Will Medicare Cover Hearing Aids?

 With millions of people in the United States affected by hearing loss, this disability represents a fair amount of financial crisis for many people. Out of the general population, it is common for many seniors and veterans to need hearing aids. Even with health insurance, hearing-aid coverage can vary. The cost of prescriptions may be substantial depending on what type of medical insurance and Medicare benefits you have. 

This process requires not just doctor's appointments but a variety of tests that a specialist, known as an audiologist, must walk you through. These appointments, visits, and tests can turn into thousands of dollars very quickly. For many people, the cost of hearing aids is as much of a challenge as that of experiencing hearing loss itself. 

People that go this route will be looking at thousands of dollars to get custom-programmed hearing aids, which can get expensive if your insurance doesn't cover it. Out-of-pocket costs can happen when your physician or health care provider orders tests like routine hearing exams, which may include a hearing test or balance exams, which might not be covered. It’s not so much the hearing aid devices cost themselves as it’s the process to get them custom prescribed that costs more. 

If you are experiencing hearing loss, here is everything you need to know about how Medicare may affect your hearing aids cost and doctor's services. 

What Is Medicare?

Medicare is a government-run financial assistance program for medical needs. It is designed to service people over 65, people who are younger that have a qualifying medical need, and people suffering from end-stage renal disease. 

This system was put in motion by President Lyndon B. Johnson, who signed into law initial bills that eventually became the Medicare and Medicaid plans that we now know. This system is built off taxes from the general population, and certain trust funds held by the department treasury specifically meant for medicare. 

In 2017, medicare helped over 58 million eligible individuals with their financial, medical needs and represented a total cost of seven hundred and five billion dollars. This program is ambitious and serves a huge demographic in the United States, and is very costly. As the average life expectancy goes up, the number of individuals who will qualify for this service also increases. 

That being said, it is by necessity limited in what it can offer to those who qualify. 

How Do I Get Medicare?

When it comes to qualifying for Medicare, the government website lays out three categories of individuals that are eligible for this service:

  • Individuals over the age of 64
  • Specific younger individuals with qualifying medical needs
  • Individuals suffering from end-stage renal failure

Medicare itself is broken down into four different parts that all cover specific services. While it may seem overwhelming to think about the concept of getting medicare and what that entails, the official government website has general guidelines that can help you find out what services they can cover. 

Unfortunately, according to the official government website, medicare does not cover hearing aids. They do not cover any of the purchase cost millions of people, for the hearing aid themselves or the testings and appointments to acquire the specific prescription. There is a gray area on what premiums are offered. Before you get medical treatment using a Medicare plan, here are the four types and what you need to know about them. 

Medicare Part A Plans

Medicare Part A can be thought of as covering medical inpatient costs. Part A also covers some home care treatments. However, Medicare Part A is typically used to cover hospital stays and skilled nursing facilities.

Medicare Part B Plans

Medicare Part B can be thought of as providing coverage for outpatient care. This would cover doctors visits, medical supplies, and select preventive services. As stated before, hearing aids that would technically fall under Part B for medical coverage are as of yet not considered eligible for Medicare coverage.  

Original Medicare

Both Medicare Part A and B Plans fall under the Original Medicare category. This means that you are 100% responsible for your hearing aids and any exams that you'll need. This also includes any fittings and batteries that you'll need to do to keep your hearing aids up to date. Under Original Medicare, you'll have to pay a copayment in a hospital outpatient setting. 

Medicare Part C Plans

Medicare Part C is a medicare plan that works in conjunction with private insurance companies. According to this article, Medicare Part C is not available to newly eligible individuals but is maintained for those who already have it. This type of plan may cover vision, dental, and prescription drug coverage. 

Medicare Part D Plans

Medicare Part D is different from medicare Part B in that it covers the cost of the actual prescription drugs. According to the government website, this does not cover the cost of medical supplies that are different from prescription medications. 

Financial Assistance for Hearing Aids

For those who are seeking financial assistance for hearing aids, the journey may be discouraging. Many private insurance companies do not cover this cost, and the price of getting prescription hearing aids is in the thousands. 

However, because hearing loss is considered a disability, it may be eligible for financial assistance through social security benefits. Hearing loss is a dynamic condition that can present in different degrees of severity. 

What Determines Hearing Loss?

A person who suffers from hearing loss is affected by what is known as a raised decibel threshold. This manifests itself at different levels, which can cause various degrees of hearing loss. Those degrees range from slight and mild hearing loss to severe and profound hearing loss. 

In contrast, a person who has normal hearing can have a negative decibel threshold. As they lose their hearing, the force, or decibel, at which a frequency is recognized goes up. Social security is not eligible for many degrees of hearing loss, including mild and moderate. Moderately severe hearing loss is categorized as a decibel threshold of 51 to 70 decibels, which does not make an individual eligible. 

The entry decibel threshold that makes a person eligible for social security for a hearing loss disability is a 90 degree plus threshold. That translates to the fact that only individuals with severe to profound hearing loss can be eligible for this kind of financial assistance. 

The unfortunate part of this is that many people will have a legitimate need for hearing assistance far before their decibel threshold is high enough for them to be eligible for medicare. 

Types of Hearing Loss

Hearing loss can have multiple origins as well, which can influence the degree that a person is affected. Hearing loss itself is one of the most prevalent disabilities meaning that there are millions of people who experience it at multiple degrees. 

This means that the number of people who experience hearing loss in a way that doesn’t qualify them for social security can be substantial. There are generally considered three kinds of hearing loss, conductive, sensorineural, and mixed.  

Conductive

Conductive hearing loss deals with impairment for sound waves to naturally interact with our hearing organs due to blockages. This blockage disrupts the conduction of a sound wave through the three compartments of the ear.

This form of hearing loss can be severe, such as a massive obstruction due to a traumatic event, but can also represent slightly to mild hearing loss. For instance, ear wax build-up can act as a form of conductive hearing loss, merely muffling sounds. 

Sensorineural

Sensorineural hearing loss is a form of hearing loss that deals with the neurological aspect of your hearing pathway. This is typically presented as damage to the inner ear or some kind of impairment to the cochlea. 

This can have a genetic or traumatic origin and typically results in more severe hearing loss. Treatment for this is a cochlear implant that directly interfaces with your hearing process’s neurological aspect and qualifies you for social security benefits. 

What Are Your Options?

If you are in a place where you are looking at the cost of hearing aids and realizing that this obstacle is as challenging as the disability itself, you are not alone. Millions of people are experiencing hearing loss, and many people don’t have the financial means to acquire hearing aids that cost thousands and thousands of dollars. 

While it may seem daunting, rest assured you do have options. Some services will help you get used to hearing aids that have been cleaned and reprogramed for your exact needs, or even non-prescription over-the-counter hearing aids.

The challenge with used hearing aids is that those getting used to prescription hearing aids must produce a specific diagnosis so the device can be reprogrammed to their specific needs. 

This implies the same amount of doctors’ and specialists’ appointments and tests that are the main part of the financial burden of going the prescription hearing aid route. Also, prescription hearing aids are made to fit the person’s ear uniquely. This means that the chances of someone acquiring used hearing aids that don’t quite fit are high.

Affordable Hearing Aids at Audien Hearing

We take pride in providing a highly dependable, advanced over-the-counter hearing aid that we are confident will help you on your hearing loss journey. Not only do we utilize cutting-edge technology to help block out background noise and help you focus on what’s important, but they won’t break the bank for you either. 

"Audien hearing aids offer a unique solution for those people who are over 65. The hearing aids are affordable, easy to use, and dependable." - Drew Sutton, MD, Board-Certified Otolaryngologist.

Our hearing aids come with our customer satisfaction guarantee and are endorsed by hundreds of satisfied customers worldwide. They are currently one of the smallest in-ear hearing aids available in two models, EV1 and EV3. To find out more about how our non-prescription, over-the-counter hearing aids could help you, click here.

 

Sources:

Association Between Hearing Aid Use  and Health Care Use and Cost Among Older Adults With Hearing Loss | ncbi.nlm.nih.gov 

Degree of Hearing Loss | asha.org

History | cms.gov

Home About Us How is Medicare funded? | medicare.gov

How to Qualify for Social Security  Disability Benefits with Hearing Loss| asha.org

Types of Hearing Loss | hopkinsmedicine.org

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Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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