Many people find that they need the assistance of hearing aids as they age. With so many seniors receiving Medicare, you are likely wondering whether Medicare will cover hearing aids. The answer can get a little complex depending on your specific Medicare plan. There is Original Medicare, Medicare Advantage plans, and Medigap. So, the answer might depend on which type of Medicare coverage you have. If you are starting to experience hearing loss, then keep reading. We will give you all the details regarding Medicare and hearing aids. We’ll tell you whether Medicare covers hearing aids and hearing tests and how much you might have to pay for your hearing aids.
Does Medicare Cover Hearing Aids?
Many people wonder, “Are hearing aids covered by Medicare?” The basic answer is no. Original Medicare does not cover hearing aids or exams for the fitting of hearing aids. However, there is more to the story. If you have a Medicare Part C plan, you might have coverage for hearing aids. So, what does Medicare cover when it comes to hearing services? Here is how coverage for hearing aids is handled under each part of Medicare.
— Medicare Part A Coverage
Medicare Part A is hospital insurance that covers hospital stays, inpatient care, hospice care, and care in a skilled nursing facility. Medicare Part A coverage is mandatory, and many people are automatically enrolled in this coverage. However, it does not provide any coverage or benefits for hearing aids. Under Part A coverage, you will be responsible for the total cost of hearing aids on your own. Part A provides basically no coverage for hearing care.
— Medicare Part B Coverage
So, does Part B cover hearing aids? Medicare Part B is medical insurance that covers doctor visits, lab tests, preventive services, and outpatient services. You typically only need to pay a copay when you visit your healthcare provider. Part B requires a monthly premium, and the amount you pay depends on your total annual income. Part B does not provide coverage for hearing aids. However, Part B does cover hearing exams in some cases. If your physician deems that a diagnostic hearing exam or balance exam is necessary for the treatment of a medical condition, Part B will cover the exam. You will still need to pay your coinsurance amount of 20% of the covered service.
— Medicare Advantage Coverage
So, are hearing aids covered under Medicare Advantage plans? Remember that Medicare Advantage plans are managed and administered by private insurance companies. These plans combine both your Part A and Part B coverage into a single plan. These plans must provide at least the same minimum level of coverage provided by Original Medicare. However, most plans provide additional benefits beyond what Original Medicare provides. This may include dental care and Medicare coverage of eye exams.
The specifics of each plan are determined by the insurance company that manages the plan since these providers are allowed to set their own rules. The majority of Medicare Advantage plans do provide hearing aid benefits. According to the Kaiser Family Foundation, more than 90% of Advantage plans provide some type of hearing aid benefit. You will likely still be responsible for copays and deductibles, but having some health insurance benefit is better than nothing.
— Medicare Part D Coverage
Medicare Part D provides prescription drug coverage. These prescription drug plans do not provide any benefits for hearing aids. Part D plans can be purchased on their own by anyone who is enrolled in Medicare. Although Part D plans are not mandatory, you might pay a late enrollment penalty if you do not sign up when you first become eligible. Most Medicare Advantage plans also provide prescription drug benefits. If you are an older adult looking for hearing benefits, then you will need to look at other options besides a Medicare Part D plan.
— Medigap Coverage
Many Medicare beneficiaries choose to enroll in a Medicare supplement plan to help with out-of-pocket costs not covered by Medicare. As a general rule, the service must be covered by your Medicare benefits for Medigap to help with payment. Medigap plans help pay for things like copays, deductibles, and coinsurance amounts, although new plans can no longer cover your Part B deductible. Medicare supplement insurance does not cover hearing aids, although they might pay for some medical treatment related to hearing. This is similar to Medicare Part B in that the diagnostic exam must be ordered by a physician for the treatment of a medical condition. You might be able to purchase a Medigap add-on policy that will provide some hearing coverage, but you should check with your plan provider for specifics.
Medicare Coverage For Hearing Tests
Medicare does not cover hearing aids, and it generally does not cover hearing tests or hearing services either. There is one exception, though. If your doctor orders a hearing test or balance test to determine whether treatment is needed for a medical condition, then the test will be covered. You might need a referral from your primary care physician in some cases. You might be referred to an audiologist to complete some of these tests. However, remember that having hearing problems is not enough to get Medicare to cover the cost of a hearing test. A physician will need to deem these tests medically necessary for the treatment of a medical condition.
Many Medicare Advantage plans provide more hearing health coverage than Original Medicare. These plans often provide benefits for both hearing tests and hearing aids. These insurance plans are managed by private insurance companies, so they can set their own coverage rules. You should contact your plan provider to determine the specifics of your plan. If you are considering enrollment, you can use the Medicare plan finder at Medicare.gov to find Advantage plans available in your area.
Cost Of Hearing Aids With Medicare
Hearing aids are not cheap, and Original Medicare does not help with the cost. Currently, most hearing aids require a prescription. This means that you will need to visit your doctor before being allowed to purchase the hearing aids. This adds to the total cost of the devices because the doctor must perform hearing tests and hearing aid fitment exams. Many people need hearing aids in both ears, so this essentially doubles the cost of the device. On average, a set of two hearing aids can cost anywhere from $2,500 to $7,500. These prices are often bundled to include all the exams and fittings that go along with the purchase.
The FDA is also working on regulations that will allow for the sale of over-the-counter hearing aids. This means that you would be able to purchase hearing aids without a prescription. This effort aims to bring down the overall cost of hearing aids to make them more accessible to those who need them. Hearing is essential to one’s overall wellness, so finding ways to make these devices more affordable is a step in the right direction.
Though Original Medicare does not provide for coverage of hearing aids, many Medicare Advantage plans cover these devices. The amount you will need to pay for the devices depends on your specific Advantage plan. Most plans require you to pay a coinsurance amount when you purchase the devices. This means that you might still need to pay anywhere from $400 to $1,500 for the hearing aids, but these amounts are much better than those without coverage.
Best Medicare Plans With Hearing Aid Coverage
Now that you know Medicare hearing aid coverage is only available through Medicare Advantage plans, which one is the best Medicare Advantage plan for those needing hearing aid coverage? Here are the three best Advantage plans for those individuals who need hearing aid coverage.
- Humana
- Blue Cross Blue Shield
- AARP / United HealthCare
Plans administered by the three providers above provide varying benefits for hearing aids. The coverage provided in these plans can greatly reduce your out-of-pocket expenses related to the fitment and purchase of hearing aid devices. With these plans, your total cost for hearing aids would be anywhere from $400 to $2,000 in most cases. The exact amount depends on the testing required for diagnosis as well as the specific device that your doctor prescribes.
The Bottom Line
Original Medicare does not cover hearing aids, and it rarely covers hearing tests unless those tests are ordered by your physician to determine whether treatment is needed for a medical condition. Medigap plans also do not cover hearing aids, but Medicare Advantage plans usually provide hearing benefits – including hearing aids. You will need to reference your plan documentation to find specific coverage details, but most plans can greatly reduce the amount that a hearing aid will cost you.
Frequently Asked Questions
Does Medicare pay for hearing aids in 2022?
No, Original Medicare does not pay for hearing aids in 2022. Medicare has never covered hearing aids. The Medicare Act of 1965 specifically excludes hearing aids. These devices were determined to be low in cost, so Medicare beneficiaries were expected to pay for the items on their own. However, people are living longer today than they did in 1965, and more people are suffering from age-related hearing loss. Hearing aids are quite expensive now, but Medicare still does not provide coverage for the devices.
When will Medicare change their coverage for hearing aids?
Some lawmakers have attempted to change Medicare to provide coverage for vision, dental, and hearing services. However, none of these attempts have gotten passed as law so far. Only time will tell whether Medicare will be updated to change their coverage of hearing aids. New legislation is frequently introduced to make this change to Medicare, but it has not gotten much traction in Congress so far. Medicare might be changed to cover hearing aids at some point in the future, but there is no guarantee this will ever happen.
Does Medicaid provide coverage for hearing aids?
Medicaid must provide hearing services to enrolled individuals under 21. However, each state has discretion whether to provide hearing services to adults over 21 enrolled in Medicaid. Many states do not provide coverage for hearing tests or hearing aids. Other states do provide coverage, although the details of the coverage vary by state. If you have questions about your coverage, you should check with your state Medicaid office to find out what is covered.
