Medicare and Hearing Aids
According to the National Institutes of Health (NIH), nearly 30 million US adults could benefit from hearing aids, with 25 percent aged 65 to 74 dealing with hearing loss. Hearing aids are a useful tool, but they can be expensive, which is why you may wonder what coverage Medicare can offer. Does Medicare cover hearing aids? Read on to find out.
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Original Medicare Hearing Coverage
Medicare Part B will cover hearing exams specifically related to diagnosing an injury or medical condition in need of treatment. As with most Part B Medicare coverage, you are responsible for the remaining 20% balance. Because of this, it’s important to check with your physician how much the test will cost and if Medicare offers coverage for the service. Medicare doesn’t cover everything. While Medicare covers some diagnostic hearing exams, there are large gaps in hearing coverage, especially when it comes to routine services.
Original Medicare does NOT cover:
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Hearing aids
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Hearing exams (unless related to an injury)
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Exams for fitting hearing aids
Medicare Advantage (Part C) Hearing Aid Coverage
If you need hearing aids, you may find more benefit from a Medicare Advantage plan. Medicare Advantage (Part C) plans are offered through private insurance companies. These plans are required to cover all of the same services as Original Medicare (Parts A and B), but many plans include additional benefits like dental, vision and hearing. They offer additional benefits and savings as well, and most Medicare Advantage plans include prescription drug coverage.
Every Medicare Advantage plan is different, which is why it’s important to seek details of the plans available to you prior to enrollment. Depending on the plan, you may find full or partial hearing aid coverage. Certain plans come with a maximum annual limit of hearing benefits, while others are unlimited.
Over-the-Counter Hearing Aids
As of October 2022, you may be able to purchase hearing aids without a prescription. The FDA has approved over-the-counter hearing aids for individuals with mild to moderate hearing impairment. This ruling will help expand hearing aid access by lowering the cost of hearing aids in comparison to prescription hearing aids.
Some Medicare Advantage plans offer an allowance on over-the-counter supplies. Medicare Advantage plans with OTC benefits provide a set amount of money to spend on specific over-the-counter items. Not all Medicare Advantage plans offer OTC benefits, so it’s important to compare plan benefits prior to enrollment.
Paying for Hearing Specialist Out of Pocket?
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Frequently Asked Questions
No. When you are enrolled in Original Medicare, just like all non-covered hearing services, you will be responsible for 100% of the cost out-of-pocket. While Medicare Parts A and B do not offer coverage in this area, many Medicare Advantage (Part C) plans offer benefits that cover some or all of the cost of hearing aids and fitting exams.
Enrollment Eligibility
Annual Enrollment Period (AEP)
Medicare Annual Enrollment Period runs each year from October 15 to December 7. What is the Annual Enrollment Period vs. Open Enrollment Period?
Initial Enrollment Period (IEP)
Your Initial Enrollment Period generally surrounds your 65th birthday but may occur if you otherwise become eligible for Medicare for the first time.
Special Enrollment Period (SEP)
You may be eligible if you experience a qualifying life event such as moving to a new zip code, losing employer coverage, or change in Medicaid status.
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