Medicare Doesn’t Cover Hearing Aids But Retirees Have Options
Medicare and most health insurance don’t cover hearing aids, but alternatives including over-the-counter devices can be less expensive.
Stephen Moore began to realize he had hearing problems more than a decade ago, when people seemed to mumble in conversations. He asked his wife to repeat lines at the movies. “It drove her crazy,” he says. He turned the TV volume up so high that family members complained.
Finally, when he felt he was missing out on hearing important details during meetings at work, he got his hearing tested and was then fitted for hearing aids.
“Hearing loss is so gradual you don’t really recognize it until your hearing is impaired, and it gets really bad,” says Moore, 57, an economist for the Heritage Foundation, a conservative think tank, who also works as a TV analyst. “And there’s still a little bit of a stigma about wearing hearing aids.”
Questions To Ask Before You Get Hearing Aids
The Food and Drug Administration suggests asking a hearing health professional the following questions about hearing aids before making a purchasing decision:
- What type of hearing aids would best suit my lifestyle?
- What factors should I consider when choosing hearing aids?
- Where should I get my hearing aids?
- Do I have to get a medical exam first? Why or why not?
- How many hearing aids will I need? One or two?
- Is there a trial period for trying the hearing aids?
- How do I take care of my hearing aids?
- How will I be able to tell if my new hearing aids are working
Medicare And Hearing Aid Costs
Probably the first question will be, “Does Medicare offer any coverage for hearing aids?”. The real battle will then begin. Like many seniors, you may be financially challenged, having little more than Social Security to cover your expenses. Must you avoid social interaction or just deal with the frustration of not being able to hear normal conversations?
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Medicare Coverage And Hearing Aids
By Joy Victory, managing editor, Healthy HearingLast updated on:October 13th, 2022
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.
Medigap And Hearing Aids
Medicare supplemental plans or Medigap plans, as they are more commonly known, are private insurance plans that fill in the gaps that Medicare does not pay for, such as coinsurance, deductibles, and copayments. These plans are especially useful for those who have diabetes or other healthcare needs that require high out-of-pocket costs. Medigap plans do not cover hearing aids or examinations however, some providers might offer discounts on particular brands of hearing aids.
Pro Tip: Over-the-counter hearing aids can be more affordable and purchased easily online.
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A And B Medicare Cover
Part A and B dont cover most hearing aid related costs like fitting appointments, the actual hearing aid and any hearing examinations specifically for the purpose of selecting or calibrating a hearing aid.
On the up side, they do cover diagnostic hearing exams, but only when taken upon referral from your doctor. However, only part of the cost is actually covered and you will still have to pay the remaining amount plus 20% of the approved medicare cost.
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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One Proposal That Could Change Everything
One proposal that was introduced on the floor of the U.S. House of Representatives was the 2019 Medicare Hearing Act. This Act, despite popular support, has languished in the U.S. Congress.
What does this Act say? First, it is important to remember that this Act was firmly grounded in facts and evidence. Bill sponsors noted that if hearing loss is left untreated that there is a dramatically increased risk of hospitalization. The bills sponsors also explained that untreated hearing loss might play a role in cognitive decline. Therefore, proponents of this bill argue that its benefits, such as improved cognitive performance and a lowered risk of hospitalization, far outweigh any costs of implementing this new program.
What are the other elements of this proposed bill?
This Act would mandate that care from qualified audiologists would be covered under Medicare. It then states that beginning in 2022, hearing aids would be considered medical prosthetics for individuals with moderate to severe hearing losses.
Medical prosthetics are covered by Medicare, meaning that hearing aids would also be eligible for Medicare payment/reimbursement. However, there are limitations to this coverage. People could only purchase new hearing aids once every five years. And, popular over-the-counter models would not be covered under the Act.
At the moment, it is unclear if members of the U.S. Senate and House plan to reintroduce this measure during the next session of Congress.
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.
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How To Buy Hearing Aids
Your choice of hearing aids will depend on many different factors: your budget, location, health insurance, and level of hearing loss. Our hearing aid buying guide provides a comprehensive breakdown of what to expect when purchasing your first pair of hearing aids. Ultimately, the first person to ask about hearing aids is your primary care physician. They know your healthcare needs and can likely point you in the right direction, whether that be a private audiology practice, an ear, nose and throat doctor, or an over-the-counter option.
No matter what option you ultimately end up choosing, there is a Medicare Advantage plan available to help you pay for the costs. The cost is well worth it as hearing aids enhance every aspect of your life: from following along with lively discussions at dinner parties to taking in your favorite movie on a Saturday night.
More Hearing Benefits For Medicare
There has been a big push to expand hearing coverage for people on Medicare. Congress proposed the Build Back Better Act in September 2021. If approved, the law would require that Original Medicare cover routine hearing tests starting in October 2023. It would also require hearing aid coverage once every five years for people with severe hearing loss.
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Who Is Eligible For Hearing Aids
Medicaid always covers children and young people under the age of 21 since prevention is the key to many ailments, including hearing loss. Adults and the elderly are subject to varying restrictions, which depend on the state.
These are the limitations in general:
- Hearing loss in the healthy ear must be greater than 30 dB.
- At frequencies, less than 2000 Hz, each ears hearing loss should be less than 30 dB.
- Patients must provide a written declaration proving that they are attentive, oriented, and capable of appropriately utilizing their hearing aid.
- Patients must be able to demonstrate a proven necessity for the hearing aid.
- Binaural hearing aids are required because the patient has substantial educational, vocational, or social responsibilities.
As is customary, each state will control the rules differently, and you may be required to cover some of the fees out of your own pocket. However, you can and will be covered for hearing aids in general.
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.
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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.
What Hearing Care Does Medicare Part B Cover
Regular hearing exams, screening services, hearing aid fittings and hearing aid maintenance are not included in Original Medicare, though some hearing-related services may be covered by Medicare Part B in certain situations.
A primary care physician may, for example, order a hearing test as part of the diagnostic work for dizziness or vertigo. Hearing tests may also be part of certain neurological exams, cancer screenings and other preventive care.
Note that, in 2022, beneficiaries must pay the full Part B deductible of $233 for the year before Part B benefits kick in, and screening services can include a 20% out-of-pocket coinsurance cost to enrollees after they meet their Part B deductible.
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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.
What Is Monaural Hearing Aid
The word monaural refers to sound reception in one ear only. A patient with monaural hearing loss has hearing loss in just one ear. A monaural hearing aid is a device thats worn in just one ear to correct a patients hearing. Monaural hearing aids were once the standard. Indeed, as recently as 1984, about 78% of all patients who had hearing aids had monaural fittings. Some recent studies have shown that patients with monaural fittings experienced hearing loss in the ear that was not wearing a hearing aid. This is called the Monaural Hearing Aid Effect. But while some studies support the use of binaural hearing aids even for monaural hearing loss, other studies have shown that patients with hearing loss in both ears experience no statistically significant difference in terms of their hearing quality whether they use monaural or binaural hearing aids to correct the problem.
The patients otolaryngologist or audiologist will likely recommend the best hearing aid that will conform to the necessary specifications to guarantee coverage by Medicaid in New York. Patients must then decide whether the prescribed hearing aid provides substantial hearing and health benefits or not.
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Can You Get Free Hearing Aids From The Veterans Health Administration
Hearing loss is the most common service-related injury for U.S. veterans.2 If you were in the service and are experiencing hearing loss in your golden years, the Veterans Health Administration, which is part of the U.S. Department of Veterans Affairs , may be able to give you free hearing aids, or at least a significant discount on them.
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.
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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.
The following are not covered under the Coverage for Seniors program:
- claims for benefit expenses incurred prior to the effective date of coverage
- claims for benefit expenses received by Alberta Blue Cross more than 12 months after the service was provided
- services covered by the AHCIP
- charges for drugs supplied directly and charged for by a physician, with the exception of allergy serums
- registration, admission or user fees charged by a hospital
- drug products not listed in the Alberta Drug Benefit List ask your pharmacist or physician if your prescribed medication is on this list
- semi-private or private hospital room
- travel insurance for emergency hospital and medical expenses outside of the province or country
Medicare Part B: Medical Insurance
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
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Does Original Medicare Cover Hearing Aids
Original Medicare does not cover hearing aids or most other types of hearing-related care. Seniors who are experiencing hearing loss, or expect to need hearing care in the future, should generally buy a Medicare Advantage plan unless they want to pay out-of-pocket for their hearing aids. The exception is for people who receive care through the Veterans Administration, as the VA covers hearing aids and other hearing care for eligible seniors.
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Democrats Plan To Expand Medicare Hearing Benefits What Can Consumers Expect
By Rachana PradhanNovember 5, 2021
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