Hearing loss is more than just missing out on certain sounds. It can change the way we talk, enjoy music and entertainment, and connect with others. While it’s more common as we age, anyone can suffer from hearing loss. About 15% of American adults over 18 report some trouble hearing – and about one in three people between the ages of 65 and 74 has hearing loss.
Generally speaking, Original Medicare, which includes Part A (hospital insurance) and Part B (medical insurance), doesn’t cover the cost of hearing aids or routine hearing exams for adults. This is where a Medicare Advantage plan can help. Also called Part C, Medicare Advantage plans are bundled plans that offer coverage for things not included in Parts A and B.
Let’s take a look at what you should know about Medicare coverage for hearing.
Hearing Exams Covered by Medicare
Routine hearing exams for adults aren’t covered by Original Medicare. However, exams that are considered medically necessary are covered. Medicare Part B (medical insurance) includes diagnostic hearing exams ordered by your doctor or healthcare provider.3 Such tests help assess and diagnose a hearing or balance problem. You can also see an audiologist once every 12 months without an order from your doctor or other health care provider, but only for:
- Non-acute hearing conditions.
- Diagnostic services related to hearing loss that can be treated with surgically implanted hearing devices.
Costs Associated with Hearing Exams
The overall costs for hearing exams can vary depending on what kind of tests you get and where you live. Medicare Part B covers eligible hearing tests once you’ve paid your annual Part B deductible. You’ll then pay 20% of the Medicare-approved amount for your doctor visit and tests.
For example, if the total cost of your doctor visit and treatment is $500, you would pay $100 (20% of $500) as a copay after you’ve met your deductible. Medicare would then cover the remaining $400. Medicare Supplemental Insurance, better known as Medigap, may cover any copayment for you.
Additional Coverage Options
Hearing aids can be expensive, but that shouldn’t stop you from getting the help you need. There are options to help with the cost.
Certain Medicare Advantage plans offer benefits that include the cost of hearing tests and hearing aids. Some will also pay for fittings and repairs for the device. The coverage varies by plan, but may include:
- Hearing aid fittings.
- Hearing screenings with no or low co-payment.
- Education on the proper usage of hearing aids.
- Routine and diagnostic hearing exams.
- A selection of hearing aids.
- Annual provider follow-ups.
U.S. Veterans are eligible for special considerations. If you have served in the military, naval or air services, you may qualify for a hearing aid through the VA healthcare system.4 And some states offer programs that provide financial assistance for hearing aids based on income or other requirements.
Taking care of your hearing is important for staying connected to the world around you. So talk to your doctor if you’re having trouble hearing.
Hearing Aid Medicare Coverage Questions
How much does Medicare pay for hearing aids?
Original Medicare doesn’t cover the cost of hearing aids. Most Medicare Advantage plans will pay for hearing aids, but the amount varies by plan. Call us today for more information on how a Wellcare Medicare Advantage plan can help with your hearing needs.
Does Medicare cover cochlear implants?
Yes, Medicare typically covers cochlear implants if they are medically necessary. But while Medicare covers the cost of the cochlear implant surgery itself, there might still be out-of-pocket costs. This includes deductibles and coinsurance. Medicare will also cover the necessary tests and evaluations related to cochlear implant candidacy.
Does Medicare pay for audiology services?
Yes, Medicare usually covers audiology services that are medically necessary. Medicare Part B may cover diagnostic hearing exams that are ordered by a doctor or healthcare provider to check for a hearing or balance problem.
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Sources
National Institute on Deafness and Other Communication Disorders
Medicare.gov - Hearing Aids
Medicare.gov - Hearing Balance Exams
US Department of Veterans Affairs - Rehabilitation and Prosthetic Services - Hearing Aids
National Council on Aging - Financial Assistance for Hearing Aids: A Complete Guide for Older Adults
Centers for Medicare & Medicaid Services - Cochlear Implants
