Wednesday, November 23, 2022

Does Medicare Cover Hearing Aids In 2020

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Medicare Part B: Medical Insurance

Medicare Coverage for Hearing Aid Update | Build Back Better Act | DrCliffAuD VLOG 097

Medicare Part B covers two types of services: medically necessary and preventative services. Preventative services include early detection of an illness. Most of these services are provided at no cost for people with Part B coverage.

  • Ambulance services
  • Inpatient, outpatient and partial hospitalization for mental illness
  • Seeing a second doctor before surgery
  • Some outpatient prescription drugs

Medicare Advantage Plans And Hearing Aids

So whats the solution if you need coverage for hearing? Sign up for a Medicare Advantage plan. Youll get comprehensive hospital and medical benefits, and many plans provide additional coverage for hearing aids, routine hearing exams, hearing aid fittings, hearing aid maintenance and hearing-related prescription drugs.

Medicare Advantage plans vary among insurance providers and regions, and some require a monthly premium while others have $0 premiums . Whether its an HMO or PPO, a Medicare Advantage plan is a good option if youve been diagnosed with hearing loss or just want to be proactive about any future hearing needs.

How Else Can I Save Money On Hearing Aids

Other options for help with hearing aid costs:

  • Hearing discount programs. You may be able to save money on hearing aids by shopping around, joining a discount program or getting help from a charitable foundation. Some Medigap plans also offer membership in hearing care discount programs.
  • Leases. Youll pay more in total for hearing aid subscription plans, just like you might for a car lease. But the idea of a monthly fee rather than paying thousands of dollars at once can help with budgeting.
  • Local hearing aid programs. Ask your hearing specialist about local sources of financial help for hearing aids. Many Kiwanis Clubs and Lions Clubs have hearing aid programs. You can also contact your Area Agency on Aging for additional resources.
  • Medicaid. Some state Medicaid programs cover hearing aids and exams for people who qualify based on their income. Contact your state Medicaid program to find out more about coverage and eligibility.
  • Retiree coverage. If you have retiree health insurance, the plan may provide some coverage for hearing tests and hearing aids. The plan may offer discounts on hearing aids or contribute a fixed dollar amount toward them, such as $1,500 every three years.
  • Veterans health care. Hearing injury is one of the top service-related medical issues for military veterans. The U.S. Department of Veterans Affairs provides hearing services and hearing aids for eligible veterans.

Keep in mind

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Hearing Services Medicare Covers

Original Medicare is composed of Part A and Part B . Medicare Part B covers some diagnostic hearing and balance exams but only if your doctor or another health care provider orders them to see if you need medical treatment. Medicare beneficiaries are responsible for paying 20 percent of the Medicare-approved amount for these exams, and the Part B deductible applies. A hospital copayment is also required in hospital outpatient settings.

Unfortunately, Original Medicare does not cover routine hearing exams, hearing aids themselves or exams for fitting hearing aids. Medicare Supplement Insurance usually does not provide coverage for routine hearing care either. The cost of these services and devices must be paid for out of pocket. That is, unless a senior has a Medicare Advantage Plan that offers additional benefits.

Medicare Hearing Aid Coverage 2022

Best Hearing Aid Alternatives

Whether or not Medicare provides hearing aid coverage will depend on the type of Medicare plan you have.

Original Medicare Doesn’t Provide Hearing Aid Coverage

Original Medicare doesn’t cover hearing aids in 20221. If you have a Medicare Part A or B plan, you will need to pay for your hearing aids out of pocket or with other insurance.

Medicare Advantage may Provide Hearing Aid Coverage

Some Medicare Advantage plans, also called Medicare Part C plans, provide some hearing aid coverage. For example, Humana, Aetna, and Blue Cross Blue Shield all offer at least one Medicare Advantage plan with hearing aid coverage.

Costs that might be covered include:

  • Audiologist visits for fitting and adjustments

Because Medicare Advantage plans are offered through private insurance companies, the benefits vary from plan to plan. And some insurers choose not to offer hearing aid benefits at all. Others only offer a plan with hearing aid coverage to seniors in certain states.

Did You Know: According to the Kaiser Family Foundation, 88 percent of Medicare Advantage plans offer hearing aid coverage, which can significantly lower your out-of-pocket cost.2

You should also be aware that plans with hearing aid coverage may cost more than those without it. But given how expensive hearing aids are, it’s likely worth paying the higher premium if it means you won’t need to pay for your hearing aids entirely out of pocket.

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Finding A Medicare Advantage Plan That Covers Hearing Aids

Seniors who need coverage for hearing care, including testing and hearing aids, should begin by contacting their Medicare Advantage provider to determine whether its covered under their existing plan. If not, their insurer can generally suggest a more suitable plan that offers the coverage they need. However, seniors who want to switch plans may need to wait until the general enrollment period to make the change. That occurs every year from October 15 to December 7.

If a senior is already working with an audiologist or other hearing care provider, its a good idea to ask the provider which Medicare Advantage plans are accepted at that clinic. Medicare Advantage plans generally only cover care at in-network providers, so selecting a plan that is already accepted can help guarantee that theres no need to find a new health care provider.

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The Over-the-Counter Hearing Aid Act of 2017 may provide some help. Sponsored by Sens. Elizabeth Warren and Chuck Grassley , it allows individuals to buy certain types of hearing aids over the counter without prior approval from a health care provider. The Food and Drug Administration has until 2020 to propose new regulations for the law, and the devices likely wont be available to the public until 2021.

Will over-the-counter hearing aids actually help address the unmet need for these devices? That remains to be seen. It will depend on how much they cost and how good they are. They likely wont replace the prescription hearing aid market nor should they much like how drugstore reading glasses dont fully substitute for prescription lenses. Nevertheless, over-the-counter products serve an essential purpose: They provide immediate, low-cost relief to health problems that may not need more advanced treatment.

One concern with the over-the-counter approach is that some consumers may believe these hearing aids address their problems when they really should be seeking professional help.

Another approach that could make prescription hearing aids more accessible is through insurance coverage. The Seniors Have Eyes, Ears, and Teeth Act has been introduced in Congress for several years in an attempt to include hearing aids and, as the laws name suggests, vision and dental services, in Medicare coverage.

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Why Doesn’t Medicare Cover Hearing Aids

Original Medicare, and even many private insurance companies, elect not to cover hearing aids due to their cost. In Medicare’s case, federal law prevents Medicare from covering hearing aids. That could change in the future, though. Several pieces of legislation introduced in 20213, including the Medicare Hearing Aid Coverage Act of 2021, would expand Medicare to cover hearing aids if passed.

Save Upfront With Unbundling

Medicare must cover dental care, hearing aids, and eyeglasses.

A newer trend is unbundling the hearing aid itself and the associated services. This usually results in a lower upfront bill, which includes the hearing aids, fitting, and a limited number of follow-up visits. After that initial period, you will pay per-visit fees for service. Exact costs vary, depending on your provider and your insurance.

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Which Medicare Plans Cover Hearing Aids

Medicare Advantage Plans, the alternative way to receive your Medicare benefits, are administered by private insurance companies. According to the Kaiser Family Foundation, 95% of Medicare Advantage Plans in the United States offer some hearing exam or hearing aid coverage.

Availability of MA plans varies depending on where you live. Some parts of the country have more options than others, but you should be able to find at least one plan in your area that helps with hearing aids. According to the Kaiser Family Foundations review of MA plans available in the United States in 2022, the three largest companies with MA plans are Humana, United Healthcare, and BCBS affiliates. There are other companies with MA plans that may be available in your area. These will come up for your review when you search for plans.

As an example, here is a comparison of HMO plans including the three largest companies and one other that are available in the Jefferson County, Denver, Colorado area. They all have $0 medical monthly premiums. You must stay in-network, and prior authorizations and referrals may apply. Hearing aid benefit information is based on each plans 2022 EOC or Summary of Benefits document.

What Is The Cost Of Hearing Aids

The cost of hearing aids depends on several factors, such as the type of hearing loss someone has, the quality of materials use in the hearing aid and the kind of technology used in the device.

At the lower end of the market, economical hearing aids can cost around $1500-$3000 per hearing aid, whereas premium models using sophisticated technology could cost as much as $6000 each. If you need one for each ear, the price will be considerably more.

When you buy hearing aids, the cost usually includes a hearing test, consultation, and the initial fitting. You’ll then return for follow-up appointments to adjust the hearing aids and customize them to your specific needs.

It’s important to factor in other associated costs. Hearing aids require maintenance, such as routine cleaning and replacement batteries. You should also consider how you would cover loss or accidental damage.

To find out more about your options and to compare plans available where you live that may cover hearing aids, call to speak with licensed insurance agent today.

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Will Medicare Part A And Part B Pay For Hearing Aids In The Future

In November 2021, the H.R.5376 Build Back Better Act was introduced to Congress, which would add hearing aids and hearing care to Medicare coverage. The bill has been passed by the House and is now awaiting review by the Senate.

Should the bill pass, hearing health and hearing aids will be included in Medicare coverage come October 2023.

Does Medicaid Cover Hearing Aids

Does Cigna Insurance Cover Hearing Aids?

Medicaid provides health coverage to eligible low-income adults, children, pregnant women, older adults, and people with disabilities. According to the Center on Budget and Policy Priorities, Each state operates its own Medicaid program within federal guidelines. Because the federal guidelines are broad, states have a great deal of flexibility in designing and administering their programs. As a result, Medicaid eligibility and benefits can and often do vary widely from state to state.5

Medicaid coverage for hearing aids varies by state, according to the Hearing Loss Association of America.4 Of the 50 states, 20 dont provide any type of hearing aid coverage for adults. For the 30 states that do provide coverage for hearing aids, there are limitations to coverage that are specific to each state. In most cases, Medicaid recipients must first have a medical diagnosis and a prescription for hearing aids from their doctor. In California, for example, hearing aids must be supplied by a hearing aid dispenser on the prescription of an otolaryngologist , or the attending physician.4

Its worth noting federal guidelines require all states to provide hearing aid coverage and services for children and young adults until the age of 21.

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How To Reduce The Cost Of Hearing Aids

does Medicare cover hearing aids?

  • Browse hearing aids – Shop around to find a device that fits your needs and budget.
  • Inspect warranties – Depending on the manufacturer, warranties may vary and include a different set of terms.
  • Compare insurance – Browse policies from multiple companies to find the best deal for you.
  • Hearing aid type – Different makes and models or device may require different parts or take different batteries, affecting cost.
  • Test your hearing – Update your hearing status so you know which features you’ll require from hearing aids.

Some things though will be unavoidable. For example, buying hearing aid batteries will be a regular occurrence.

Why Doesn’t Medicare Cover Hearing Care

As this clinical review explains, “The Medicare Act of 1965 statutorily excluded coverage of hearing aids under the premise that they were ‘routinely needed and low in cost,’ suggesting that consumers would be responsible for their purchase.” Also, at the time, many seniors didn’t live as long as they do today, and so fewer people had age-related hearing loss. There also was little understanding of how important it is to treat hearing loss to reduce depression and social isolation.

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Is Hearing Covered By Any Parts Of Medicare

Medicare Part A and Part B not only dont cover hearing aids, they also dont pay for basic hearing exams or fittings for hearing aids. Which means, if you rely on Original Medicare alone, youll be responsible for 100 percent of the cost for a hearing aid or any routine exams.

However, if your doctor orders you a hearing and balance exam, it might be covered by Medicare Part B . You would typically pay 20 percent of the Medicare-approved amount for the exam the Part B deductible of < $185> may also apply. In addition, if your hearing and balance exam has to be done in an outpatient hospital setting, youd also owe the copayment for Medicare Part A .

Getting Your Hearing Tested

Medicare Hearing Aid Coverage | Build Back Better Act Review | DrCliffAuD VLOG 094

Don’t wait to address your hearing health as the guidance is sorted out. Get tested by an audiologist, take an online screening test, or visit a hearing center that has licensed hearing health providers. Find a hearing aids guide at hearingloss.org.

Take advantage of hearing aid discounts. Costco offers its own brand of hearing aids and other hearing services. Drugstore chain CVS has opened 32 hearing centers in seven states, with plans to expand this year, a company spokesperson says. Single device costs range from about $400 to $2,500. Try a high-tech device that’s not a hearing aid. Hearing technology company Nuheara sells wireless earbuds that work with a smartphone app for about $300 a pair. Wearers can tune out background noise at restaurants, offices or outside and “control how they hear the world around them,’ says company co-founder David Cannington.

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How Much Are Hearing Aids

Hearing aids can range widely in cost depending on the type and the features involved, and, unfortunately, out-of-pocket costs can be high.

One hearing aid option is a behind-the-ear variety another is one that sits completely in the ear canal and is molded to fit the inside of your ear. Special hearing aid features, which can add to the cost, might include rechargeable batteries, wireless connectivity, wind noise reduction and even remote controls.

The price of just one hearing aid could be as much as $2,400, according to a 2015 report from the Presidents Council of Advisors on Science and Technology.9 Most people end up needing a hearing aid for each ear, which would bring your out-of-pocket cost to nearly $5,000.

Medicare Coverage And Hearing Aids

By Joy Victory, managing editor, Healthy HearingLast updated on:August 2nd, 2021

Details on what Medicare will pay for when it comes to hearing aids, hearing tests and other hearing care.

Unfortunately, when it comes to vision, dental and hearing care, traditional Medicare doesn’t offer much coverage for older adults.

Check with your plan provider to see whatkind of hearing coverage you have, if any.

If you have supplemental insurance, however, it may pay for some or all of these services, depending on your plan.

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Preventing Devastating Medical Consequences Of Hearing Loss

Far too many people go without hearing aids because they are too expensive, Rep. McBath said in a news release. Rep. Dingell added that the coverage is necessary because hearing loss can lead to a sense of isolation and other negative health impacts.

The two representatives drew on groundbreaking research developed by Frank R. Lin, M.D., Ph.D, and others at Johns Hopkins University to make their case that Medicare coverage for hearing aids can help prevent devastating medical consequences of hearing loss:

  • Hearing loss affects nearly 48 million Americans and, left untreated, has serious emotional, social and medical consequences for older adults.
  • Older adults with hearing loss are 32% more likely to require hospitalization, face a 24% increased risk for cognitive impairment, and increasingly suffer from isolation and depression.
  • A 10-year longitudinal Johns Hopkins study found that patients with hearing loss had a higher probability of developing dementia, with the probability rising as the severity of hearing loss increased.

I was *thrilled* to see the Medicare Hearing Act reported successfully out of the House E& C Committee yesterday. This is the first hearing bill that leverages the impact that the bipartisan OTC Hearing Aid Act of 2017 will have on reshaping hearing care in the US.

Frank R. Lin, MD PhD

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Medicare Supplement Insurance

Medicare would likely reimburse manufacturers at prices lower than they currently receive, as it does for other health care goods and services. The Department of Veterans Affairs has had success paying just $400 per hearing aid, about $2,000 less than the private market. Further research is needed into how the VA policy affects veterans access and health outcomes, as well as manufacturer contracts. This policy could go two ways: lower prices could slow innovation in hearing aid technology, or an expanded market could increase innovation because it raises potential revenue even at Medicare prices.

Medicare coverage for hearing aids could be structured in several ways. For example, The Commonwealth Fund proposes that Medicare beneficiaries pay a $25 monthly premium for bundled vision, hearing, and dental services. Others may recommend the services simply be added under the umbrella of Medicare Part B. Should Roybal-Allards bill pass, the regulations that emerge from it will greatly influence the laws impact on access.

The Eyes, Ears, and Teeth Act doesnt address Medicaid or private insurance coverage for hearing aids. But changes to Medicare coverage might prompt other types of insurance to reassess their own coverage of these necessary devices.

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