Key Points
Many bewildered older adults gathered early one Thursday morning recently outside the Elder Options office off Tower Road for a walk-in clinic to get help from counselors to determine their best Medicare options.
Five counselors for SHINE (Serving Health Insurance Needs of Elders ) program were on hand. Ten minutes after the doors opened at 11 a.m., a dozen people had signed up for assistance.
“So far it’s been a busy year overall,” said Cheryl Harris, Elder Option’s SHINE liaison. “Every year is a unique year because things are always different. We have been very busy since we serve 16 counties. Families should support one another and be informed about what health insurance plans are available, so that everyone understands how it impacts health care.”
Unknowingly, taking Harris’ advice was 93-year-old June Sassaman and her daughter, Joanne Watson. They were there to get guidance about which drug plan to choose.
“I was doing fine, but then I received a letter from my insurance company for my prescription plan that they were dropping my plan,” said Sassaman.
Watson explained they needed assistance.
“There’s too much to look at, and she takes a lot of medications, so we are here for help to find the correct prescription plan,” Watson said.
The Medicare Open Enrollment period ends Dec. 7. For those enrolling in Medicare for the first time because they are turning 65 years old, or those already on Medicare but trying to decide whether to continue with existing plans or make changes, this is the time to act.
Otherwise, those who celebrate their 65th birthday in 2026 will be able to get Medicare then.
Most of the Medicare counselors are volunteers, like Suzanne Hall, who has been counseling for a year and a half.
“I am a retired nurse, and I am used to trying to help people…I wanted to get involved in this because I was confused about my insurance, and I figured if I am going to learn it, I may as well help other people,” she said. “It’s not a matter of smarts; it’s a matter of knowing how to get through the system.”
There is a lot to consider. Consumers need to decide between what is known as original Medicare or an Advantage plan.
According to Medicare’s website, traditional Medicare is a federal health insurance program that covers 80% of the costs. You can go to any doctor or hospital that takes Medicare anywhere in the United States. Those making this choice will sign up for a supplemental or Medigap plan for additional coverage. A drug plan must be purchased separately
An Advantage plan is a bundled package from a private company and may offer additional benefits. However, you may need to use doctors and other providers who are in the plan’s network and service area, according to Medicare.
Yes, it’s complicated.
Then there is the question of rising costs. The Medicare Part B premium is expected to top $200 a month in 2026, according to the estimates made by Medicare trustees. You pay that premium to the federal government whether you have an original Medicare or a Medicare Advantage plan.
“There are upsides and downsides to either pathway and what’s best for your personal situation,” Harris said. “Each individual needs to evaluate what is the best option for their personal situation.”
Elder Options, located at 100 SW 75th St., Ste. 301, in Gainesville, offers monthly online classes explaining Medicare options.
Elder Options serves 16 counties in and around Gainesville, including Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee and Union counties.