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.
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Scheduling Your Hearing Exam
Under Part B, you can expect to pay 100% of the cost for exams to get fitted for hearing aids and hearing aids. If you have the financial resources and are willing to pay for it, call your doctor or hearing loss specialist to schedule a hearing exam.
If you have a Medicare Advantage plan and hearing services are covered, then follow your health plans rules for scheduling hearing appointments. For example, dont call a hearing specialist directly if your Medicare Advantage plan requires you to go through a primary care doctor first for a referral. You might want to contact your Medicare Advantage or other health plan to see if it offers hearing exams and hearing aid discounts through a specific program.
If you belong to Medicaid, or any other program that may help cover hearing costs, then follow the programs instructions for accessing your hearing benefits or buying a hearing aid.
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Costs Of Hearing Aids
Hearing aids are expensive. Thankfully, there are now over-the-counter devices you can buy cheaply, if you have mild hearing loss. However, it is still recommended that you see an audiologist to determine if these will help long term.
Hearing aid costs can range from $1000 $4000. The costs can explain why many seniors do not benefit from hearing devices.
What Medicare Plans Or Parts Cover Hearing Aids
Only Medicare Advantage plans provide coverage for the cost of hearing aids. These plans are legally required to provide all the same coverage as Original Medicare and are free to offer additional benefits, says Worstell. Hearing aid coverage is a common extra benefit in these plans, along with coverage for dental, vision and prescription drugs, he adds.
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What Does Hearing Aid Coverage Include
Coverage varies based on your exact plan and insurance provider.
Medicare Advantage plans can cover hearing tests to determine a persons need for a hearing aid, the cost of the hearing aids themselves and the fitting process, as well as maintenance and repairs, says Worstell.
Some plans may use a copayment or coinsurance structure to cover the cost of the hearing aids, he adds. Other plans may allocate an allowance that the plan member may spend on their hearing aids.
Medicare Part B Plans
Medicare Part B can be thought of as providing coverage for outpatient care. This would cover doctors visits, medical supplies, and select preventive services. As stated before, hearing aids that would technically fall under Part B for medical coverage are as of yet not considered eligible for Medicare coverage.
Original Medicare
Both Medicare Part A and B Plans fall under the Original Medicare category. This means that you are 100% responsible for your hearing aids and any exams that you’ll need. This also includes any fittings and batteries that you’ll need to do to keep your hearing aids up to date. Under Original Medicare, you’ll have to pay a copayment in a hospital outpatient setting.
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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.
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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Types Of Hearing Loss
Hearing loss can have multiple origins as well, which can influence the degree that a person is affected. Hearing loss itself is one of the most prevalent disabilities meaning that there are millions of people who experience it at multiple degrees.
This means that the number of people who experience hearing loss in a way that doesnt qualify them for social security can be substantial. There are generally considered three kinds of hearing loss, conductive, sensorineural, and mixed.
How Can You Get Add
For those who don’t have hearing aid coverage, you can get a standalone policy that offers hearing benefits. Many people purchase these add-on policies through their Medigap company, but plans may be available through any private insurance company.
Hearing insurance plans are outside of your Medicare coverage and will have an extra cost. Benefits can also vary widely, but they’re usually a good deal when plans are available.
For example, Blue Cross Blue Shield offers Dental Vision Hearing Packages in some areas. It costs about $15.25 per month, and the benefits could mean you pay $495 to $1,695 per hearing aid.
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Medicare Coverage For Cochlear Implants
When deemed medically necessary, Part B of Medicare will cover cochlear implants. These can also be paid for by Medicare Advantage plans. Those who have a Medigap plan will likely pay the least amount out-of-pocket for medically necessary cochlear implants. Talk to your doctor about the cost of cochlear implants with your policy. Further, discuss the specific rules or criteria that may apply.
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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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.
Where Can You Get Help To Pay For Hearing Aids
There are a variety of options when it comes to getting help paying for hearing aids. If youre a veteran and you qualify for VA health benefits, your hearing tests and hearing aids may be fully covered.10
Hearing aids can also be paid for with money in a Health Savings Account or Flexible Spending Account, if you have one, while people with Medicaid may be able to qualify to get a hearing aid through their state Medicaid benefit.
Many civic and nonprofit organizations can help seniors find help to cover the cost. For example, Sertoma connects people who need hearing assistance with help. The organization has a thorough listing of national and state charitable programs and also runs a hearing aid recycling program through its 420 clubs.
Hear Now, sponsored by the Starkey Hearing Foundation, provides hearing aids to low-income individuals and some local Lions Clubs run projects that give affordable hearing aids to people in need. Reach out to your local Lions Club chapter to learn more.
Another option is to purchase a hearing aid at a warehouse club. Respondents to a Consumer Reports survey found that CR members spent around $1,926 for a pair of hearing aids at wholesale clubs versus $4,107 at name-brand hearing aid stores, $3,909 at audiology offices and $3,517 at hospitals and clinics.11 The survey also found that many survey respondents who asked for a discount got one. Yet, some patients still prefer the service they receive at a professional audiology clinic.
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Hearing Aid Prices On Medicare
Theres no such thing as a Medicare discount for hearing aids. Hearing aids are costly, and you must be fitted for them by your audiologist. The average cost of a single digital hearing aid is $3,000 to $4,000. Some retailers offer hearing services. Their advertised prices are less than you might pay at an audiologists office. But even though these retailers, a pair of hearing aids can cost thousands of dollars.
This factor of cost is one reason only about one in four adults who could benefit from hearing aids has used them. Many people wait years before finally getting hearing aids. If you need help with the cost of your hearing aids, do an online search for assistance paying for hearing aids in your state.
Do Medicare Advantage Plans Cover Hearing Aids
Part C Medicare is a private policy offered through Medicare that offers the same benefits as Part A and B, as well as potentially some additional coverage. These extra benefits may include dental and/or vision insurance, prescription drug coverage, and in some case hearing aids. To date, most Medicare Advantage Plans still do not offer hearing aid coverage.
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How Can I Find Medicare Plans That Cover Hearing Aids
If you want to shop for Medicare plans, you can use the Medicare Plan Compare site to get a sense of what plans are available in your area.When you do this, pay close attention to the Extra Benefits section. Here you will find the copays for the different hearing services.
As helpful as Medicare Plan Compare is as a first step, it does not include all the information you will need. What kinds of hearing aids are covered? What brands are covered? What are the plans limits on hearing services? You may then want to reach out to the plan directly or find an insurance broker in your area to find out more.
NOTE: Access to hearing aids could change in the future. Recent legislation, known as the Build Back Better Act, made its way to the House Committee on the Budget on September 27, 2021. It has provisions that would add hearing aids to your Part B benefits starting on October 1, 2023. Certain services performed by audiologists would also be covered. All of these services would be subject to the 20% Part B coinsurance. Depending on what happens with the Build Back Better Act, you may need to turn to a Medicare Advantage plan for coverage in the meantime.
National And State Resources For Free Hearing Aids
Many agencies and foundations at the national and state levels provide assistance to seniors in purchasing hearing aids. For seniors seeking financial hearing aid assistance, it is just a matter of contacting these foundations and filling out any necessary applications to see if you qualify for help. It can take some time, but if it saves you thousands of dollars, we think it is worth it!
For a list of financial assistance options, visit HearingLoss.org. You may also find an option through the list provided by the Hearing Aid Project at the state or national level. Your local Area Agency on Aging may also be able to direct you to local resources.
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Blue Cross Medicare Supplement Or Legacy Medigap
Blue Cross Medicare Supplement plans do not include routine hearing exams, hearing aid fittings or hearing aids. You may choose to pair a new or existing Blue Cross Medicare Supplement or Legacy Medigap plan with the Dental Vision Hearing Package that includes coverage for an exam and hearing aids. It also includes dental and vision benefits.
Learn more about how to get coverage for your Blue Cross Medicare Supplement or Legacy Medigap plan.
This is a solicitation of insurance. We may contact you about buying insurance. Blue Cross Medicare Supplement plans arent connected with or endorsed by the U.S. government or the federal Medicare program.
Fees Warranties And Batteries
The fees charged by audioprothetists and recognized aid facilities are covered by the program when you purchase or replace a hearing aid or when you have it repaired. You have nothing to pay for these services when you are registered for the program. Nevertheless, you are responsible for the maintenance costs of your hearing aid, for instance, to have it cleaned and checked.
The warranty is valid for at least 1 year for a hearing aid. Audioprosthetists and recognized aid facilities can provide you with further information in this regard.
Batteries are covered when you purchase or replace a hearing aid. However, thereafter, you are responsible for the cost of replacement batteries.
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Medicare Hearing Aid Coverage Audiology Services As Physician Services And Practitioner Status For Audiologists And Hearing Aid Specialists
Following the latest White House proposal, the House Rules Committee released a draft of the reconciliation text on Thursday afternoon. A number of significant changes to how audiologists and hearing aid specialists would be treated under Medicare are included in the latest draft, including:
Inclusion of qualified audiologists and qualified hearing aid professionals as RHC and FQHC Practitioners Section 1861 of the Social Security Act ) is amended by inserting or by a qualified audiologist or a qualified hearing aid professional
Hearing aid coverage is said to be provided for individuals with severe to profound hearing losses, approximately every 5 years.
The text relating to the hearing benefit proposal can be read here.
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The majority of major insurers who offer Medicare Advantage plans have at least one plan that covers hearing aids. These insurers include Humana, Aetna and Blue Cross Blue Shield. However, some seniors may not be eligible for those plans, and the plans may have a higher premium than those that dont offer hearing aid coverage.
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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
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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