The Palm Beach Post - What to know about Medicare, Advantage open enrollment, which starts Oct. 15

What do experts say about original Medicare vs. Medicare Advantage?

Arlene Arkin, a certified health insurance broker based in Boca Raton, says that she’s agnostic on which is better for enrollees.

“It depends on their economics, their financial situation, if they can afford a premium,” Arkin said, noting that few Medicare Advantage plans in this area charge a premium. “There’s zero premium (for Medicare Advantage) … which people really like.”

She adds, though, it’s becoming more difficult to find a doctor in the plans’ networks and that the extra services that Medicare Advantage offers that original Medicare doesn’t are contracting for the second year in a row after years of expansion.

Philip Economou, a certified insurance broker in Sarasota, agrees the services started contracting, manifested in fewer Medicare Advantage plans offered, higher copays for specialist visits and less commissions for brokers like him.

“The insurers I write for all talked about sustainability — they are concerned about costs and continuing to be a profitable company,” Economou said.

“I try to educate people on their options,” he added. “I do get people asking what plan I am on. I tell them what works for me may not work for them.”

The way providers are limited to a network on Medicare Advantage is why certified insurance agent Christopher Turner, based in Hobe Sound, recommends people go with original Medicare with a supplement.

“Original Medicare with a supplement is probably the best insurance in the United States,” Turner said, noting that almost every doctor and hospital takes it.

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It could run a married couple $1,000 a month in total premiums they have to pay, however.

“It’s quite a bit of money, for somebody on a fixed income,” Turner said. “So that's where the Medicare Advantage plans come into play. So most people see that (no extra premium) and are like, ‘Wow.’ "

He counsels them from being taken in by gym memberships, over-the-counter medicine discounts and movie tickets that some Medicare Advantage plans offer to sweeten the deal, though.

“There are a lot of people that pick the plans because they look good on paper,” he said, drawing up a scenario in which the enrollee is hospitalized and in need of specialized care where there’s no in-network doctor. “This is where you get clients that say, ‘That Medicare Advantage plan killed my friend.' ”

Where can you get help enrolling in Medicare?

Certified insurance brokers provide the service without a cost to the enrollee and can be found on the state Department of Financial Services website, licenseesearch.fldfs.com. Local Area Agency of Aging offices often have counselors who can help through the Serving Health Insurance Needs of Elders (SHINE) program.

Statewide, the number to get connected to these services is 800-262-2243.

Here’s some information you should have ready: A list of your doctors, current drugs, chronic conditions or family histories, annual income and budget and other needs like vision or dental.

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