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Does Medicare Cover Hearing Aids?
Did you know there is an app you can get for your phone or tablet from the app store called “Medicare – What’s Covered”…? Many people aren’t aware of this handy little tool, and I suggest you go ahead and download it. Once you do, go ahead and search “hearing aids” on that app… and it comes back as not covered. So that means traditional Medicare currently doesn’t cover hearing aids.
So why are you hearing so much on TV about Medicare covering hearing aids? And is there any likelihood of it getting approved any time soon? And if not, what’s a person to do? Hearing aids can be grossly expensive!
Find What You Need
Recent Efforts to Get Medicare to Cover Hearing Aids
In the fall of 2021, President Joe Biden proposed having Medicare cover hearing aids as a part of his domestic spending plan. The plan would have gone into effect beginning in 2023 and would have covered having a new hearing aid for each ear every five years. However, when the scope of the spending plan was reduced from $3.5 trillion to $1.75 trillion in order to appease the demands of the party’s moderates, the funding for hearing aids was cut.
Even though funding for hearing aids did not make the cut, the fact that it was considered does mean that there is some support for the measure and maybe in the future it will be addressed again.
How Expensive Are Hearing Aids?
According to the National Institutes of Health, the average price of a pair of digital hearing aids is about $1,500 and can range as high as $5,000 for higher-end models. The cost of a good hearing aid typically includes a hearing test done by an audiologist, consultation of recommended hearing aids, an initial fitting, follow-up adjustments, routine cleanings, and a warranty. It’s safe to expect a good hearing aid to have a lifespan of about 8 years. Batteries are a different matter – you’ll have to replace those frequently.
There are cheaper over-the-counter hearing aids available, but they tend to amplify all sounds and cannot be calibrated to an individual’s special hearing needs. In other words, you get what you pay for. Hearing amplifiers for television and telephones are cheaper than hearing aids, but they can still cost hundreds of dollars.
Original Medicare
As stated above, original Medicare does not offer coverage for routine or preventative care for hearing loss. The beneficiary is responsible for paying 100% of the exams, fittings, and hearing aids. Read on.
Medicare Supplements – Any Hope There?
In addition to having Original Medicare, beneficiaries can purchase Medicare supplements (MediGap Insurance) from private insurance companies. These policies pay expenses not covered by Original Medicare, such as coinsurance, copayments, and deductibles. Coverages vary by plan, but unfortunately, these plans cover only Medicare approved charges… and we’ve already established that hearing aids are not Medicare approved.
On a brighter note, some Medicare supplement insurance companies offer discounts on hearing aids as a value-added feature. These discounts are not categorized as insurance coverage, but they could sure make a difference to your bottom line.
If you have a MediGap policy, call the customer service number (look on the back of your card to find it) and ask if they have any hearing aid discounts available for you to use. If the answer is no, all you’ve lost is one phone call. If they do offer a discount, be advised that it may not be available forever; these discounts are subject to change since they aren’t part of the core insurance benefits of your plan.
Medicare Advantage Plans
You’ve probably heard of Medicare Advantage plans, which are plans offered by private insurance companies and cover Original Medicare Parts A and B, and in many instances, prescription drug costs (Part D.)
Guess what? Many of these plans actually cover hearing aids! If you are fortunate enough to have access to an Advantage plan with this benefit, there are a few important things to take into consideration. First, even if you have this benefit, the hearing aids will still cost you something. A copay per device of $400 – $1400 per device is a reasonable expectation.
Also, it’s important to note that coverage can vary tremendously by plan, and the health plan premium may be higher if it includes hearing coverage. Make sure to check the plans available for your state and county of residence. You’ll almost invariably need to use health care providers who participate in the plan’s network.
I’ll say it again, in case you didn’t read between the lines: you’ve got to follow the rules of your plan if you want to use their benefit! Do NOT assume that you can walk into the audiologist your friend recommended and use your plan’s allowance. It’s always smart to call your plan and ask what you need to do in order to tap into their benefit.
I don’t recommend switching plans frequently, but you are allowed to change your Advantage plan each year during the Annual Enrollment Period (AEP.) That means you could enroll in a plan that has a hearing aid benefit and then change back to the plan you previously had the following year during AEP. If you choose to do this, beware of what you might be losing. You’d hate to give up access to an important doctor in order to cut costs on hearing aids!
Insurance carriers change their plans every year in order to attract more members, so even if you don’t currently have access to a plan with this benefit, it may be available in the not-too-distant future.
People who receive both Medicare and Medicaid are eligible for more benefits as a result of their dual status. These Advantage plans are called Dual Special Needs plans, and enrollees in these plans may have no out-of-pocket expense for hearing aids. As stated earlier in this article, in order to receive the plan’s benefit, you must follow their procedures.
Summary
Traditional Medicare does not cover hearing aids, but you may get coverage through a Medicare Advantage plan or a discount from a Medicare supplement policy. In order to use any benefit made available, you must follow the insurance company’s guidelines. When in doubt, call your insurance company and ask them if you have the benefit and what to do if you want to access it.
