As if insurance coverage isn’t complicated enough, the world of Medicare and Medicaid isn’t any simpler. Medicare is a federal health insurance program that offers coverage for people over the age of 65, as well as individuals with disabilities or serious diseases. Medicaid is a state-run public insurance program that offers coverage to low-income families. Though both programs are essential, there are many ways in which their offerings are limited. For starters, they don’t offer much coverage for adults when it comes to vision, dental, or hearing care.
Which parts of Medicare cover hearing aids?
Medicare does not cover all costs of medical services, including hearing aids. Per the Medicare website, “Medicare doesn’t cover hearing aids or exams for fitting hearing aids. You pay 100% for hearing aids and exams. Some Medicare Advantage Plans (Part C) offer extra benefits that Original Medicare doesn’t cover – like vision, hearing, or dental. Contact the plan for more information.” So, while Medicare may not offer coverage, there may be other options to consider, namely the Medicare Advantage Part C Plan.
Which Medicare plans may be best for you if you know you need hearing aids?
If you know you need hearing aids, then Medicare Advantage Plan Part C may be an option to consider. These are plans offered by private companies pre-approved by Medicare, that must follow pre-set Medicare rules, that set a limit on what you’ll have to pay out of pocket each year for covered services.
Part C plans may include hearing benefits, like the cost of hearing aids, but you’ll need to discuss your plan directly with Medicare Advantage to be sure exactly what you have access to. According to the Kaiser Family Foundation, as of this writing, 90% of individual Medicare Advantage plans provide access to a combination of vision, fitness, telehealth, hearing, and/or dental benefits. It’s also important to note that the availability of these plans will change based on state and county.
How much do hearing aids cost with Medicare?
Seeing as Medicare provides no coverage for hearing aids, that means you are responsible for 100% of the cost. Of course, if you are part of Medicare Advantage Plan Part C, then that cost will be different, and it will be based on your location and what kind of hearing aid you need.
Without insurance, you can expect to pay around $2,000-$3,000. It can range from $1,000 and up to more than $4,000 for each device (meaning, per ear), depending on the level of technology. More basic models of hearing aids will cost less than the ones offering more advanced features and customization options. Pediatric hearing aids, thankfully, cost less and are often covered by insurance.
Are hearing aids covered by Medicare?
Unfortunately, as stated by the Medicare website, “Medicare doesn’t cover hearing exams, hearing aids, or exams for fitting hearing aids.”
Does Medicare cover hearing tests?
Coverage for hearing tests will sometimes be provided by Medicare, but only if your primary care doctor or physician recommends one. That means you can only go to a hearing clinic if you have a referral from a doctor, or else Medicare will not cover the cost.
According to the Medicare website, “Medicare Part B (Medical Insurance) covers diagnostic hearing and balance exams if your doctor or other health care provider orders them to see if you need medical treatment. You pay 20% of the Medicare-approved amount for your doctor’s services for covered exams, and the Part B deductible applies. Medicare doesn’t cover hearing exams, hearing aids, or exams for fitting hearing aids.”
Why doesn’t Medicare cover hearing aids?
The Medicare Act of 1965 stated explicitly that hearing aids would be excluded because they were ‘“routinely needed and low in cost.” Of course, over fifty years later the “low cost” statement is no longer the case. It also doesn’t take into consideration the advances in science and how populations are living longer than ever before, which means age-related hearing loss is more common now than it was back then.
How much do hearing aids cost?
Unfortunately, without assistance from insurance, hearing aids can be quite expensive, and prices vary depending on how sophisticated the hearing aid is. The average cost of a pair of hearing aids falls between $2,000-$3,000. More complicated devices with more customization options can cost upwards of $4,000.
How can I get help paying for hearing aids beyond Medicare Advantage?
In some states, people can get help paying for hearing aids with Medicaid through a “medically needy program.” However, this assistance will only apply to people with a low enough income to qualify for assistance. To find out more, contact your local government’s county social services and request an appointment to determine your eligibility for Medicaid.
Another way to get help is through incredible non-profit organizations, like Hearing The Call. This organization is committed to bringing help to the hearing impaired by hosting events throughout the year to provide affordable treatment. Patients register to attend and receive hearing exams and get fitted for hearing aids, all at a cost based on income, sometimes even for free. Visit their website to find out if there’s an event near you!
Can You Combine Medicare and VA Benefits?
The good news is that you can have both Medicare and Veteran’s Affairs (VA) benefits, but they do not work together. This means Medicare will not pay for care that you receive at a VA facility. If you want VA benefits to pay for your care, then you must receive healthcare services at a VA facility.
The US Department of Veteran’s Affairs may also provide assistance with hearing aids and other services for veterans of military service. To find out if this applies to you, contact the medical facility for the appropriate branch of the military.
Per the Hearing Loss Association of America, “In an effort to improve the quality of life for those who serve our country, Williams Sound has proudly partnered with the Military Audiology Association (MAA) to offer the Retiree Assistive Listening Devices (RALD) program to both retired and active-duty military service members and their families. The RALD program was created to provide these individuals access to assistive listening devices (ALDs) at a reduced cost, along with free personalized telephone support. For more information on RALD, please visit Williams Sound or Military Audiology Association.”
Though it may seem as though Medicare coverage is light, there is some assistance to be had out there, it just takes some digging. The important thing to remember is not to lose hope, and more importantly, not to ignore your hearing loss. If you notice any sort of hearing loss and you have Medicare, ask your primary care physician for a referral so you can see an audiologist immediately. The sooner you see an expert, the better your chances of finding a solution that works well for your needs.
