How much does Medicare cost?


The cost of Medicare can seem confusing but it’s really quite simple. Because it is very case-by-case for each individual’s situation, this is a very brief guide to reference Medicare premiums in 2021. Part A, which is for hospital coverage, has $0 premium regardless of who is qualifying or what their income and employment status is. Part B, however, is determined by income level and how taxes are filed. This chart shows the different brackets for each and the current premiums for 2021.

File Individual Tax Return File Joint Tax Return File Married & Separate Returns 2021 Monthly Premium
$88k or less $176k or less $88k or less $148.50
$88k – $111k $176k – $222k N/A $207.90
$111k – $138k $222k – $276k N/A $297.00
$138k – $165k $276k – $330k N/A $386.10
$165k – $500k $330k – $750k $88k – $412k $475.20
$500k or above $750k or above $412k or above $504.90

 

This chart is specific to Florida Blue’s current Advantage Plan and Plan G supplement but may also be helpful to show the estimated cost of both routes you can go if purchasing additional coverage to Parts A and B.

ADVANTAGE PLAN SUPPLEMENT
Medical Coverage Medical Coverage
Monthly Premium: $47.90 Monthly Premium: $180.60 (Plan G at age 65)
Part A: $0 Part A: $0
Part B: contingent on income (see above) Part B: contingent on income (see above)
Prescription Drug Coverage Standalone Part D
Monthly Premium: included in plan Monthly Premium: $73.70
Deductible: $250 Deductible: $405

 

MONTHLY TOTAL

ADVANTAGE PLAN

$47.90 (+ Part B)

SUPPLEMENT

$254.30 (+ Part B)

Includes copays & coinsurance.

Out of pocket max: $6,500 in network/$10,000 out of network

Part B deductible ($203) must be met.

No copays or coinsurance.

Medicare Open Enrollment is upon us!


There’s Medicare Part A, B, C and D. All we need is another acronym, right? Well here’s OEP! Open Enrollment Period. This is the time of the year that any and all changes must be made for the following year’s coverage. Individual insurance for those under 65 as well as employer-provided group plans have this as well. But for those 65 or older on Medicare, go time is from October 15-December 7.

During this time, you can enroll in Medicare for the first time if you missed your eligibility window around your 65th birthday as well as make changes to the plan you have if you’re already on Medicare.

There are a couple of different options when it comes to Medicare. Once you have Parts A and B, you’ll need either a Supplement or Advantage Plan. You can read about the differences between the two here.

Supplements don’t change much from year to year but the Advantage Plan does get slightly revised, similar to individual under 65 plans.

For example, the only changes to the Florida Blue Advantage Plan (also known as the BlueMedicare Choice PPO) for 2021 coverage are the following:

• Specialist Physician copays are now $50 instead of $45
• Inpatient hospital care copays are now $345/day for days 1-5 rather than $295
• Routine hearing exams are now $0 copay for one per year, when it used to be $45

Regarding prescription drug coverage on the Florida Blue Part D plan, there were very few changes as well. Here is a chart that shows the two plans we offer in our area for 2021: 2021 part D summary

Of course everyone’s situation is different so please reach out to us to discuss your Medicare needs and we are happy to help during this year’s open enrollment period.

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!

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 coverageâ€. 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.