A Guide to Medicare and Hearing Aid Coverage.
On average, it takes about seven years from the time a person develops hearing difficulty to the time they are ready to pursue treatment. If you or someone you know is seeking hearing aids, you might wonder whether Medicare offers coverage to help with the costs. In this guide, we'll go over everything you need to know!
What is Medicare?
Medicare is a federal health insurance program for people 65 or older, those under 65 with certain disabilities, and those of any age with end-stage renal disease (ESRD). (ESRD is when your kidneys can no longer function independently, and you need dialysis or a kidney transplant.)
Medicare and hearing aid coverage are two topics that often arise when discussing hearing healthcare treatment options. Many people have questions about what is covered by Medicare and what type of out-of-pocket costs can be expected.
So let's take a closer look.
Hearing Health Services Medicare Does Cover
Medicare offers coverage for various healthcare services, including hospital stays, doctor's visits, and prescription drugs. For the purposes of this guide, we'll focus on hearing-related coverage. Here's what is covered:
- Hearing evaluations (with physician referral)
- Surgical management of hearing loss (e.g. cochlear implants, Bone Anchored Hearing aids, etc)
- Equipment related to the surgical procedure (e.g. cochlear implant batteries)
One routine service that Medicare does cover is hearing evaluations. If you have a concern about your hearing, your doctor can make a referral to an audiologist for a hearing evaluation. The evaluation will assess your hearing loss, and the provider can determine your best treatment options.
Following this evaluation, your provider will go over information on various treatment options that are appropriate for your hearing loss. If you need surgery to address your hearing loss, Medicare will cover the cost of the surgery.
This includes cochlear implants, bone-anchored hearing aids, or other surgical interventions. Medicare also covers the cost of related supplies for those procedures, such as cochlear implant batteries and accessories.
What Medicare Doesn't Cover
Does Medicare cover hearing aids? The answer is, unfortunately, no. Here is what Medicare (Parts A and B) do not cover:
- Hearing aids
- Professional services associated with hearing aids
Hearing aids are not considered to be medically necessary by Medicare standards and as such, are not covered by Original Medicare (Parts A and B).
That doesn't mean there isn't help available if you need hearing aids and you're on Medicare. Many private insurance companies offer supplemental insurance plans to help cover the costs of hearing aids and other services not covered by Original Medicare.
There are various plans available, so be sure to do your research to find the one that best fits your needs.
Why doesn't Original Medicare cover Hearing Aids?
It's a fair question to ask why there isn't basic coverage for hearing healthcare. Millions of adults over 65 have some degree of hearing loss and could benefit from treatment for their hearing loss.
There are several reasons that hearing aid coverage isn't included in Original Medicare, some of which stem from misunderstandings regarding the overall health impact of hearing loss.
Research is evolving, and trends are showing a link between overall health, cognition, and well-being related to hearing health. One day, Medicare will likely add to or change its policies on hearing aid coverage. Hearing aid coverage under Medicare was included in a 2019 bill and the recent Build Back Better legislation, but both fizzled out before passing.
For those looking for a solution now, let's look at other available options starting with Medicare Advantage.
Medicare Advantage Hearing Aid Coverage
If you're enrolled in a Medicare Advantage plan, you may be wondering if your plan covers hearing aids. While each Medicare Advantage plan is different, many do offer coverage for hearing aids.
It's important to be aware of the different available levels of coverage before choosing a plan.
Some Advantage plans include coverage for hearing aids and their maintenance costs, while others do not. If you're interested in enrolling in a plan that offers this coverage, review the policy carefully to ensure that it meets your needs.
Humana, Aetna, and United Healthcare offer popular Medicare Advantage plans that may include hearing aids at a reduced price through a third-party payer (like TruHearing), discounted hearing aids, or a lower price for specific companies.
It's always best to check with your plan coverage before purchasing any hearing aids.
If you're already enrolled in a Medicare Advantage plan and are in need of a new pair of hearing aids, be sure to check with your insurance company to see what to expect for out-of-pocket costs.
Many companies will cover at least some of the cost, but there may be a limit on how much they will pay.
How to Get Medicare Advantage With Hearing Health Benefits
Here is how to enroll or request more information:
- Visit Medicare's Plan Finder and look up information or join online.
- Call 1-800-633-4227 for more details.
- Or request a paper version of the form be sent to you.
Before you reach out, make sure to have your Medicare card handy. They'll want to know your Medicare number and the date your coverage began.
Ask for more information about each available plan. Some important questions to ask:
· Does this policy cover hearing aids?
· How much will Medicare Advantage pay for hearing aids?
· Do I need to go to a specific clinic or provider?
Other Options for Lower Cost Hearing Aids?
If you're on a limited budget, there are a few ways to get hearing aids with low or no cost. Consider these options:
- Veterans Affairs (VA)
- Lions Club Hearing Aid Recycling Program
- Vocational Rehabilitation
- Financing (available through brands like Lively)
Hearing Aid Coverage Through Veterans Affairs (VA)
If you've served in the U.S. military, the VA is an option worth looking into. The VA has certain requirements regarding eligibility for treatment as well as paperwork and procedures to follow. Read more here.
Hearing Aids Through Lions Club
The Lions Club Hearing Aid Recycling Program (HARP) is another option available to anyone in need of a hearing aid with a low income. The program helps make hearing aids more accessible for those in need of assistance by providing refurbished or new hearing aids affordably. Read more here.
Hearing Aids Through Medicaid
Medicaid also offers hearing aid coverage to those who qualify based on income. To see if you are eligible, contact your state Medicaid office. Read more here.
Hearing Aids Through Vocational Rehabilitation
Working-aged adults with hearing loss can also look into Vocational Rehabilitation programs in their state. Vocational rehabilitation provides assistance and support to those with disabilities, including hearing loss, in order to retain or pursue employment. More information here.
Finally, financing is another option to break down the cost into monthly payments rather than one lump sum. Check with your hearing aid clinic regarding what types of financing options they offer—popular brands like Lively offer modest monthly memberships.
While hearing aids aren't covered by Original Medicare, there are still options available to help you get the care you need.
Private insurance companies offer supplemental Medicare Advantage plans to pick up where Medicare left off.
Lastly, know that other options are available if you need additional resources to get hearing aids.
You can read more about affordable hearing aid options here.