No, Medicare does not cover hearing aids or exams for hearing aid fittings. However, there are some hearing-related services that Medicare may cover, and certain Medicare Advantage plans may also offer coverage for hearing aids. Keep reading to learn more about coverages and limitations for hearing aids under Medicare.
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Hearing Loss a Concern for Older Adults
Approximately 15% of American adults who are 18 or older say they have some trouble hearing. The likelihood of hearing loss, however, increases significantly with age. Consider that among adults aged 55 to 64, 8.5% report disabling hearing loss. In adults aged 65 to 75, almost 25% have disabling hearing loss. For adults older than 75, this number jumps to 50%.
In total, nearly 30 million Americans could benefit from hearing aids.
Limitations on How Original Medicare Covers Hearing Aids
Original Medicare is healthcare coverage managed by the federal government. It is divided into two parts, Medicare Part A and Medicare Part B. While Medicare Part A covers inpatient hospital stays and skilled nursing facility care, Part B covers services from doctors along with preventative services and medical equipment.
Medicare does not cover the cost of hearing aids. The costs for both hearing aids and hearing exams are paid out-of-pocket if you are enrolled in Original Medicare. However, Medicare Advantage plans may offer coverage for hearing health and equipment.
What Medicare Does Cover For Hearing Health
In some cases, Medicare Part B may cover diagnostic hearing and balance exams if they are ordered by your primary care physician (PCP) or another health care provider. Medicare Part B also covers services from an audiologist once every 12 months for non-acute hearing conditions, such as the slow loss of hearing over time, and diagnostic services for hearing loss that is addressed with surgically-implanted devices. Additionally, Medicare may help cover cochlear implants for patients with bilateral moderate-to-profound sensorineural hearing impairment.
Once you meet the Part B deductible, you pay 20% of the Medicare approved amount for services. For example, if your exam costs $200, you pay $40. You may need to pay the hospital copayment if your hearing tests occur in an outpatient hospital. There are also variations in costs and coverage related to other insurance you may have, such as Medigap, along with how much your doctor charges for services and where you get your test or service performed.
How Does Medicare Advantage Cover Hearing Aids?
Some types of Medicare Advantage plans may cover hearing aids. This is because Medicare Advantage plans often include extra benefits such as Part D prescription drug coverage, dental coverage, and vision coverage, and may also include coverage for hearing exams and the costs of hearing aids.
If you have a Medicare Advantage plan, it’s worth reviewing your plan details to see if it offers any specific benefits for hearing aids or testing. If it does not, and if you are worried about hearing loss, it may be worth speaking with a trusted insurance agent to find a plan that works for you.
If your plan covers hearing tests and aids, it typically falls under expanded Part B coverage. The amount of coinsurance and copayments required varies from plan to plan. Under Part B, you typically have a deductible which must be paid before coverage begins. For Medicare hearing aid coverage in 2023, this deductible is $226. Your deductible does not count toward your coinsurance or copayments — it must be paid in addition to these amounts.
How Much Do Hearing Aids Cost?
The average cost of hearing aids in the United States is approximately $2,500. Low and high-end costs can range from $1,500 to $6,000 depending on the type of hearing aid and its features.
If your Medicare Advantage plan offers hearing aid coverage, it can help offset these costs.
Medicare Hearing Aid Costs with Medicare Advantage
Under a Medicare Advantage plan that covers hearing aids, several costs are common.
- Monthly premium: A premium is the cost you pay each month for insurance coverage, whether you use this coverage or not.
- Coinsurance: This is the amount you pay, expressed as a percentage, for hearing services and hearing aids. For example, if you have 80/20 coinsurance, your insurance company pays 80% of the cost of treatment, and you pay 20%.
- Copayments: A copayment is a set amount you pay for each healthcare service. This means that if you have a $20 copayment, you pay this amount every time you receive healthcare services for your hearing.
- Medicare Advantage Network: If you choose to use a hearing provider outside your plan network, your plan may cover a smaller portion of the costs or offer no coverage for out-of-network services.
If you have coverage under Medicare Advantage, it typically falls under Part B, which comes with a deductible that must be paid before coverage activates.
How to Find Coverage For Hearing Aids
While Medicare Advantage is one option for hearing aid coverage, there are other potential paths for assistance, including:
Medicaid
Medicaid may cover hearing aids. The amount of type of coverage varies by state. For example, in Connecticut, Medicaid covers either a hearing aid or a listening-assisted device but not both. Medicaid in Indiana covers one hearing aid every five years, while Kentucky covers up to $800 every 36 months. Meanwhile, in states such as Georgia and New Mexico, hearing aids are not covered by Medicaid.
Hearing Health Charities
Non-profit agencies such as the Hearing Loss Association of America (HLAA) offer resources to help offset the cost of hearing aids, while foundations such as Starkey Hearing collect and recycle hearing aids that are repurposed for people in need.
Community Health Programs
Programs such as Hearing Health Equity through Accessible Research and Solutions (HEARS) help train trusted older adult community health workers to provide and fit hearing aids to their peers with significant hearing loss.
Protecting Your Hearing Health
While coverage may be available for hearing tests or hearing aids under Original Medicare or Medicare Advantage plans, these options still come with out-of-pocket costs. As a result, it’s worth taking steps to protect your hearing health wherever possible to reduce the likelihood of hearing loss.
Suggestions for protecting your hearing health include:
- Turning down the volume: Lowering the volume of your television, car stereo, or earbuds can help protect your ears from damage.
- Walking away from the noise: If possible, walk away from a loud noise when it occurs. For example, if you find yourself at a restaurant that shifts from a quiet ambiance to louder crowds as the night goes on, consider leaving to minimize hearing damage.
- Taking breaks: There may be situations where you can not walk away from loud noise, such as mowing the lawn. In this case, regularly take a break from the noise to give your ears a chance to rest and readjust.
- Avoiding loud activities: You can also reduce your risk of hearing damage by avoiding loud activities such as sporting events or concerts.
- Using hearing protection: Hearing protection such as noise-reducing headphones or earplugs can limit the impact of noise on your hearing.
What This Means for You
Under Original Medicare, there is no coverage for hearing aids or hearing aid tests unless your PCP orders diagnostic tests. While you can see an audiologist once per year, any hearing devices are paid for out-of-pocket.
Meanwhile, Medicare Advantage plans may include additional coverage for hearing tests and devices, but the amount of coverage varies from plan to plan. Suppose hearing loss is a growing concern for you or your family. In that case, it may be worth examining your Medicare Advantage options or looking into solutions such as Medicaid, hearing health charities, or community health programs.
It’s also worth taking steps to protect your hearing wherever possible. By avoiding loud noises and wearing ear protection, you can reduce the risk of hearing damage or loss and, in turn, reduce the overall costs of auditory healthcare.
FAQ
Are there any special conditions under which Medicare would cover hearing aids?
No. While Medicare may cover cochlear implants if patients have moderate-to-profound hearing loss and don’t benefit from current hearing device technology, it does not cover hearing aids for those with hearing loss.
Are there any special conditions under which Medicare would cover hearing screenings?
There are two conditions under which Medicare may cover hearing screenings. First is a screening by an audiologist once every 12 months without an order from your doctor to assess non-acute hearing conditions or for diagnostic services related to surgically-implanted devices. The other is if your PCP or another healthcare provider orders these examinations to determine your need for medical treatment.
Are cochlear implants covered by Medicare?
In some cases, yes. If patients have bilateral, moderate-to-profound hearing loss, the cognitive ability to use auditor clues, freedom from a middle ear infection, and no contraindications to surgery, Medicare may cover the costs of a cochlear impact.