TAMPA -- Joseph Salvatore did the right thing. He's in good health and was relatively satisfied with his Medicare coverage, but last week, Salvatore and his mother-in-law trekked to the Freedom Square retirement community in Seminole, where consultants from a senior agency were holding court to help people navigate the complex health insurance market for seniors.

"It's so easy to just kick the can down the road and say, 'Ah, I've got coverage,'" the St. Pete Beach retiree said. "Every year, regardless of how happy you are with your existing plan, you have to take a look at it. Things change, and you might have to adjust your coverage."

Officials with local Area Agencies on Aging wish they had more of Salvatore's attitude to spread around. Open enrollment for Medicare is underway, and people have until Dec. 7 to make changes if they're in the program.

"Medicare is a very individual process, to the point where spouses can have different plans," said Patricia Henderson, community services coordinator for the West Central Florida Agency on Aging. "That is one of the biggest mistakes people make -- assuming their neighbor's plan will work for them. Every year, we want people to check their plan. Because people change, and plans change."

Medicare was created in 1965 as part of Lyndon Johnson's Great Society, a series of policies designed to combat poverty and other societal ills. It is a different program than Medicaid, the health insurance system for the poor that was also part of Johnson's agenda.

Medicare covers those 65 or older, some people under 65 who have certain disabilities, and people of any age with end-stage renal disease.

It has four main parts:

--Medicare Part A is hospital insurance. It helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.

--Medicare Part B is medical insurance. It helps cover services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and some preventive services.

--Medicare Part C is Medicare Advantage. More on that later.

--Medicare Part D is prescription drug coverage. Policies are run by Medicare approved private insurance companies and may help lower drug costs.

Since the 1970s, seniors have been able to choose either the federally administered "original Medicare" or a private plan approved by the government. Those policies are known as Medicare Advantage plans, and in 2014, about 38 percent of Floridians chose this option. Like other private plans, they come in the form of health maintenance organizations (HMOs) and preferred provider organizations (PPOs), which can limit you to certain providers in their network.

There are also supplement plans, or "Medigap" policies, offered by private companies that can cover co-pays and deductibles, and special-needs policies.

Advisers say seniors should probably enroll in both Part A and Part B. There are dozens of Medicare Advantage plans. Dozens more drug plans. Special needs plans. With all of that on one's plate, how in the world can anyone decide which plan to choose?

The Kaiser Family Foundation reports that selecting a Medicare plan is "an unexpectedly daunting task" for many seniors. The foundation said that due to the sheer volume of information out there, seniors found it frustrating and difficult to compare plans.

There's an official government handbook, "Medicare & You." It runs 151 pages.

But there's plenty of help out there.

Medicare.gov, the government's official website, has a Plan Finder online that walks anyone through the procedure, asking for a zip code, which drugs a respondent takes, and previous Medicare information if it's available.

Want face-to-face help? Local Area Agencies on Aging have a service called Serving Health Insurance Needs for Elders, or SHINE, that provide help over the phone or in person. Call the group at 1-800-963-5337.

While it's tempting to simply look at price, SHINE advisers say they focus on a couple of major variables before they get around to money.

"It's a total look at things," said Janet Mills, Pinellas-Pasco SHINE area coordinator. "If you're just looking at the premium, that doesn't tell you the whole story at all."

First, a counselor will want to know who your doctor is and how important it is to you that you keep that doctor. That limits you to plans in which those doctors participate.

The list of drugs a person takes "is really driving towards one plan or another, too, more this year than it ever has before," said Mills. Plans' formularies -- the roster of drugs they cover -- vary widely.

Then, enrollees can start comparing premium, co-pays, out-of-pocket caps, and the 1- through 5-star ratings of plans.

Using the government Medicare site or SHINE's site -- www.floridashine.org -- will be a big help. But advisors warn against answering personal questions from solicitors who may sound like they are official Medicare representatives. There's a lot of fraud out there.

Medicare plans aren't allowed to ask for your social security number, bank account numbers, or credit card information over the phone. Do not give out personal information to any solicitor.

Anyone who plans to rest on the status quo might recall last year's open enrollment period, when hundreds of Tampa area doctors and the renowned H. Lee Moffitt Cancer Center were dropped from various commercial Medicare policies.

The bottom line: Yes, it may be confusing, and yes, it will take some effort, but re-evaluate your plan annually.

"That's what we're here for," said Mills, the Pinellas-Pasco SHINE coordinator. "It is not a good idea to 'set it and forget it.' You really do have to advocate for yourself."

That's what Salvatore did. He took a new look at his original Medicare plan, visited a SHINE booth at the retirement community, and set up an appointment for one-one-one help.

"I'm probably going to be switching to one of the Medicare Advantage plans, because it serves my needs, my health situation, better," he said. "I'm in good health -- so far, so good."

jstockfisch@tampatrib.com

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