Understanding your Medicare coverage can feel like communicating in a foreign language.
There are so many parts to your plan, additional plans that offer options Original Medicare doesn’t, and the issue of how much you’ll have to pay before meeting your deductible.
In addition, there are some health items and devices that Original Medicare doesn’t cover.
That means you’ll have to cover the cost of these items at 100 percent of their retail cost or look for additional insurance plans to help you cover them.
If you’ve suffered a hearing loss, you might wonder if your Medicare coverage will help pay for the cost of hearing aids.
Hearing aids generally cost between two and three thousand dollars per pair, which can be burdensome on a fixed income.
Together, we’ll discuss a few Medicare basics, including whether or not your plan will cover hearing aids. We’ll also discuss other ways to offset the cost of hearing aids if you find you don’t have insurance coverage.
First, let’s talk about the types of hearing loss that require a hearing aid.
What Is Hearing Loss?
There are two main types of hearing loss.
- Sensorineural hearing loss. This type of hearing loss affects the structures of the inner ear, including the cochlea, semicircular canals, and auditory nerve.
- Conductive hearing loss. This type of hearing loss affects the outer and middle ear structures, including the pinna, the ear canal, the eardrum, and the three bones of the inner ear.
Most age-related hearing loss, called presbycusis, is sensorineural and caused by damage to the tiny hair cells inside the cochlea.
Degrees of Hearing Loss
Hearing loss is usually in five groups: mild, moderate, moderately-severe, severe, and profound.
Mild hearing loss may make it hard to hear children’s voices, whispers, or soft music.
Profound hearing loss makes it impossible to hear noises below 91 decibels. Without a hearing aid, it’s impossible to hear loud sounds like jet engines or fire alarms.
When Do You Need a Hearing Aid?
Most experts agree that a hearing aid is needed once a person experiences moderate hearing loss.
This type of hearing loss makes it hard for a person to hear normal conversation and can make it sound as though people are mumbling or not annunciating their words correctly.
It also affects how a person speaks and can cause them to experience social isolation.
They may avoid social engagements where they feel they wouldn’t be able to hear conversations. This can lead to feelings of depression and isolation.
What About Cochlear Implants?
Hearing aids are beneficial for people who have mild to moderately-severe hearing loss.
Severe and profound hearing loss usually requires the assistance of cochlear implants to restore the ability to hear.
These implants are surgically placed and bypass the damaged part of the ear, making it possible for sound waves to be changed into electrical signals and delivered directly to the auditory nerve.
Unfortunately, the out-of-pocket cost of hearing treatment can be quite expensive. If you have Medicare, you should know what is and is not covered.
What Is Medicare?
Medicare is a federal health insurance plan that covers individuals who are aged 65 and older.
This health insurance is offered to all Americans, regardless of income. If you already have private insurance, you are still eligible for Medicare.
Medicare includes four different parts.
Medicare Part A
This portion of your Medicare benefits covers inpatient hospital stays and is often referred to as your hospital insurance.
If you are injured, need surgery, or otherwise need to stay overnight in the hospital, this portion of your Original Medicare plan will offer coverage.
After you pay your deductible (which can change every year), your stay is covered up to a certain amount of days per benefit period.
Medicare Part B
This is the portion of your Medicare benefits that covers outpatient services.
Doctor’s visits, certain diagnostic tests and screenings, mental health services, and durable medical equipment (DME) are covered under your benefits section.
Also included under Part B are ambulance transportation, X-rays, and certain orthopedic visits.
Services and equipment are covered after you have reached your Part B deductible.
Medicare Part C
Part C refers to the Medicare Advantage Plan, a type of medicare supplement insurance.
This is offered through private insurance companies. To be eligible, you must be enrolled in Medicare Parts A and B and live in an area that offers Part C.
The option to enroll in Medicare Part C plans was eliminated in January of 2022. Now, Americans who want further coverage can opt for private insurance Medigap plans.
Medicare Part D
This portion of Medicare offers prescription drug coverage. Not all prescription drugs are covered under Medicare Part D.
What Is Medigap?
Medigap insurance is private insurance that covers certain gaps in Medicare coverage.
Still, it isn’t the same as Medicare Part C. These plans cover many benefits that Medicare does not, including hearing, vision, and dental care.
Does Medicare Cover Hearing Tests?
Medicare Part B (your medical insurance) does cover hearing exams and balance exams.
Your doctor or healthcare provider must order these tests to determine if you need medical treatment.
You’ll need to schedule an appointment with your general provider to discuss your hearing concerns.
Your doctor will then refer you to an audiologist or hearing professional to administer diagnostic hearing exams. Part B covers these exams but does not cover additional hearing services.
Does Medicare Cover Hearing Aids?
Unfortunately, Medicare doesn’t cover the cost of hearing aids or the exams for fitting hearing aids.
Some Medicaid services include coverage for hearing aids for children and adults under certain circumstances.
If you have Medicare Advantage Plans (part C), you may have extra benefits that Original Medicare does not cover, including vision, dental, and hearing.
Medicare supplement plans cost more out of pocket, but if you have hearing problems, it may be worth speaking to a licensed insurance agent to consider enrollment in one of these plans.
How Can I Afford Hearing Aids?
Losing your hearing can affect your quality of life and may lead to early onset dementia.
It can cause a person to isolate socially and can lead to feelings of depression and anxiety.
Hearing aids can restore a person’s hearing and communication with their loved ones.
A recent study showed that 75 percent of Medicare beneficiaries who needed hearing aids didn’t have them.
While hearing benefits may be something that Medicare covers in the future, those without coverage must find ways to afford their hearing aids.
Over-the-Counter Hearing Aids
Recently, the FDA approved over-the-counter hearing aids that do not require a hearing exam or prescription.
This would also not require a fitting or even a visit to an audiologist. Much like reading glasses sold through retail outlets, these over-the-counter hearing aids would be more affordable and available to anyone who needs them.
These hearing aids would be more affordable and accessible to those needing them and would not require any insurance coverage.
Hearing Aid Coverage
If you use private insurance or consider coinsurance to help cover the cost of hearing aids or other non-Medicaid covered devices and services, read the fine print.
Many private insurance plans also fail to cover hearing aids and require hearing health coverage to be purchased separately.
Some states, however, have laws requiring private insurance to offer coverage for hearing aids for older adults.
The Department of Veterans Affairs
If you are a veteran and have suffered hearing loss, you are likely eligible for hearing aids through the VA.
The VA provides more hearing aids to people than any other agency in the United States.
Many retailers offer financing for hearing aids through private programs. If you cannot get coverage through insurance, you may be able to obtain financing and make payments on your hearing aids.
If you need hearing aids and don’t have coverage, other more affordable treatment options may be available.
For more information and to learn more about protecting your hearing, check out the USA Rx Hearing Loss Hub.
There, you’ll find information about hearing loss and prevention, along with a review of hearing devices and options for treating your hearing loss.
References, Studies and Sources:
Hearing & balance exams – Your Medicare Coverage | Medicare.gov
Hearing aids – Your Medicare Coverage | Medicare.gov
What is Medicare Part C? | HHS.gov
How Medicare Could Provide Dental, Vision, and Hearing Care for Beneficiaries | Commonwealth Fund.org
FDA Finalizes Historic Rule Enabling Access to Over-the-Counter Hearing Aids for Millions of Americans | FDA.gov
Insurance and financial assistance for hearing aids | Healthy Hearing.com
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