Does Medicare Cover Hearing Aids
Medicare is a national health care insurance program for Americans age 65 and over, with coverage provided under Part A. Medicare also covers certain medical services in the case that they are medically considered “necessary,” which is defined as needing your care and attention because you cannot be cared for at home without the need of skilled assistance.
Hearing aids are one of the many services considered necessary by Medicare. Hearing aids are among the most expensive technological devices one can purchase, costing anywhere from $4,600 a pair or $2,700 per ear. Most people in need of hearing aids try to cover the associated costs through Medicare.
So does Medicare cover hearing aids? Medicare covers certain medical services that are considered necessary, and hearing aids are one of those services. This has caused many people to wonder if they may be able to claim a Medicare benefit for the cost of their hearing aids.
Medicare Parts A & B doesn’t make up for the costs associated with hearing aids, hearing exams, or fittings for hearing meant explicitly for purchasing a hearing aid. Yet, Medicare Parts A & B covers hearing exams that are meant for diagnostic purposes, provided there is a referral from a doctor. Choosing a Medicare supplement plan requires input from a doctor to make sure you are getting what you need.
For instance, if a person were diagnosed with hearing loss, they would likely be sent to an audiologist (a professional specializing in the treatment of hearing loss) by the patient’s doctor. Medicare covers the cost of this appointment and hearing aids upon a doctor’s referral. Medicare Part C (Medicare Advantage) offers a certain degree of coverage, depending on the type of plan according to this website.
Certain Medicare Advantage plans to take care of hearing exams, aids, and other hearing services associated with hearing loss, provided that the client currently suffers from hearing loss and requires auditory-related services. The plan must be a Medicare Medical Savings Account (MSA), a Private Fee-for-Service (PFFS), or an HMO.
The device itself/the hearing equipment does not have to be covered by Medicare if it is not considered medically necessary for the person in need of them. The device needs to be medically necessary if you need the equipment to live a normal, fulfilling life.
When it comes to most hearing aids and hearing instruments, Medicare covers them, but they do not pay for anything beyond the initial cost of purchasing. Hearing aids are considered medically necessary if there is a lack of noise in the environment that causes you to ask people constantly, “can you tell me what is happening?” Medicare does not cover the replacement of hearing aids, monitors, or memory systems for people with severe hearing loss.
Medicare Advantage is considered a private medical insurance package alongside your initial Medicare Part A & B plan. Therefore, the degree of hearing aid coverage depends on which private insurance provider you have. It is important to remember that hearing aid coverage will only cover part of the purchase price. Medicare will only cover a certain amount, around 50% or 60% of the cost.
To establish whether Medicare Advantage Policy will take care of your hearing aids, it is important to contact your insurance provider using the phone number indicated on the membership card and inquire from a customer representative to understand more about the coverage.
If you are an individual with Medicare Parts A & B, you need to call the Medicare Customer Service Center to set up an appointment with a specialist. You will be asked to provide your member number, beneficiary identification, and proof of your age.
How to add Medicare Advantage to your Medicare plan
Suppose you do not have Medicare Advantage but are still interested in getting it. In that case, you can call the number on your Medicare card and ask a customer service representative to help you with the process. You can also inquire from a licensed Medicare professional to weigh up various insurance plans available to help you with your hearing services.
A licensed Medicare professional will assist you in comparing the benefits provided by different insurance providers to establish which insurance provider offers the best hearing aid coverage. An agent will also help you compare additional benefits that fit your needs and calculate the monthly deductibles and premiums to determine the most suitable plan within your budget.
Who can claim the hearing aid benefit?
Medicare benefits are normally authorized for people over the age of 65. The benefit is claimed by those needing hearing aids, i.e., those who have experienced hearing loss and require auditory-related services. You will also be required to provide a referral from your doctor saying you need hearing aids to cover your initial or routine examination and eventually claim Medicare benefits for them.
The co-payments for Medicare providers vary depending on the type of plan a person has. For instance, Medicare Advantage plans will normally have a high co-payment if you have the particular plan, whereas some Private Fee for Service plans will not require co-payments. As such, it is important to read the plan conditions carefully and make inquiries from a health insurance professional to determine which plan best suits your needs.
If you have a Medicare Advantage plan that offers hearing aid coverage, you can visit local hearing aid dispensers to choose from the various devices and purchase them. You cannot purchase devices from third-party medical providers if you do not have a Medicare Advantage Plan. Only devices purchased from MID-approved (Medical Information Drug database) hearing device clinics and manufacturers can be covered by Medicare Advantage.
Medicare covers the hearing device, but the fitting and follow-up services are not included. If a person with hearing loss purchases a medical device from a third-party medical provider, they cannot claim the cost inside Medicare. The same treatment applies if a person with hearing loss opts to purchase the aid themselves without getting any recommendation from an Audiologist.
Conclusion
Hearing aids are considered expensive, and thus, not many people can afford them on their own. For this reason, some people wait until they get old or start experiencing hearing issues to get them. However, Medicare provides hearing aid coverage for people who want to get them earlier than the stipulated age.
It is important to remember that Medicare is not the only solution to your hearing problems. You can always get a recommendation from a specialist to determine the Medicare plan that will be best for you.
