Kathy Sarmiento heads the Miami-Dade and Florida Keys office of the Shine program, which stands for Serving Health Insurance Needs of Elders. It helps Medicare beneficiaries navigate and select their medical insurance plans.
Right now, she’s hard at work helping beneficiaries during Medicare’s open enrollment period that ends Dec. 7. '
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“It's the time of year when people can change the insurances that they have along with Medicare. So, you can change your HMO, your PPO, your drug plan, and it's important to do an insurance comparison,” Sarmiento said.
The AARP says there’s lots of reason to evaluate your current selection.
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“Perhaps they have a plan, an Advantage plan that has an additional premium and they don't want to pay that premium," said David Parra, a spokesperson for the AARP. "Well, they can pick another plan that doesn't have an additional premium… Maybe they got to notice that their doctor is no longer going to work with their plan. Maybe they want to follow the doctor. They can find out where the doctor will be if they change to a different plan."
First, check what your plan includes. If you have original Medicare, known as part A, it covers your hospitalizations while, part B includes your doctors’ appointments, labs, outpatient care, durable medical equipment such as wheelchairs, and preventive services such as exams and vaccinations. If you don't have it, now you can add Part D, which covers your medications.
There’s also Medicare Advantage.
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“Some people add on an Advantage Plan to have a lower, if any, copayment and deductible,” Sarmiento said.
Medicare Advantage is a Medicare health plan offered by a private insurance company. What’s the difference?
“When you have plain old Medicare, which they call original Medicare, you can go anywhere in the United States as long as the doctor takes Medicare, you're good to go," Sarmiento said. "With an Advantage Plan, they have a network of doctors and hospitals in your county.”
Most of the time, those private plans only allow you to see providers in their network, but your out-of-pocket costs are lower. Sometimes they also offer additional benefits, like hearing, dental and vision.
The enrollment process must be done online at www.Medicare.gov, but you can get free help navigating the system. You can make an appointment with a Shine volunteer at www.FloridaShine.org or by calling 305-671-6356 in Miami-Dade and 954-745-9567 in Broward.
“We're not allowed to tell you what to do, but we can say, well, this is the least expensive, or this one has this particular benefit, and give you the information so that you can make an informed decision,” Sarmiento said.
Staying vigilant is also important as scammers use this open enrollment period to try and get people to hand over their personal Information.
“If they get any phone calls or mail, trying to confirm, you know, asking them, would you mind verifying your social security number? Verifying your, you know, Medicare number… That's definitely going to be fraudulent,” Parra said.
The AARP says the Social Security Office or Medicare won’t call you unless you initiate the contact so beware.
