Does Medicare Cover Hearing Aids in 2020?
The simple answer is no, original Medicare (Parts A and B) typically does not cover hearing aids or examinations for fitting them in 2020. This article explores why, alternative coverage options, and what Medicare does cover regarding hearing-related health.
Understanding Medicare and Hearing Health
Medicare is a crucial health insurance program for millions of Americans aged 65 and older, as well as younger individuals with certain disabilities or conditions. However, its coverage of hearing healthcare is limited, creating a significant gap for many beneficiaries who need hearing aids.
What Medicare Doesn’t Cover Regarding Hearing
Original Medicare (Parts A and B) generally does not include coverage for:
- Hearing aids themselves
- Routine hearing exams to diagnose hearing loss
- Fittings for hearing aids
This lack of coverage can create a financial burden for seniors and others who rely on Medicare. The high cost of hearing aids can be prohibitive, impacting their quality of life and overall health.
Why Medicare Doesn’t Cover Hearing Aids
The decision to exclude hearing aids from Medicare coverage stems from various factors, including cost considerations and legislative history. Historically, hearing aids have been categorized as durable medical equipment that is not deemed “medically necessary” for treating illness or injury, according to Medicare’s definitions. This interpretation has remained consistent over time, despite advocacy efforts to expand coverage.
Alternatives to Medicare for Hearing Aid Coverage
While original Medicare doesn’t cover hearing aids, there are alternative options:
- Medicare Advantage (Part C): Some Medicare Advantage plans do offer coverage for hearing aids, hearing exams, and fittings. Coverage varies significantly between plans, so carefully review plan details before enrolling.
- Medicaid: Depending on your state, Medicaid may cover hearing aids and related services for eligible individuals. Eligibility requirements vary by state.
- Private Insurance: Some private insurance plans offer hearing aid benefits. Review your plan documents to determine your coverage.
- Veterans Affairs (VA): Veterans who qualify for VA healthcare benefits may be eligible for hearing aids and related services through the VA.
- Nonprofit Organizations: Several nonprofit organizations offer financial assistance or discounted hearing aids to individuals who meet certain criteria.
- Hearing Aid Manufacturers’ Programs: Some hearing aid manufacturers offer financial assistance programs or discounts to help make hearing aids more affordable.
Checking Your Medicare Advantage Plan
If you are enrolled in a Medicare Advantage plan, it’s crucial to verify your specific coverage for hearing aids.
- Contact your plan provider directly.
- Review your plan’s Summary of Benefits.
- Inquire about any limitations, co-pays, or deductibles related to hearing aid coverage.
What Medicare Does Cover Regarding Hearing
While Medicare doesn’t cover routine hearing exams or hearing aids, it does cover diagnostic hearing and balance exams when ordered by a physician to evaluate a medical condition. For example, if you experience sudden hearing loss or dizziness, Medicare Part B may cover an exam to determine the cause.
The Impact of Hearing Loss on Overall Health
Untreated hearing loss can have a significant impact on overall health and well-being. Studies have shown that hearing loss is linked to:
- Increased risk of cognitive decline and dementia
- Social isolation and depression
- Increased risk of falls and accidents
- Reduced quality of life
Addressing hearing loss with hearing aids or other interventions can improve these outcomes.
Navigating the Hearing Aid Selection Process
Choosing the right hearing aid can be overwhelming. Consider these steps:
- Consult an audiologist: A qualified audiologist can assess your hearing loss, recommend appropriate hearing aid styles, and fit the devices properly.
- Explore different styles: Hearing aids come in various styles, including behind-the-ear (BTE), receiver-in-canal (RIC), and in-the-ear (ITE) models.
- Consider features: Hearing aids offer various features, such as noise reduction, directional microphones, and Bluetooth connectivity.
- Ask about trial periods: Many hearing aid providers offer trial periods, allowing you to test the devices before making a final purchase.
- Inquire about warranty and service: Ensure the hearing aids come with a warranty and that the provider offers ongoing service and support.
Common Mistakes to Avoid
- Assuming Medicare covers hearing aids: As stated earlier, original Medicare typically does not cover hearing aids.
- Delaying treatment: Ignoring hearing loss can lead to further health complications.
- Purchasing hearing aids online without professional consultation: Proper fitting and programming are essential for optimal performance.
- Not exploring alternative funding options: Take the time to research and apply for available financial assistance programs.
Frequently Asked Questions (FAQs)
Does Medicare Part B ever cover hearing exams?
Yes, Medicare Part B does cover diagnostic hearing and balance exams if they are ordered by a physician to determine the cause of a medical condition, such as sudden hearing loss or dizziness. Routine hearing exams for the purpose of getting fitted for hearing aids are generally not covered.
What is the difference between original Medicare and Medicare Advantage in terms of hearing aid coverage?
Original Medicare (Parts A and B) generally does not cover hearing aids, while some Medicare Advantage (Part C) plans do offer coverage. Medicare Advantage plans are offered by private insurance companies and may include extra benefits, such as hearing, vision, and dental coverage.
How do I find a Medicare Advantage plan that covers hearing aids?
You can find a Medicare Advantage plan that covers hearing aids by using the Medicare Plan Finder tool on the Medicare website or by contacting a licensed insurance agent. Be sure to compare plans carefully and look at the Summary of Benefits to confirm hearing aid coverage details.
Are there any limitations on hearing aid coverage under Medicare Advantage plans?
Yes, Medicare Advantage plans may have limitations on hearing aid coverage, such as: specific brands or models covered, maximum dollar amounts covered per hearing aid, requirements to use certain providers, or a co-pay/co-insurance amount. Always review the plan’s details.
If my doctor refers me to an audiologist for a hearing test, will Medicare cover it?
Whether or not Medicare covers the hearing test depends on the reason for the referral. If it’s for diagnostic purposes related to a medical condition, it likely will be covered under Part B. If it’s a routine hearing test to determine if you need hearing aids, it likely will not be covered.
Can I appeal a Medicare denial for hearing-related services?
Yes, you have the right to appeal a Medicare denial for any service, including hearing-related services. Follow the instructions on your Medicare Summary Notice (MSN) to begin the appeals process.
Are there any Medicare demonstration projects or pilot programs related to hearing health?
From time to time, Medicare may implement demonstration projects or pilot programs to test new healthcare models, including those related to hearing health. Check the Centers for Medicare & Medicaid Services (CMS) website for updates on any such initiatives.
Does Medicare cover cochlear implants?
Yes, Medicare does generally cover cochlear implants when deemed medically necessary for individuals with severe to profound hearing loss who meet certain audiological criteria. Coverage typically includes the implant device, surgery, and related services.
How can I advocate for better hearing aid coverage under Medicare?
You can advocate for better hearing aid coverage under Medicare by contacting your elected officials, participating in advocacy organizations, and sharing your personal experiences with hearing loss and the financial burden of hearing aids.
Where can I find reliable information about hearing loss and hearing aids?
You can find reliable information about hearing loss and hearing aids from sources such as the National Institute on Deafness and Other Communication Disorders (NIDCD), the American Academy of Audiology (AAA), and the Hearing Loss Association of America (HLAA).
If I have a Medicare Supplement (Medigap) plan, will it cover the costs that Medicare doesn’t for hearing aids?
No, Medicare Supplement (Medigap) plans do not cover the costs of hearing aids. Medigap plans help pay for Medicare’s cost-sharing expenses, such as deductibles, co-pays, and co-insurance. If Medicare does not cover a service, neither will Medigap.
Will Medicare coverage of hearing aids ever change?
The potential for Medicare coverage of hearing aids to change is an ongoing topic of discussion and advocacy. Legislative efforts are frequently undertaken to expand Medicare benefits to include hearing aids, but there is no guarantee of success. Stay informed about any proposed changes or policy updates through official Medicare channels and advocacy organizations.