Boise, Idaho-based St. Luke’s Health System will begin offering Medicare Advantage coverage for the first time in 2027, making it one of just a handful of new entrants into the market.
The launch comes as more than a dozen payers nationwide, including several prominent health systems, have made the decision to stop offering MA plans next year as reimbursement pressures and high medical costs have persisted across the industry.
“We’re doing everything internally here to create the best, most seamless experience for Idahoans, and we’ve been building slowly and smartly,” St. Luke’s Health Plan President Matt Wolff told Becker’s. “I think now’s the right time.”
St. Luke’s first launched its health plan in 2023 with individual and employer-based products, growing to around 65,000 members as of this year. The new MA-PD HMO plan will be available in seven counties across Idaho, corresponding with where St. Luke’s and its provider partners have specialists in place for a robust network.
The new plan will also offer $0 copays for primary care visits, outpatient mental health services and preventive care.
“Our basic tenets for how we design plans are to remove barriers wherever possible and make sure people have access to care, so that a financial barrier like a copay isn’t in the way when they have to make really hard decisions,” Mr. Wolff said.
Following the national trends, Idaho’s MA market is shifting next year, with Boise-based Saint Alphonsus Health System exiting the market entirely, while large insurers like UnitedHealthcare and Humana shrink their footprints in the state.
“We have a significant amount of market intelligence that makes us believe now is the right time to go forward with this part of our mission,” Mr. Wolff said. “I think we’re doing it for the right reasons, and definitely for the long haul.”
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