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.
Does Medicare Cover Hearing Tests
In some cases, yes, but only if recommended by your primary care doctor or another physician. In other words, you can’t go to a hearing clinic without a referral and expect Medicare to pay for it.
Here’s how Medicare explains hearing exam coverage: “Medicare Part B covers diagnostic hearing and balance exams if your doctor or other health care provider orders them to see if you need medical treatment. You pay 20% of the Medicare-approved amount for your doctor’s services for covered exams, and the Part B deductible applies. Medicare doesnt cover hearing exams, hearing aids, or exams for fitting hearing aids.”
What Do Hearing Aids Cost
The price for a pair of hearing aids typically ranges from around $1,000 for low-end models to as much as $8,000 for premium devices. This price tag may also include a consultation, hearing test, fitting and follow-up adjustments. Some sellers even include periodic cleanings, battery replacements and a warranty that provides future cleanings, fittings and protection against damage or loss.
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Lowering your hearing aids costs can sometimes be as simple as speaking up. When purchasing hearing aids, ask what discounts are available. Veterans, union members and people with company retirement plans may have access to additional price breaks.
Those with mild hearing loss who are unable to afford hearing aids have the option of using personal sound amplification products instead, which usually cost under $500 for a set. These dont require a fitting or prescription, can sync with smartphones and are wearable right out of the box. These devices aren’t a replacement for a doctor’s care, though, and don’t address all aspects of hearing loss.
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Why Doesnt Original Medicare Pay For Hearing Aids
Hearing aids aren’t covered by Medicare Parts A or B because when Medicare was established in 1965, hearing aids were specifically excluded from benefits via Section 1862 of Title XVIII of the Social Security Act.
However, when the law was written, hearing aid technology was still in development, and the first full digital wearable hearing aid wasn’t available until the 1980s.
Many more people wear hearing aids now than in previous decades, and since 1980, hearing aid sales have increased about sevenfold.
Today, one-third of adults over age 65 have hearing loss. However, Medicare legislation hasn’t caught up to consumer medical needs.
Does Medicare Advantage Cover Hearing Aids
Medicare Advantage offers coverage for hearing services, and in many cases Medicare Advantage covers some of the cost of hearing aids.
Medicare Advantage is private medical insurance bundled with your original Medicare Part A or B plan, so the level of hearing aid coverage will depend on which private insurance company you have chosen for your Medicare Advantage plan.7
To find out whether your Medicare Advantage policy covers hearing aids and services, contact your insurance company at the phone number listed on your membership card and ask the customer representative, What are my hearing aid benefits?
You can also contact a Medicare representative at 1-800-MEDICARE, chat with a representative online at medicare.gov, or consult NCOAs extensive guidance on navigating your Medicare benefits.
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Do Medicare Supplement Plans Cover Hearing Aids In 2022
Medicare Supplement plans work as secondary coverage to Original Medicare. Also known as Medigap, these policies only cover the balance of what Medicare covers. Because Medicare does not cover hearing aids, Medicare Supplement plans do not cover them either.
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You can, however, enroll in a separate insurance policy that includes hearing services and hearing aids. Often, hearing coverage comes bundled with vision and dental coverage. Hence, Medicare beneficiaries receive coverage for the most significant gaps in Original Medicare from such ancillary policies. Policy coverage limits vary depending on the carrier.
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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Can I Get Free Hearing Aids
Free hearing aids aren’t the norm, but you might be able to snag a free pair. This is welcome news if you’re on a Medicare plan that won’t help with the cost.
Here are some groups that may offer free or highly discounted hearing aids to seniors:
- Your insurance company
- Medicare Advantage
- Department of Veterans Affairs
- Vocational rehabilitation
- Local agencies and programs like Lions Club chapters
- National groups and foundations like Hearing Aid Project
- Hearing aid manufacturers
For a more detailed look, head over to our guide to free hearing aids. Just know that finding free hearing aids can take time, as you may need to add your name to a waiting list or wait for open enrollment. Another option for married seniors is to look at their spouse’s private health insurance policy to see if it covers hearing aids. If so, it may be worthwhile to join their plan.
For more information, watch the video below on free and discounted hearing aids with our Editor-in-Chief, Jeff Hoyt, and audiologist Brad Ingrao.
Will Medicare Cover Hearing Aids In The Future
Not without Medicare reform, said Travis Price, an independent licensed insurance agent in Michigan. Price is also not hopeful Medicare will cover hearing aids in the future. There have been multiple attempts to pass legislation that would add coverage for hearing aidsas well as dental and visioninto Medicare, he said.
One of the more recent ones was the Seniors Have Eyes, Ears, and Teeth Act, which was introduced in 2019 but never made any progress.
Other programs to help with the costs of hearing aids exist, Ball said, but he felt uncertain about whether the Medicare program would ever add hearing aids to their standard Medicare coverage.
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Which Parts Of Medicare Cover Hearing Aids Or Treatment
Original Medicare is made up of two parts, known as Part A and Part B. Part A is hospital coverage and doesnt cover any regular hearing treatment. Part B covers medically necessary services and services that help prevent illness or catch conditions at an early stage. Medicare Part B may cover a diagnostic hearing and balance exam if its been ordered by a doctor. It doesnt cover a regular hearing exam, hearing aids or exams for fitting hearing aids.
Seniors who have Medicare Part C, also known as Medicare Advantage, may be covered for hearing exams or hearing aids. Medicare Advantage plans are offered by private companies that have been approved by Medicare. They must provide everything thats included in Part A and B but can also cover extras. One of these extras may include hearing care however, its not a common inclusion. Its a good idea to consider coverage of hearing exams and hearing aids when choosing a Medicare Advantage plan. Seniors who are already enrolled can call their provider and ask if hearing aid coverage is included.
The Extent Of The Problem
Hearing loss is not considered a disability in the U.S., but if it were it would rank as having the largest group of affected Americans. About 15 percent of Americans have some hearing loss, and this number rises to as high as 50 percent for people ages 75 and older. Between two and three children per 1,000 are born with permanent hearing loss and more experience hearing loss after birth. Unfortunately, new hearing aids can cost thousands of dollars per ear, and even people who get used hearing aids have to pay to have them refitted and reprogrammed to fit their specific hearing test results. It is likely that the high cost of hearing aids and lack of insurance coverage is much of the reason that up to 80 percent of Americans who could benefit from the devices do not have them.
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Does Medicare Advantage Cover Hearing Aids In 2022
Medicare Advantage plans often include hearing benefits as an additional perk. However, not all plans offer this benefit, and the coverage varies per plan.
Before signing up for a Medicare Advantage plan, you must be sure the network includes your preferred providers and the dental coverage you require. Also, check to ensure that you have access to a local and reputable audiologist within your plan network for your hearing health needs.
When you enroll in a Medicare Advantage plan, you should budget for out-of-pocket costs such as copayments, coinsurance, and the plans deductible. When you purchase hearing aids, you want to keep the plans maximum hearing benefit in mind.
What Is A Baha Hearing Aid
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.
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Why Arent Hearing Aids Covered By Medicare
Hearing aids are not covered by Medicare because they are considered an elective itemwhile hearing aids certainly improve quality of life, Medicare does not consider them a necessary item to survive.
Other reasons why Medicare does not cover hearing aids are mostly speculative, but likely fiscal. Many people 65 and older have some degree of hearing loss and could benefit from hearing aids, but providing coverage to all these millions of people would not be financially beneficial for insurance companies.
In addition, the work involved with Medicare is an incredibly complex and slow process, so some hearing aid providers do not want to accept Medicare in the first place.
Does Insurance Cover Hearing Aids
While there are around 20 states in the US that require health insurance companies to provide hearing-aid insurance coverage for children, according to the American Speech-Language-Hearing Association, just five require hearing aid insurance coverage to be available for hearing aids for adults. These are: Arkansas.
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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.
Does Aetna Medicare Cover Hearing Aids
Based on data reported by the American Speech-Language-Hearing Association during the Healthy People 2020 initiative, 32.46% of adults 70 years and older self-reported that they have used or currently use a hearing aid. The process of getting hearing aids involves exams and fittings to ensure the features and characteristics meet your needs. Hearing loss can lead to withdrawal from social settings, which can impact your overall well-being. So its important to get it right.
Medicare Benefits Solutions
Original Medicare covers neither hearing aids nor the exams needed to get fitted for hearing aids. But if you are enrolled in Medicare Part C, which you may know as Medicare Advantage, you may be covered.
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Are Hearing Aids Covered By Medicare
No. Medicare is very clear about this on their website:
“Medicare doesn’t cover hearing aids or exams for fitting hearing aids. You pay 100% for hearing aids and exams. Some Medicare Advantage Plans offer extra benefits that Original Medicare doesnt cover – like vision, hearing, or dental. Contact the plan for more information.”
How Much Will A Hearing Test Cost With Medicare Part B Or Medigap
Some audiologist services are covered by Original Medicare if a health care provider orders it to develop a medical treatment plan. If you have Medicare Part B, youâll pay 20% of the approved Medicare cost for each service, including diagnostic hearing and balance exams.
| Audiology service |
|---|
| $11 |
Medicare-approved average amount
If you have a Medicare Supplement plan alongside Medicare Part B, youâll pay a smaller portion of the appointment cost. Your out-of-pocket costs will be determined by the Medigap planâs benefits for the Part B coinsurance.
For example, Medigap Plan F and Plan G cover 100% of the medical coinsurance. That means these plans will provide free hearing exams if the procedure qualifies under Medicare and if youâve already met your Part B deductible.
On the other hand, Medigap Plan K covers half of the coinsurance cost. This will reduce your cost for a hearing assessment from $10 down to $5.
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Can I Get Insurance That Pays For Hearing Aids
Yes, you can get standalone insurance that helps cover the costs of hearing aids and other related services. You can use many of these plans, whether you have Original Medicare alone, a Medicare Supplement plan, or a Medicare Advantage plan. The details of each plan may vary, so be sure to check for information such as networks and deductibles or copays.
If you think that you may need insurance in thefuture, you should consider your options now, as many plans have waitingperiods that you must meet before theyll cover more expensive items likehearing aids. Ultimately, hearing insurance is important. It can help youafford services that might otherwise be too expensive to pay for out-of-pocket.
Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.
Early Intervention And Schools
Your child can get hearing services through early intervention, or EI, and schools. The Individuals with Disabilities Education Act, or IDEA, is the law that requires hearing services in schools. The Rehabilitation Act is another law that may help your child. Under this law, your child will have a Section 504 plan . These laws say that the school must give your child the hearing services she needs. These laws do not, however, make schools pay for hearing aids.
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What Is Medicare Advantage Plan
Many Medicare beneficiaries choose to receive their Part A and B benefits through a bundled Medicare Part C plan, often called a Medicare Advantage plan. These plans must offer at least the same level of coverage as Original Medicare, and they typically cover additional benefits. Part C plans must at least match Medicare Part B hearing care …
What Is Medicare Part A
Medicare Part A covers in-patient care in a hospital, nursing home care, skilled nursing facility care, hospice care and home health care. Medicare Part B covers medically necessary and preventative services. While hearing aids are not covered, there is coverage for hearing exams recommended by a doctor to see if medical treatment is required.
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Why Aren’t Hearing Aids Covered By Insurance
If you have recently been diagnosed with hearing loss, you may be considering hearing aids. For many people, hearing aids can be a lifeline. They enable people to not just communicate and understand speech, but also feel confident, engaged, stay connected, and maintain a steady income, while also helping to prevent cognitive decline.
However, with the average cost of hearing aids ranging from $1,500 to $6,000, you may be wondering: are hearing aids covered by insurance?
