What Hearing Coverage Does Medicare Advantage Offer
While most Medicare Advantage plans cover hearing aids and exams, that coverage can be limited and can vary significantly by plan.
Coverage capped. Most Medicare Advantage plans regulate the dollar amount or frequency of hearing aid purchases. In 2021, the average annual limit was $960, ranging from $66 to $4,000, according to the Kaiser Family Foundation study.
Typically, Medicare Advantage plans limit enrollees to one set of hearing aids a year, but more than a quarter of the plans restrict hearing aid coverage to one pair every two years. And 14 percent cover one set every three years, according to the Kaiser study.
Expect different copayments based on the level of digital technology often basic, standard, advanced and premium. Copays may start around $699 for an advanced level hearing aid and $999 for a premium level hearing aid. Because Medicare Advantage plans can have such a wide range of hearing coverage, its important to compare all plan options in your area.
How to check out plans. To find out more about a Medicare Advantage plans hearing aid coverage, type your zip code into the Medicare Plan Finder and click Medicare Advantage Plan under Plan Type for plans in your area. A green check mark notes plans that include hearing benefits.
For more information about the plans hearing coverage, click Plan Details and scroll down to Extra Benefits. Youll see copayments for hearing aids, exams, hearing aid fitting/evaluation services and other hearing benefits.
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Additional Resources For Help With Hearing Aids
If you have Medicare and need help paying for a hearing aid, there are some programs that might be able to offer some assistance.
- Foundation for Sight and Sound provides hearing aids to individuals with limited financial resources. Visit their website for more information about the program.
- If youre a veteran, you may be eligible for financial help for your hearing aids through the U.S. Department of Veterans Affairs.
- Some local organizations such as the Lions Club International may also be able to help people with hearing problems. Reach out to your local branch to find out if you qualify for assistance.
- Medicaid may cover hearing aids in the following states:
- AK, CA, CT, D.C., FL, GA, HI, IN, KS, KY, ME, MD, MA, MT, NE, NH, NJ, NM, ND, OH, OR, RI, SD, TX, VT, WI, WY
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Plan F Coverage For Other Medicare
This plan coverage also includes 80% of approved costs associated with foreign travel emergencies, which is vital for the many seniors who enjoy taking cruises or other trips outside the United States. There are plan limits, but this coverage can help offset charges associated with becoming sick or injured while traveling outside of the U.S.
Plan F also includes Medicare-approved skilled nursing facility coinsurance costs. This coverage is essential as hospitalization can lead to the need to stay for an extended period in a skilled nursing facility for recuperation. Medicare limits this benefit to the first 100 days of a stay in a skilled nursing facility. Because of this, If you need extended coverage beyond 100 days, individuals should consider a long-term care plan.
Save Upfront With Unbundling
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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Get Help From A Medicare Specialist
Medigap plans are nuanced when it comes to pricing. For example, not everyone understands that there is only one Medigap Enrollment Period in your lifetime, not an annual one like other Medicare plans. Signing up late can cause your rates to go up based on preexisting conditions. Your local State Health Insurance Assistance Program or State Insurance Department can help you with issues like this. You can also ask your broker for details.
Why Doesn’t Original Medicare Cover Hearing Aids
Original Medicare doesnt cover hearing aids, hearing exams or hearing aid fittings when provided by an audiologist. Though hearing aids today can be a significant expense, sometimes costing upward of $6,000 for a pair, the devices were available at a lower cost when Medicare was first introduced in 1965. Medicare excluded hearing aids from coverage, claiming consumers could make the purchase themselves.
However, some Medicare Advantage plans may offer hearing aids coverage, depending on the insurance provider and specific plan selected. If you need help paying for your hearing aids, consider researching the various Medicare Advantage plans available to you and speaking to providers about potential hearing health benefits.
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Will Coverage On Hearing Aids Change
Over the years, many organizations and lawmakers have tried to update Medicare to cover vision, hearing and dental costs for seniors.
Many people would like to see Medicare evolve to cover dental, vision and hearing care. A Commonwealth Fund report details the financial and health burdens these gaps place on older adults. The report said:
“Among Medicare beneficiaries, 75 percent of people who needed a hearing aid did not have one 70 percent of people who had trouble eating because of their teeth did not go to the dentist in the past year and 43 percent of people who had trouble seeing did not have an eye exam in the past year.”
However, so far, no one has been successful at getting changes made to this part of Medicare coverage. In the summer of 2019, several U.S. representatives introduced H.R. 4056, a bill that would require Medicare to pay for certain audiological services. Time will tell if this bill gets passed.
Medicare Part A And Part B
Medicare Part A covers home health services, hospice care, inpatient hospital care, nursing home care , and skilled nursing facility care. Medicare Part B covers limited outpatient prescription drugs, clinical research, necessary medical services, preventive services like flu immunizations or diabetes screenings, mental health , durable medical equipment, and ambulance services. Medicare Parts A and B do not cover hearing aids or related hearing exams, eyeglass exams, dental care, dentures, routine foot care, acupuncture, cosmetic surgery, or long-term care.
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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.
Does Medicare Supplement Cover Hearing Aids
Typically, Medicare Supplement plans do not cover hearing aids. Much like Original Medicare, these plans place the responsibility of the cost of hearing aids on the user.
Meanwhile, veterans in need of hearing aids may qualify for coverage through the U.S. Department of Veterans Affairs , and federal workers may be eligible for hearing aid coverage through the Federal Employees Health Benefits program, which assists federal employees, their families and survivors with coverage of their health needs.
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Does Original Medicare Cover Hearing Aids
Original Medicare covers a wide range of services. Unfortunately, some often-needed services get left behindincluding routine hearing tests and hearing aids.
This does not mean that no hearing services are covered at all. If you have symptoms such as hearing loss or ringing in the ears , Medicare may cover a hearing test with an audiologist, a trained hearing specialist.
Unfortunately, even when a hearing problem is identified, Original Medicare will not cover the hearing aids to correct it.
Interestingly, if you meet certain criteria, cochlear implants are covered by Original Medicare. One of the criteria to getting cochlear transplants is that hearing aids do not provide adequate relief.
Hearing aids work by amplifying sounds in the inner ear, making it easier to detect and interpret them. When hearing aids are not effective, cochlear implants may be considered.
The cochlea is the part of the inner ear that transmits sounds to the auditory nerve and then sends those signals to the brain. Cochlear implants bypass the cochlea and stimulate the auditory nerve directly. This can be effective when the cochlea is damaged.
Hearing benefits are covered by Medicare Part B. You will need to pay a 20% coinsurance for each service.
What Do Hearing Plans From Unitedhealthcare Cover
Specific hearing aid benefits can vary between UnitedHealthcare plans. In some cases, your policy may not cover them at all, and not all plans are available in all locations. Before you commit, it’s a good idea to compare quotes and coverage levels.
Not sure if you need hearing aids? Take UnitedHealthcare’s online hearing test. It can help you identify potential problems and decide if you’re ready to seek hearing care.
If your plan covers hearing aids, you may receive a discount of 50-80% on the device itself. The actual discount depends on your policy and the hearing aid brand. Other potential benefits include:
- Trial period to test the hearing aids
- Warranty for repairs
- Hearing aid accessories
Do Medicare Advantage Plans Cover Hearing Aids
Some Medicare Advantage plans cover hearing exams and hearing aids. Medicare Advantage plans often offer benefits not typically included with Original Medicare , such as routine hearing exams and hearing aids. Since each Medicare Advantage plan is different, you should compare plans carefully to find one that fits all of your medical needs. You can see if any Medicare Advantage plans in your area cover hearing aids and exams by using our Medicare Advantage plan comparison tool.
If you have insurance that covers hearing exams, such as a Medicare Advantage plan or Medicaid, follow your planâs instructions for getting an exam. If your doctor does not perform hearing exams, he or she may refer you to a specialist.
Are Hearing Aids Covered By My Plan
Who is this for?
If youre shopping for a Medicare plan or need to find out if your current plan covers hearing aids and fitting exams, this information is for you.
Whether your hearing aids and fitting exams are covered depends on what kind of Medicare plan you have.
- Original Medicare is run by the U.S. government. It doesnât cover hearing aids or fitting exams. Youâll pay for them out of your own pocket with Original Medicare.
- Private health insurance companies offer Medicare Advantage plans that include everything Original Medicare offers, plus extra benefits. They may include hearing aids and fitting exams, depending on what type of Medicare Advantage plan you have.
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What Hearing Loss Services May Be Covered By Medicare Part B
Diagnostic hearing exams. Medicare Part B can cover diagnostic hearing exams if your healthcare provider requests them to diagnose or evaluate certain symptoms you may be experiencing and to see if you need further medical treatment. In these cases, medicare.gov states that once youve met your Part B deductible, you will most likely pay:
- 20 percent of the approved charge, plus
- any copay for a hospital stay or outpatient service.
The actual amount you pay can depend on a number of factors, such as: how much your doctor charges, other insurance you may have, the facility where you get treated, etc., so its best to get an estimate for services upfront.
Cochlear implants. Medicare Part B covers prosthetics that can replace a body part or function. Cochlear implants, while not technically hearing aids, are indeed electronic devices that, through surgery, can restore or replicate sound in a severely damaged ear.
If you try hearing aids first and find they dont help you hear any better, Medicare Part B can cover 80 percent of the cost of cochlear implants, if you qualify. However, for Medicare to pay for them, youll have to go to a Medicare-enrolled supplier. For more information, check out medicare.gov.
Need help? Our Guided Medicare team can help you understand your coverage and your options. Contact us today.
Do Any Medicare Supplement Plans Cover Hearing Aids
Medicare Supplement Insurance plans, also called Medigap, do not provide coverage for hearing aids. In fact, these plans dont provide coverage for any health care services or items at all.
Instead, Medigap plans provide coverage for out-of-pocket costs associated with Original Medicare, such as Part A and Part B deductibles, coinsurance and copayments.
Learn more about Medicare Supplement Insurance plans.
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Does Medicare Pay For Tinnitus Treatment
No, Medicare doesnt pay for tinnitus treatment. According to the Centers for Medicare and Medicaid Services, tinnitus treatment is considered an experimental therapy and doesnt have enough controlled clinical trials demonstrating effectiveness.14
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What About Medicare Hearing Aid Coverage Through Advantage Plans
Some Medicare Advantage Plans may providehearing aid coverage. Not all plans offer this, so youll need to take a lookat the details of your Medicare Advantage Plan to see if hearing screening,testing, and hearing aid services are available.
If the plan offers coverage for theseservices, you may have to receive them from specific providers. Be sure toverify that your coverage applies to any provider before you visit their locationfor a hearing screening. Also, learn about any deductibles or the percentage ofthe bill you may be responsible for. All of this can be verified before youactually have the test done.
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What Doesnt Medigap Plan F Cover
- Prescription drug coverage: Medicare Supplement policies sold after January 1, 2006, do not cover prescription drugs. Original Medicare doesnt cover prescriptions either. So, you can only get Part D prescription benefits if you enroll in a Medicare Part D prescription drug plan or buy a Medicare Advantage policy that includes coverage for prescription drugs.
- Supplemental health benefits: Like other Medigap plans, Medicare Supplement Plan F doesnt include coverage for things like hearing aids, vision and dental care, long-term care, and private-duty nursing. You can get some of these benefits through a supplemental health insurance plan or through Medicare Part C, also known as Medicare Advantage.
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Getting Supplemental Medicare To Cover Hearing Aids
Hearing aids are essential for some and certainly not cheap. Since Medicare wont cover them, getting a Medicare Supplemental plan can turn a small monthly paid premium into benefits for your hearing and much more.
For all of the things that Medicare doesnt provide for, you can talk to our licensed insurance agents about your best options to fill the gaps in your coverage. They are extremely knowledgeable and can help match you with a supplement plan that can completely protect your health.
Give us a call today to talk with our agents for free. Or if youre more comfortable online, you can fill out our rate form to get the best rates for plans in your area.
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Can You Get Help Paying For Hearing Aids Without Medicare Advantage
If youre paying for hearing aids out of pocket and looking for ways to save on cost outside of Medicare Advantage coverage, there are several options available.
Retirees may be able to receive coverage through the Federal Employee Health Benefits program. If you have a health savings account or flexible savings account through your insurance program, you may be able to dedicate pre-tax income toward your hearing aid cost as well. Purchasing hearing aids through Costco or other wholesale retailers can also help reduce your expenses, as these vendors typically sell hearing aids at a lower cost than audiology offices.
If you did purchase a hearing aid through an audiologists office, ask about unbundling their services from your payments to ensure youre only paying for the device. Choosing a basic hearing aid over one with special features, such as streaming capabilities, can also help keep costs low.