Open enrollment season is underway and for thousands of South Floridians on Medicare, this year brings major changes, especially in Broward County.
Jamie Forsyth recently finished navigating the confusing process of picking a new Medicare Advantage plan, which includes PPOs and HMOs.
“It’s just causing a lot, a lot of headaches for a lot of people,” he said.
In Forsyth’s case, his current plan is changing next year.
“Before I could go to a specialist. Now, I have to go to my doctor first, get a referral before I can see a specialist. So, just be a lot more complicated,” he said.
PPOs pull out, limiting Medicare Advantage options
Forsyth is one of more than 850,000 people in Miami-Dade and Broward counties who are on Medicare. Of those, more than 294,000 are enrolled in Medicare Advantage plans.
Clifton Eserman, who owns Incompas Insurance, said Broward residents are seeing a reduction in available options.
“In Broward County, we’re seeing a tremendous shrinkage, mostly in the choice realm. So, you have a bunch of PPOs that have pulled out of the market,” Eserman said.
Plans vary widely in cost and coverage
According to Medicare, four insurance companies in Broward County offer Advantage plans at no additional charge, though some do not include prescription drug coverage. Paid plans are also available, ranging from $39 to $184 per month.
Many HMO plans require referrals before members can see a specialist and some patients may need to switch doctors who are part of a new network.
“It’s a very, very complicated market, even for someone like myself, who’s been doing this for, you know, over two decades,” Eserman said.
Experts urge seeking guidance before choosing a plan
Forsyth advised others not to go through the process alone.
“I would not consider doing this without a professional,” he said.
Open enrollment for Medicare ends Dec. 7.
