What Medicare Plan Covers Hearing Aids?
Uncover Medicare's approach to hearing aid coverage. Explore how different plans address costs and help you access essential hearing devices.
Uncover Medicare's approach to hearing aid coverage. Explore how different plans address costs and help you access essential hearing devices.
Medicare, a federal health insurance program, provides coverage primarily for individuals aged 65 or older, and for certain younger people with disabilities. A frequent question among beneficiaries concerns coverage for hearing aids, which can be quite expensive. Understanding Medicare’s approach to hearing care helps manage potential costs.
Original Medicare, comprising Part A (Hospital Insurance) and Part B (Medical Insurance), generally does not cover hearing aids or routine exams for their fitting. Beneficiaries are responsible for 100% of these costs under Original Medicare. While direct hearing aid coverage is absent, Original Medicare does cover some hearing-related services under specific conditions. Medically necessary diagnostic hearing and balance exams ordered by a doctor to determine if medical treatment is needed are typically covered by Part B. For instance, if a hearing problem is a symptom of an underlying medical condition, such as vertigo or a balance disorder, the diagnostic exam and any necessary treatment for that condition would usually be covered.
Medicare Advantage Plans, also known as Part C, are private insurance plans approved by Medicare that offer an alternative to Original Medicare. These plans are required to provide all the benefits of Original Medicare (Part A and Part B) and frequently include additional benefits not covered by Original Medicare. Such supplemental benefits often encompass coverage for hearing aids, vision care, and dental services.
Hearing aid coverage within Medicare Advantage plans varies significantly depending on the specific plan, provider, and geographic location. Plans may offer various forms of hearing aid benefits, including:
A fixed allowance or stipend towards the cost of hearing aids, requiring the beneficiary to pay any difference.
Mandatory use of specific in-network audiologists or hearing aid centers to access benefits.
Copayments or coinsurance, which are fixed amounts or percentages paid per hearing aid or service.
Limits on the number of hearing aids covered, such as one or two aids per year or every few years.
Fitting and follow-up care as part of their benefits.
Finding a Medicare Advantage plan that includes hearing aid benefits begins with utilizing official resources. The Medicare.gov Plan Finder tool allows individuals to compare Medicare Advantage plans available in their area and check for hearing aid benefits. It is also helpful to contact individual insurance companies directly or work with licensed insurance brokers specializing in Medicare plans. When evaluating plans, beneficiaries should carefully review the plan’s “Summary of Benefits” and “Evidence of Coverage” documents for specific details about hearing aid coverage.
Enrollment in Medicare Advantage plans typically occurs during specific periods. The Annual Enrollment Period (AEP), from October 15 to December 7 each year, allows beneficiaries to make changes to their Medicare Advantage or prescription drug coverage. There is also a Medicare Advantage Open Enrollment Period (MA OEP) from January 1 to March 31, during which individuals already enrolled in a Medicare Advantage plan can make a one-time change to another Medicare Advantage plan or return to Original Medicare. Special Enrollment Periods (SEPs) may also allow for changes outside these periods due to specific life events, such as moving or losing other coverage.
Once enrolled in a plan with hearing aid benefits, beneficiaries should contact the plan’s member services to understand the specific process for accessing their benefits. This may involve obtaining a referral if required by the plan and scheduling an appointment with an in-network audiologist or hearing aid provider. During the selection process, beneficiaries will need to understand any out-of-pocket costs, such as copayments, coinsurance, or amounts exceeding the plan’s allowance. Regular follow-up appointments for adjustments and maintenance are also important to ensure proper hearing aid function.