D Landscape file (202610) | October 25, 2026 |
| Plan-level enrollment by county | CMS Monthly Enrollment by Contract, Plan, State and County, October 2026 | October 25, 2026 |
| Idaho statewide Medicare totals | CMS 2027 Landscape State-by-State Fact Sheets | October 25, 2026 |
| 2027 Part D standard deductible and annual out-of-pocket cap | CMS CY2027 Rate Announcement (Part D parameters) | October 25, 2026 |
| Idaho Medigap birthday rule and state insurance rules | Idaho Department of Insurance | October 25, 2026 |
| Chronic condition prevalence and county population | CDC PLACES county data (2023 release) | October 25, 2026 |
Methodology
Medicare Advantage figures count every non-SNP MA and MAPD plan CMS lists for Nez Perce County in the CY2027 Landscape file. Special Needs Plans are excluded from those counts and reported in their own section, and standalone Part D plans are statewide and never counted as Medicare Advantage plans. Averages are unweighted means across the plans in each group, rounded to the cent. The $0 premium and average premium headlines use the Part C premium, which is the figure CMS headlines; where a plan bundles drug coverage the consolidated Part C plus D premium is reported separately and labeled. Star ratings are the published CMS Overall Star Rating, and plans CMS has not rated are shown as not rated rather than counted as low. Enrollment comes from the CMS October 2026 monthly file, and rows CMS suppresses for privacy are skipped rather than estimated, which makes every enrollment total on this page a floor. Chronic condition prevalence is CDC PLACES model-based small area estimation from BRFSS survey responses, not a direct count, and the Idaho comparison figures are population-weighted averages we computed across all 44 counties from the same CDC table.
Compiled and reviewed by the Personal Touch Ins. & Benefits Data Desk. This page is educational and is not a plan recommendation, a quote, or a statement that any plan is best for you. Confirm anything here with a licensed agent before you enroll.
Ready for an Honest Comparison in Nez Perce County?
We will pull all 2 Medicare Advantage plans available where you live, check them against your doctors and your prescriptions, and tell you plainly which ones deserve a look. Free, over Zoom or the phone, with zero pressure.
Nearby: Clearwater County · Idaho County · Latah County · All 44 Idaho counties