How Does Medicare Part B Cover Hearing Aids And Hearing Care
Medicare Part B may cover care for a hearing related medical condition or diagnostic hearing tests to help a doctor assess a hearing problem.
You may feel that hearing aids are medically necessary, but Medicare Part B does not cover most people’s cost. However, Part B does cover cochlear implants and bone-anchoring hearing aids because Medicare classifies them as prosthetic devices rather than hearing aids.
These hearing systems are surgically implanted devices that work differently than standard hearing aids. A BAHA is anchored to a bone in the skull. Rather than simply amplifying sound, it sends vibrations directly to the inner ear and bypasses the middle and outer ear. In comparison, a surgically placed cochlear implant stimulates the auditory nerve through electrodes.
These devices can help people with middle ear or ear canal problems that prevent sound waves from reaching the inner ear. For people with this hearing loss problem, traditional hearing aids may not work as effectively.
When Do You Know You Need A Hearing Aid
Obvious signs that you might need a hearing aid include:
- Trouble understanding group conversations.
- Feeling like people are always mumbling when they arent.6
- Frequently asking people to repeat themselves, especially in noisy environments.
- Nnot being able to hear well on the phone.
- Needing the television or radio volume set especially loud in order to understand.
- A ringing or hissing sound in your ears.
Normal hearing means you can hear sounds less than 25 decibels . If the softest sound you can hear is 30 decibels or louder, it may be time to consider getting a hearing aid.7
Its important to know that hearing aids dont make your hearing revert to normal. Instead, they help amplify sounds in certain pitch ranges, specifically the ranges in which youve experienced hearing loss. Its not uncommon to find that you need a hearing aid in both ears.
Wearing a hearing aid in both ears often comes with benefits, including better understanding of speech when theres background noise and you may find that youre not as worn out at the end of the day.8
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.
Medicare Coverage And Hearing Aids
Contributedby Joy Victory, managing editor, Healthy HearingThis content was last reviewed on:August 2nd, 20212021-08-02 00:00:00Details on what Medicare will pay for when it comes to hearing aids, hearing tests and other hearing care. 2021Medicarehttp://www.healthyhearing.com/help/hearing-aids/medicare-cover
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.
Medicare Hearing Aid Coverage Act Of 2017
In the past few years, legislation has been introduced in Congress to expand Medicare coverage to hearing aids. This includes the Medicare Hearing Aid Coverage Act of 2017 and the Seniors Have Eyes, Ears, and Teeth Act. The latter would also provide Medicare beneficiaries with coverage for vision and dental care.
In late 2019, a pair of lawmakers introduced the Medicare Hearing Act of 2019 in the House of Representatives. The bill would allow Medicare to cover hearing aids for people with severe to profound hearing loss.
Medicare would pay for one pair of hearing aids every five years, but it wouldnt pay for over-the-counter hearing aids. The hearing aids would also need to be deemed necessary by a qualified audiologist or physician.
Its difficult to say if and exactly when in the future beneficiaries will be able to take advantage of expanded benefits for hearing. The goal of the legislations listed above is to make costly elements of healthcare more affordable for seniors and disabled individuals. Well keep this page up-to-date with the latest information about the status of these legislations.
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When Does Medicare Cover Hearing Services
Original Medicare covers diagnostic hearing exams if your doctor states that theyre necessary to diagnose or treat a medical issue. For instance, if youve started to experience hearing loss after hitting your head, your doctor may want further testing to ensure theres not an underlying medical issue.
Medicare And Medicaid Coverage For Hearing Aids
Weve discussed the fact that its rare to find hearing aids covered by insurance provided by private lenders, but what about Medicare and Medicaid? In most cases, hearing aids arent covered by Medicare, the government health program for individuals ages 65 and up. Thats because Medicare typically covers services, not devices. There are a few Medicare Advantage plans that include hearing aid coverage however, traditional Medicare doesnt include any hearing aid coverage whatsoever. In addition, tinnitus is not recognized by Medicare as medically necessary to treat. It is also a non-covered diagnosis for devices with major insurance companies.
Medicaid, on the other hand, often covers hearing aids, with different standards for each state. Unfortunately, this coverage typically only includes young people. For example, the Medicaid programs in Colorado and Arizona only cover hearing aids for individuals under the ages of 20 and 21, respectively. Curious about Medicaid and Medicare coverage in your state? You can find more information about coverage by state through the Department of Health and Human Services.
Do you have more questions about getting your hearing aids covered by insurance? Reach out to Sound Relief Hearing Center in Colorado or Arizona, and our friendly team members will help you understand your options. You can also visit our Insurance and Financing page to learn more.
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How Much Will It Cost
At least 88% of Medicare Part C providers cover hearing aids. So, how much will it cost?
You already know Medicare Part C isnt run by the government. It is managed by private insurance companies, so youll have to pay. But the price varies.
However, the cost is mostly dependent on the type of your plan.
The average cost for a Medicare Advantage plan is put at about $34/month.
Meanwhile, it is important to note that the actual cost of hearing aids may also vary depending on the severity of the hearing deformity. The cheapest hearing aids go for about $2,000 while more expensive ones may sell for as high as $6,000 each.
There are additional maintenance costs to be factored in as well, which will drive up the costs. It is a very expensive procedure that is best handled through medical insurance. For hearing aids, go for a Medicare Advantage plan that covers your need, and contact an insurer for more guidance.
Hearing Aid Brand Reviews
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Medicare Advantage Plans Provide The Best Overall Hearing Benefits
Unlike Original Medicare, most Medicare Advantage plans cover hearing aids and exams.
- Hearing aids are covered by 88% of Medicare Advantage plans.
- Hearing exams are covered by 97% of Medicare Advantage plans.
Medicare Advantage plans, also known as Medicare Part C, are more like traditional insurance, and they combine multiple categories of coverage, including medical, hospital, prescription drugs and add-on benefits for hearing, dental and vision. As a result, they offer more robust support for hearing health.
Keep in mind that hearing benefits vary widely with Medicare Advantage plans, and partial coverage could still leave you with high out-of-pocket costs.
On average, Medicare Advantage enrollees still pay about 79% of the cost of a hearing aid. That means it would cost you about $1,817 for a $2,300 hearing aid.
Plans may also have coverage specifics about audiologist appointments. For example, 57% of Medicare Advantage enrollees need preauthorization for a routine hearing exam. Check your policy for details on benefits and restrictions.
Best Medicare Advantage plans for hearing aids
- Typical hearing aid cost: $375 to $2,075
- Options for virtual hearing care and devices shipped to your home
Medicare Advantage Plans And Hearing Benefits
At Clover Health, we understand how hearing and hearing loss affects our members overall health. Thats why, unlike Original Medicare, we include hearing benefits in all of our Medicare Advantage plans. We know how important it is to understand your Medicare coverage options for hearing exams as well as hearing aids. Below is an overview of what Medicare plans offer in terms of hearing coverage and how Clover Health steps in to provide this essential supplemental benefit.
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Other Uhc Plan Benefits
Many UHC Medicare Advantage Plans also offer other benefits with $0 copayments, including:
- routine vision care
- routine dental care
- doctors appointments, whether in-person, by phone, or online
- a telehealth service, allowing a person to speak with a healthcare provider 24 hours per day, 7 days per week
UHC Medicare Advantage plans also include a fitness and well-being program called RenewActive. The program features a free gym membership and access to fitness locations across the country.
Coverage with UHC also includes travel throughout the U.S. and worldwide emergency and urgent care.
There are options to help pay for hearing aids using local, state, or national resources.
A person can contact local programs, including:
- speech and hearing centers
Which Medicare Plans Or Parts Cover Hearing Aids
As noted above, Part A and Part B do not cover routine hearing tests or hearing aids, but some Medicare Advantage plans do offer the benefit.
If this coverage is something youre interested in, youll need to shop for a Medicare Advantage plan that offers the benefit. The good news is that shouldnt be too hard to find one: In 2021, 88% of Medicare Advantage plans offered coverage for hearing aids.
If you want to compare Medicare Advantage plans or enroll in one consider shopping around during the annual Medicare open enrollment period, which starts October 15 and continues through December 7.
NOTE: Do not confuse Medigap with Medicare Advantage planss supplemental benefits. Although Medigap plans are referred to as Medicare supplement insurance, they do not include the supplemental benefits that Medicare Advantage plans offer. You may see a lot of marketing during Medicare open enrollment about both types of plans. A Medigap plan will not help you pay for hearing aids.
Call now to learn more about Medicare supplemental benefits with a licensed advisor.
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Why Does Medicare Not Cover Hearing Aids
Since its inception, Medicare expressly hasnt covered hearing aids.
A solution beyond Medicare, the FDA Reauthorization Act of 2017, set the stage for affordable over-the-counter hearing aids to be approved by the Food and Drug Administration. In November of 2020, two senators encouraged the FDA to begin implementing it.
But, as things now stand, the most extensive Medicare hearing aid coverage is available via Medicare Advantage.
Additional Resources For Hearing Aid Assistance
If you have Medicare and require assistance with the cost of a hearing aid, there are a few programs that may assist you.
- The Foundation for Sight and Sound assists individuals with limited financial resources to obtain hearing aids. For questions and more information about the program, please visit their website.
- If you are a veteran, you may be eligible for financial assistance from the United States Department of Veterans Affairs for your hearing aids.
- Certain local organizations, such as Lions Club International, may also assist individuals experiencing hearing loss. Contact your local branch to determine your eligibility for assistance.
- In the following states, Medicaid may cover hearing aids: AK, CA, CT, DC., FL, GA, HI, IN, KS, KY, ME, MD, MA, MT, NE, NH, NJ, NM, ND, OH, OR, RI, SD, TX, VT, WI, WY.
Through NewMedicare.com we help you to compare rates from different carriers so that you can make smart decisions about your insurance coverage.
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How Much Do Hearing Aids Cost With Medicare
With Original Medicare, you are responsible for 100% of the costs for hearing aids and exams. The average out-of-pocket cost without insurance for a pair of hearing aids is around $2,500, but can range from several hundred dollars to several thousand. If you need hearing aids, there are other ancillary costs to consider as well, such as batteries and money spent for on-going fittings and adjustments.
With a MA plan that has hearing aid coverage, you will be responsible for either a copay for their in-network hearing aids, or you will be given a maximum allowance that goes toward paying for hearing aids. MA plans have set maximum out-of-pocket costs however, your cost sharing expenses for hearing aids do NOT count toward this limit. When you are considering your healthcare budget, know that hearing aid expenses will be in addition to your potential out-of-pocket expenses for your medical care.
Hearing aid costs vary widely depending on the type and severity of hearing loss. Most often, hearing aid coverage that is available through MA plans is helpful, but limited in scope and choice of providers. Most MA plans offer some coverage versus comprehensive coverage for hearing benefits including hearing exams and hearing aid fittings, plus a limited number of hearing aid adjustments.
For examples of hearing aid costs through MA companies, see the comparison chart below.
History Of Hearing Aids And Medicare
In 1965 when Medicare was established, hearing aids were specifically excluded. However, since then, politicians have pushed to find a way for federal coverage. Here are a few of the most recent bills brought before Congress. If passed, they require approval from the Senate and the President before making their way into law.
- Medicare Hearing Aid Coverage Act of 2019 This bill aims to add hearing aids and any related expenses to Medicare coverage. It was brought before the Subcommittee on Health in March of 2019 where it awaits investigation into medical testing, diagnostic measures, and best practices regarding hearing loss.
- Medicare Hearing Act of 2019 Similar to the last bill, this would add hearing aids to coverage with the following stipulations: only one pair covered every 5 years, cannot include over-the-counter hearing aids, and an audiologists referral is necessary. It was introduced to the House in October 2019 and picked up by the Committee on Energy and Commerce in January of this year.
- Elijah E. Cummings Lower Drug Costs Now Act This all-encompassing bill includes not only an expansion in Medicare coverage for hearing aids, glasses, and dentures, but also requirements for prescription drug pricing, healthcare costs, and general public health. It passed in the House in December 2019, so it is on to the Senate.
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Does Medicaid Cover Hearing Aids
Whether or not Medicaid will cover your hearing aids depends on your income and where you live. Each state has its plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need or disability regardless of age.
Some Medicaid coverage is universal. Medicaid provides hearing services for children age 21 and under. For those over 21, Medicaid hearing coverage varies by state.
The Hearing Loss Association of America has compiled a state-by-state guide.
Medicare Part B May Cover Diagnostic Hearing Exams
While Part B wont cover hearing aids, it will cover diagnostic hearing and balance exams if your doctor or other health care provider orders these tests to see if you need medical treatment for a recent injury or illness, such as vertigo or other balance problems.
If you do have an exam covered by Medicare, youll still have to pay the Part B deductible and 20 percent of the Medicare-approved amount for the doctor’s services. If you have testing done in a hospital outpatient setting, you will also be responsible to pay a hospital copayment.
If your doctor recommends you get other hearing-related services Medicare doesnt cover, you may have to pay some or all the costs. Before you do anything, be sure to ask why your doctor is recommending certain services and whether Medicare will pay for them.
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