Medicare Resources & FAQ

Question 1

What is Medicare?

Accepted Answer

Medicare is a federal health insurance program primarily for people 65 and older, as well as certain younger people with disabilities. It is divided into parts: Part A (hospital), Part B (medical), Part C (Medicare Advantage), and Part D (prescription drugs).

Question 2

When can I enroll in Medicare?

Accepted Answer

Your Initial Enrollment Period (IEP) is a 7-month window that starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. Missing this window without qualifying for a Special Enrollment Period can result in late enrollment penalties. There are additionally special circumstances where those under the age of 65 can also enroll — those individuals will have ALS, End Stage Renal Disease (ESRD), or have been on Social Security Disability Income for 2 years or longer (SSDI). Not to worry, Matt can assist you in determining whether or not you're eligible for what's known as a Special Election Period.

If you miss your Initial Enrollment Period without a qualifying reason, you may face a late enrollment penalty for Part B (10% per 12-month period you were eligible but didn't enroll) and Part D (1% per month). These penalties are typically permanent.

Question 3

Is Medicare free?

Accepted Answer

Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes for at least 10 years. Part B has a standard monthly premium (set annually by the government). Part C and Part D premiums vary by plan.

Question 4

What happens if I miss my enrollment window?

Accepted Answer

If you miss your Initial Enrollment Period without a qualifying reason, you may face a late enrollment penalty for Part B (10% per 12-month period you were eligible but didn't enroll) and Part D (1% per month). These penalties are typically permanent.

Question 5

What is the difference between Medicare Advantage and Medicare Supplement?

Accepted Answer

Medicare Advantage (Part C) replaces Original Medicare with a private plan that bundles Parts A, B, and usually D. Medicare Supplement (Medigap) works alongside Original Medicare to help cover out-of-pocket costs like copays, coinsurance, and deductibles. They serve different needs — the right choice depends on your health, budget, and preferences.

Question 6

Can I have both Medicare Advantage and a Medicare Supplement plan?

Accepted Answer

No. Medicare Supplement plans are designed to work with Original Medicare only. If you're enrolled in a Medicare Advantage plan, you cannot use a Medigap policy.

Question 7

Which is better — Medicare Advantage or Medicare Supplement?

Accepted Answer

Neither is universally better. Medicare Advantage plans often have lower premiums but include networks and cost-sharing. Medicare Supplement plans offer more predictable costs and broader provider access but typically have higher premiums. We help you compare both based on your specific situation.

Question 8

Do I need a Part D plan?

Accepted Answer

If you have Original Medicare and don't have other creditable drug coverage (like from an employer), enrolling in a Part D plan when you're first eligible is strongly recommended. Going without coverage for an extended period can result in a permanent late enrollment penalty.

Question 9

How do I know which Part D plan covers my medications?

Accepted Answer

Each Part D plan has a formulary — a list of covered drugs. Plans vary significantly in which drugs they cover and at what cost. We can run a side-by-side comparison of plans based on your specific medications and preferred pharmacy.

Question 10

What does "Dual Eligible" mean?

Accepted Answer

Dual Eligible means you qualify for both Medicare and Medicaid. If you're dual eligible, you may have access to special plans called D-SNPs (Dual Eligible Special Needs Plans) that coordinate both benefits and often include extra coverage.

Question 11

What is the Extra Help program?

Accepted Answer

Extra Help (also called the Low Income Subsidy or LIS) is a federal program that helps people with limited income and resources pay for Part D prescription drug costs — including premiums, deductibles, and copays. Many people who qualify don't know they're eligible. More people qualify than you might think. Matt can assist you in applying for these benefits.

Question 12

What are Medicare Savings Programs in Idaho?

Accepted Answer

Idaho offers Medicare Savings Programs (MSPs) that help pay Medicare premiums, and in some cases deductibles and coinsurance, for people who meet income and resource limits. There are four levels: QMB, SLMB, QI, and QDWI. We can help you understand if you qualify.

Question 13

Does it cost anything to work with Idaho Medicare Resource Center?

Accepted Answer

No. Our services are always at no cost to you. We are compensated by the insurance carriers when you enroll in a plan. Your premium is the same whether you use us or go directly to a carrier.

Question 14

Are you tied to one insurance company?

Accepted Answer

No. We are an independent broker, which means we work with multiple highly rated carriers across Idaho. That allows us to compare plans objectively and recommend what actually fits your needs — not what benefits us most.

Question 15

What if I'm moving to Idaho and already have Medicare?

Accepted Answer

Original Medicare and Medicare Supplement Plans will continue to work anywhere in the country. However, if you have a Medicare Advantage plan, Medicare will require you to change your plan based upon the new service area (plans have local or regional networks known as a service area).

Moving to a new state is a qualifying life event that triggers a Special Enrollment Period, giving you the opportunity to enroll in a new plan that covers Idaho providers. Matt can help you review your current coverage and find the right plan for your new home in Idaho.

Question 16

What if I already have Medicare coverage — can you still help?

Accepted Answer

Absolutely. We help people review their current coverage every year during the Annual Enrollment Period (October 15 – December 7) to make sure their plan still makes sense. Plans change, and so do your needs.

What to Do When You Turn 65

Frequently Asked Questions

Medicare Basics

Medicare Advantage vs. Medicare Supplement

Part D Prescription Drug Plans

Dual Eligible & Extra Help

Working with an Independent Broker

Still Have Questions?