Does Medicare Cover Hearing Aids?
- Original Medicare doesn’t cover hearing aids, but Medicare Advantage plans can. Find out what Medicare hearing care benefits are available and how to get them.
Medicare is the federal government’s main health insurance program for older adults. As part of the program, over 60 million seniors get basic screening and treatment services, as well as prescription drugs and other vital services.
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Original Medicare (Medicare Part A and Part B) does not typically provide coverage for hearing care such as exams or devices. However, many plans under the umbrella of a popular alternative known as Medicare Advantage (Medicare Part C) do offer some form of hearing services.
In this guide we'll discuss what exactly is covered by these plans when it comes to hearing aid costs and other services that may be included in a Medicare Advantage plan.
Table of Contents:
- Does Medicare Pay for Hearing Aids?
- What is Medicare Advantage?
- How Does Medicare Advantage Hearing Aid Coverage Work?
- Are Over-the-Counter Hearing Aids Covered by Medicare Advantage?
- What Other Services May Be Covered by Medicare Advantage Plans?
- Does Medicare ever pay for hearing aids?
- What changes are coming to Medicare in 2023?
- Why do hearing aids cost so much?
Does Medicare Pay for Hearing Aids?
Original Medicare does not provide hearing coverage, but 97% of Medicare Advantage plans (Medicare Part C) cover hearing services in 2023, which typically includes hearing aids.1
Hearing aids can enable those experiencing hearing loss to maintain their connections and be more engaged in life. With a Medicare Advantage plan that covers hearing aids, seniors save money on hearing exams, hearing aid fittings, batteries, maintenance and more.
Most Medicare Advantage plans offer some degree of coverage for those experiencing hearing loss, contingent upon meeting certain criteria like having a diagnosis from a doctor which indicates that you have a medically necessary need for the hearing device.
Generally speaking, most plans will fully or partially reimburse one pair of digital custom fitted earmolds per year up to an agreed-upon limit, usually ranging between $500-$3000 annually.
Hearing aid providers in these networks may offer discounts to further reduce out-of-pocket expenses when replacing devices due to normal wear and tear over time.
What Is Medicare Advantage?
Medicare Advantage is an alternative way to get your Original Medicare (Part A and Part B) benefits through private health insurance companies approved by Medicare. These plans often include additional benefits like vision, dental or prescription drug coverage and may offer lower out-of-pocket costs than traditional Original Medicare.
Medicare Advantage plans also include an annual out-of-pocket maximum spending limit which can help protect you from high medical bills in case of serious illness or injury. Original Medicare doesn't include and out-of-pocket max.
When it comes to hearing aid coverage specifically, many Medicare Advantage plans will cover at least part of the cost associated with purchasing a hearing aid device if medically necessary.
Some policies may necessitate certain sorts of devices to be covered, or mandate additional criteria before being qualified for repayment. For example, some policies require a doctor’s note confirming that the device is medically necessary before they will reimburse any portion of the purchase price.
Some Medicare Advantage policies may cover non-prescription hearing aids, but this could be different depending on the plan. Check with your Medicare Advantage insurance company before buying an OTC device without a prescription.
How Does Medicare Advantage Hearing Aid Coverage Work?
When it comes to hearing care covered by Medicare Advantage, there are two main types: full coverage or partial coverage.
- With complete coverage, Medicare Advantage plans will cover the total expense of acquiring a new set of hearing aids and any repairs or maintenance that may be necessary for its lifetime.
- Partial coverage means that some portion of the cost is paid by Medicare while you must pay the remaining balance out-of-pocket.
Some Medicare Advantage plans offer coverage for OTC devices such as Bluetooth headsets or earbuds tailored to those with mild hearing loss, enabling them to enjoy conversations without the expense of custom-made aids. OTC devices can help reduce background noise levels so conversations can be heard more clearly without having to purchase an expensive pair of custom-made devices.
Are Over-the-Counter Hearing Aids Covered by Medicare Advantage?
Many Medicare Part C plans do cover hearing aids, including over-the-counter models. This means that seniors in most parts of the country should be able to compare Medicare Advantage plans from several different providers to find the right hearing care insurance coverage.
What Are Over-the-Counter Hearing Aids?
Over-the-counter (OTC) hearing aids are devices designed to help people with mild to moderate hearing loss hear better without needing a prescription from a doctor or audiologist.
OTC devices are typically less expensive than traditional custom fitted options and can be purchased directly from retailers such as drug stores or online vendors.
Popular brands include Eargo, Oticon Opn S1 MiniRITE, Starkey Livio AI, ReSound LiNX Quattro and Widex Beyond Z Power BTEs.
How Does Coverage Work?
The specifics of coverage vary depending on the individual’s plan. Some plans provide reimbursement for at least one OTC device per ear every three years, up to certain dollar amount limits set by the insurer.
In addition, some plans may also offer additional benefits such as free batteries or discounted services like hearing aid cleaning and maintenance.
It is important for individuals considering purchasing an OTC device through their Medicare Advantage plan to check with their provider first in order to understand what is covered under their specific policy.
What Other Services May Be Covered by Medicare Advantage Plans?
Medicare Advantage plans provide an array of coverage for seniors and other eligible individuals. In addition to hearing aids, many Medicare Advantage plans also cover vision care, dental care, prescription drugs mental health services, and more.
- In terms of vision care coverage through a Medicare Advantage plan, plans may cover eye exams at least once every two years (or a similar type of time frame) along with discounts on glasses and contacts lenses if necessary. Some plans may even offer additional benefits such as laser surgery discounts and no-cost cataract screenings in certain cases.
- Dental coverage through a Medicare Advantage plan can vary greatly depending on the specific policy you choose. Plans may cover basic preventive treatments like cleanings and x-rays at no extra cost to you.
- Plans may also cover major procedures such as fillings or crowns up to a certain amount per year after which you would be responsible for paying out-of-pocket expenses beyond that limit.
- Prescription drug coverage is another area where having a Medicare Advantage plan can save you money since it often covers generic medications at lower costs than what one might pay without insurance protection in place.
Depending on your particular plan’s structure there may be limits placed on how much medication you are able to obtain each month so make sure that you understand all aspects related to this type of service before signing up for it if needed.
Medicare Hearing Aid FAQs
Does Medicare ever pay for hearing aids?
No, Original Medicare (Parts A and B) does not typically pay for hearing aids. However, some Medicare Advantage plans may offer coverage for them as a supplemental benefit. In certain cases, Medicaid and other government aid programs may offer assistance in obtaining hearing aids.
Why do hearing aids services cost so much?
Hearing aids are expensive because they contain sophisticated technology and components that require extensive research, development, and testing.
The production of hearing aids necessitates a high degree of accuracy, making it an expensive process. Hearing aid companies must cover their overhead costs associated with marketing, distribution channels and customer service.
Since hearing aids are considered medical devices in most countries there can be additional taxes or fees added onto them which increases the cost even further.
In conclusion, it is important to understand the differences between Original Medicare and Medicare Advantage plans when considering hearing aid coverage.
While Original Medicare does not cover hearing aids or routine care such as exams, 97% of 2023 Medicare Advantage plans do provide some form of coverage for these services. In addition, some plans may provide coverage for over-the-counter hearing aids depending on the individual's requirements.