We are all aware that hearing loss is a prevalent concern among older adults. It’s been estimated that approximately one-third of individuals aged 65 to 75 encounter hearing difficulties, with the likelihood increasing as one ages. According to the National Institute on Deafness and Other Communication Disorders, 30 million American adults could benefit from using hearing aids.
While a quality hearing aid can significantly improve one’s quality of life, the question arises: does Medicare cover it? What alternatives exist? Let’s delve into what Medicare does and doesn’t cover regarding hearing aids, explore potential coverage alternatives, and discuss strategies for saving money.
Does Original Medicare Cover Hearing Aids?
Original Medicare does not include coverage for hearing aids or the necessary fitting exams. This means beneficiaries must cover the costs out of pocket, which can be quite substantial. On average, a single hearing aid may cost around $2,000 or more, depending on the specific device required. However, there are various avenues to explore, such as Medicare Advantage plans, discount options, and more.
Why isn’t hearing aid coverage included in Original Medicare?
To comprehend the absence of hearing aid coverage in Medicare, it’s necessary to delve into the program’s origins. When the Medicare Act of 1965 was established, hearing aids were excluded from coverage based on the assumption that they were within reach financially for beneficiaries to procure independently.
Fast forward to today, and we find ourselves in a different landscape. With longer life expectancies, a growing portion of the population is likely to require hearing support services and devices. Moreover, our understanding of the impact of hearing issues on both physical and mental health has evolved, highlighting heightened risks of depression, social isolation, and cognitive decline with age. Additionally, the affordability of hearing aids has diminished compared to earlier times.
Is hearing test coverage included in Medicare?
General hearing services and examinations are not typically covered by Original Medicare, unless deemed medically necessary. For example, if you fall ill or sustain an injury affecting your ear health, such tests may be utilized to diagnose potential conditions. In such cases, Part B of Medicare would cover 80% of the expenses, with the remaining 20% payable by you after meeting the deductible. However, it’s essential that your physician accepts Medicare, and you’ll require a referral from an audiologist to qualify for coverage.
Medicare Advantage Options for Hearing Aids
Although Original Medicare doesn’t include coverage for hearing devices, there are still alternatives available. Numerous Medicare Advantage plans (Part C), and in certain regions, Medicare Cost plans, offer options to meet your needs. Depending on the plan you select, provided by private insurance companies, hearing aids, examinations, and additional benefits may be covered.
Strategies for Saving on Hearing Aids
If you’re enrolled in Original Medicare and seeking ways to economize on hearing aids, there are several avenues you can explore. Recognizing that hearing aids represent a significant investment and acknowledging the individuality of financial and health circumstances, consider these cost-saving options:
Over-the-counter Hearing Aids: With recent FDA regulatory changes, individuals with mild to moderate hearing loss can now purchase hearing aids without a prescription or audiologist fitting. While still relatively pricey, over-the-counter options are estimated to be $2,000-$3,000 less expensive than prescription devices, potentially saving you 40%-60%, depending on the chosen model.
Discount Programs: Numerous online and local discount programs are available to help reduce the cost of hearing aids. Start your search with associations you may already be affiliated with, such as AARP and local senior groups.
Direct-to-consumer (DTC) Options: Many online retailers offer DTC hearing aids, allowing you to take a hearing test and have the aids sent directly to you. Typically more affordable, some retailers even offer monthly payment plans as part of a subscription package.
Medicaid: While coverage varies by state, Medicaid may cover hearing aids and examinations for eligible individuals based on income. Contact your state Medicaid program to determine your eligibility.
Federal Employee Health Benefits (FEHB): Current and retired government employees enrolled in FEHB may qualify for hearing aids and exams. Generally, enrollment in FEHB is required for at least five years before retirement.
U.S. Department of Veterans Affairs (USDVA) Benefits: U.S. veterans, who are statistically more likely to experience severe hearing issues, may be eligible for hearing aids, exams, and additional services through USDVA.
Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs): If you possess an HSA or FSA, you may be eligible for reimbursement when purchasing hearing aids.
Securing the Necessary Medicare Coverage for Hearing Aids
Despite the limitations of Original Medicare, solutions exist to address your hearing needs. Whether through a Medicare Advantage or Medicare Cost plan, you can access the care and coverage required, encompassing everything from hearing aids to examinations.