Does Medicare cover hearing aids?

Asking for a friend, right? Nah, don’t be silly. Hearing loss is a real thing! According to the National Institute on Deafness & Other Communication Disorders, 8.5% of adults age 55-64 experience significant hearing loss. Technology today has created some pretty incredible hearing aids to solve this problem, however they can be rather pricey. It may not seem possible to put a price tag on the sound of your grandchild’s voice that warms your heart, a honking horn in traffic that keeps you safe, a movie you’d like to enjoy with your spouse, or your favorite song… but the reality is that, given how far they’ve come, the average cost of hearing aids in 2020 is around $2,500 each.

Individual insurance policies do not typically cover hearing aids and neither does original Medicare (parts A&B). Therefore a Medicare Supplement, such as the most commonly known Plan F, does not cover them either. Supplements only extend coverage to what original Medicare covers first so if it’s excluded by parts A&B, it’s excluded by the Supplement as well.

Some Medicare Advantage plans will offer coverage for hearing aids with a copayment. Medicare Advantage plans, such as the Blue Medicare Choice PPO from Florida Blue, take the place of original Medicare. They function more like an individual under-65 health plan in that they have copays, coinsurance, deductibles, out of pocket maximums and prescription drug coverage built in. These plans usually have a lower monthly premium but more out of pocket expenses for medical services. The Florida Blue Advantage plan that we have and are most familiar with has a copay of $699-$999 per hearing aid (with up to two aids per year), depending on the details of the aid itself.

Hearing aids and any available insurance coverage for them varies from plan to plan and company to company. If you’re considering them, please talk with your doctor and your insurance advisor to fully understand what may be available to you. We’re happy to hear out any questions you may have.

Why We Want to High Five You at 64.5!

Medicare has been so closely associated with the age of 65 for so long now that many people think they can wait until they actually turn 65 to address their health insurance needs and begin that transition. With regard to eligibility and actually enrolling in Medicare, that’s perfectly fine since you have a 7 month window surrounding your 65th birthday to do so. However, there are several things to consider as you approach 65 that make it really beneficial to do your research and get things moving in that direction in advance. This being said, we encourage that you start this process at 64.5.

If you are still working, there are things to consider such as comparing your employer provided group coverage to that of Medicare for both coverage and cost. Another important factor is if you are contributing to an HSA, you must stop at least 6 months before going on Medicare for tax purposes. Also, if you currently have a spouse and/or family members on your plan that will need to come off, you’ll want some time to quote that and make arrangements financially as it can be much more costly than what you’ve been used to.

Whether you are working with a financial advisor or not, you will want to plan for Medicare financially and weight out your options. Gathering all of the information on Advantage plans vs Supplements and those cost differences will help you decide what aligns with your budget. There are also many prescription drug plans you can shop in order to make the right decision for you.

All of this can take time and there is no need to wait, which will only add more stress to an already somewhat overwhelming process. We have a 64.5 checklist that may be helpful if you’d like to see the steps we advise taking at that time. And of course, we’re always ready and willing to hand out some high fives for being on top of your Medicare at 64.5!

What if I lost my job and health insurance and don’t know when I’ll be employed again?

Contrary to hours being cut but remaining employed, when it comes to losing employment (and health benefits) altogether, there’s a little bit more action to take. The following information is from healthcare.gov:

If you lost your job-based health plan: You may qualify for a Special Enrollment Period if you lost health coverage through your employer or the employer of a family member in the past 60 days OR you expect to lose coverage in the next 60 days, including if you lose health coverage through a parent or guardian because you’re no longer a dependent. Note: Losing coverage you have as a dependent doesn’t qualify you for a Special Enrollment Period if you voluntarily drop the coverage. You also don’t qualify if you or your family member loses coverage because you don’t pay your premium.

If your employer reduced the hours you work and you’re enrolled in a Marketplace plan: Update your application immediately within 30 days to report any household income changes. You may qualify for more savings than you’re getting now.

If you were furloughed: In some situations depending on the status of your health coverage from your employer, you may qualify for a Special Enrollment Period. You may be eligible for a premium tax credit to help pay for Marketplace coverage too.

If you have COBRA continuation coverage:

– If you’re entitled to COBRA continuation coverage after you lost your job-based coverage, you may still qualify for a Special Enrollment Period due to loss of coverage. You have 60 days after your loss of pre-COBRA job-based coverage to enroll in Marketplace coverage. You may also qualify for premium tax credits if you end your COBRA continuation coverage.
– If you’re enrolled in COBRA continuation coverage, you may qualify for a Special Enrollment Period if your COBRA continuation coverage costs change because your former employer stopped contributing, so you have to pay full cost.

If you lost your job, but didn’t also lose health coverage, because your former job didn’t offer coverage: You generally won’t qualify for a Special Enrollment Period. By itself, a job loss (or a change in income) doesn’t make you eligible for a Special Enrollment Period to enroll in Marketplace coverage… It’s the loss of coverage that does.

What should I do if my income has changed due to Covid-19 and I have a subsidized health plan with the Marketplace?

A subsidized health plan is a policy provided by the Marketplace with a discounted premium, since a portion of it is covered by the government. Eligibility is based on whether or not the insured’s household income qualifies. There is certain criteria for those that are single and those with other dependent family members in their household. It is extremely important that the applicant provides true and accurate information regarding their income, as that is what determines how much help they receive.

It’s also imperative that the insured then updates any changes to their income throughout the year of the policy’s coverage. In situations where their income increases, their subsidy may decrease and vice versa. The penalty for not keeping this information up to date is that a portion of the subsidy could be owed back at tax time if they failed to provide the right information earlier in the year.

The only instance in our current situation that does NOT need to be reported as an income change is the “economic impact” stimulus check that some recently received from the government. That is not required to be considered as true income.

With the current pandemic of Covid-19, there are unfortunately many people that have either had their income decreased, hours cut, or even lost their job altogether. If this happened or happens to you, contact the Marketplace or your agent immediately to update all income information and keep it as accurate as possible, no matter how many times it may change.

COBRA and Medicare… Oil and vinegar or two peas in a pod?


There are lots of things that are consistent when it comes to Medicare. It runs very smoothly, is a pretty well-oiled machine, and policy holders are overall very pleased. But we also see a lot of uncertainty or overwhelm when trying to fully understand it all. It can be intimidating with the regulations and guidelines to follow that could result in financial penalties if not abided by appropriately. But it doesn’t have to be scary or stressful. That’s what we’re here for.

One of the areas that can seem confusing is when people are approaching age 65 (Medicare eligible) and planning to no longer work. There are options to select COBRA coverage, essentially extending the employer’s group coverage, or enroll in Medicare. Here, we’ll break this down as simply as possible to provide a little guidance.

First, let’s be sure we’re on the same page with what exactly COBRA is. COBRA (Consolidated Omnibus Budget Reconciliation Act) gives employees the right to choose a continuation of the previous employer’s group health plan for a limited time. Usually, that time frame is 18 months but may be extended up to 36 months in some situations. There may be some instances where the coverage changes slightly and the premium is usually a little higher than it was for an active employee prior to retirement, up to 102% of the cost of the plan. Employers with 20 or more full time equivalent employees are generally required to offer COBRA. Spouses can also be eligible for COBRA if:

• The covered employee either voluntarily or involuntarily leaves the job
• The covered employee’s number of hours are decreased making them ineligible for benefits
• The covered employee becomes eligible for Medicare
• Divorce or legal separation from the covered employee
• Death of the covered employee

A commonly used term when entering the Medicare world is “creditable coverage”. This is referring to coverage outside of Medicare being qualified to take the place of Medicare so that there are no late enrollment penalties if you don’t enroll on time. “Creditable” also means that the coverage is expected to pay on average as much as the Medicare coverage would. COBRA is NOT considered creditable for Part B of Medicare. Only active employer group coverage for an employee still working would suffice for that. Regarding Part D prescription drug coverage, it is plan specific whether or not it’s creditable.

Real life example: Bill decides to retire right at age 65. He’s been on his employer’s group plan for 25 years. He can elect COBRA to keep that plan but also needs to enroll in Medicare, now that he’s eligible. Medicare would then become his primary. If he didn’t enroll in Medicare and stayed just on COBRA, he could face a substantial gap in coverage. Let’s say he sees a doctor, they bill Medicare A&B for the standard 80% payment but he doesn’t have any Medicare. So then they bill COBRA, who could pay just 20% of the total cost or possible nothing at all, since they’re secondary with him being 65+ now and he technically doesn’t have any primary coverage. Bill could now be stuck with a bill (see what we did there?) for 80-100% being his responsibility to pay out of pocket. So, Bill, lesson learned… what he should have done is upon retirement, enroll in Parts A&B as soon as he stopped working and then compared his COBRA coverage and premium to that of a supplement or advantage plan to decide on the best secondary coverage.

A few things to consider if you’re going to stop working or are 65+ with COBRA:

• What are the options for your spouse or family?
• Is your employer’s COBRA coverage “creditable” for Medicare?
• What is the cost of COBRA vs a Medicare supplement or advantage plan?
• You have 8 months from when you stop working to enroll in Parts A&B without penalty

It may seem like a lot but this is a big transition from working to not, so don’t take it lightly. We can help work through the details and relieve some of the stress. The positive part of it all is that there are options for care and you get to pick the best fit for you.