There are a lot of seniors in Miami-Dade who are 65 or older but have never worked in this country, she said. If they are U.S. residents and have lived here for at least five years, and if their income and assets meet the limits, they can apply for assistance programs for low-income residents, Sarmiento said.
There are 32 SHINE volunteers in Miami-Dade and Monroe counties, and 31 volunteers in Broward. Counseling sites are listed at FloridaShine.org. Appointments can be made by calling 800-96ELDER (963-5337). In Miami-Dade, residents also can call 305-670-6500, ext. 1156.
“Go to a SHINE counselor in your county, because the insurance is different in every county,” Sarmiento said.
Last year, 150,000 people in Florida used SHINE services, Chansler said.
Here’s a look at what to review during open enrollment:
Start with a list of the prescription drugs you take, including the brand names. Go to www.medicare.gov/find-a-plan and enter your ZIP Code or Medicare number to find plans in your area. You can check monthly premiums, deductibles and co-payments, as well as if a plan covers the medicines you take.
If you have Original Medicare, you can check separate stand-alone prescription plans. Medicare Advantage Plans usually include prescription drug coverage, Sarmiento said.
Check to see if your plan uses step therapy, which requires patients to use generic drugs before they can get a name brand drug, or if there are quantity limits for a drug. If you have a chronic health condition, such as heart disease, you can filter your online search to find “special needs plans,” which are geared for people with chronic conditions.
Do your research and talk to your doctors’ offices about what plans they will accept next year, said Vanessa Rico-Robie, SHINE liaison for Broward. Sometimes a doctor will stop accepting a plan, or begin accepting new plans.
“When you know what the costs are going to be, and you know what the coverage is going to be, that’s making an educated decision,” Rico-Robie said. “An educated decision is the best decision.”
If you need help paying your premiums, there are programs to help people who meet certain income and asset limits, Sarmiento said.
Medicare Savings Plans help pay Original Medicare premiums, and Extra Help reduces the cost of prescription coverage, co-payments and deductibles. A SHINE volunteer can help determine if you qualify for assistance, or you can check the Social Security Administration’s website at www.ssa.gov or call 800-772-1213.
“Most people are concerned about what is going to change between 2013 and 2014,” Rico-Robie said. “For beneficiaries who are very elderly and don’t know who their insurer is, or who don’t have family (to help them), it can be very difficult for them to piece everything together, and that’s how SHINE can help.”