Ask Dr. Gosu: Are Hearing Aids Covered by Medicare

In this first installment of our blog series, I will address a common question we receive in the clinic, "are hearing aids covered by Medicare?"

Ask Dr. Gosu: Are Hearing Aids Covered by Medicare

Hello, I am Dr. Goutham Gosu, the owner and audiologist at the Hearing Solution Center in Charlotte, NC. I am here to provide answers to some of the most pressing questions we receive from our patients. In this first installment of our blog series, I will address a common question we receive in the clinic, "are hearing aids covered by Medicare?"

Why is it So Hard to Know What is Covered?

Understanding whether Medicare covers hearing aids can be challenging for a few reasons:

Rules and Regulations: Medicare has a number of guidelines that specify what is covered. These rules can also change over time, making it hard to keep up-to-date.

Multiple Plans: Medicare is divided into different parts, like Part A for hospital care and Part B for medical services. Each part covers different things, so you have to know which part might cover hearing aids.

State Differences: While Medicare is a program run by the U.S. government, individual states may have additional programs that can affect what is covered.

Does Medicare Cover Hearing Aids?

To answer whether Medicare covers the cost of hearing aids, we need to delve into the different parts of Medicare.

The Original Medicare, also known as Medicare Part A and Part B, unfortunately, does not cover the cost of hearing aids or the exams required to fit them. This also applies to Medigap, a type of supplemental insurance that is purchased through private insurers.

While Medicare doesn't cover the cost of hearing aids, it covers diagnostic hearing and balance exams in some cases. These are covered if your primary care doctor or another physician recommends them to see if you need medical treatment.

Medicare Part C: An Possible Alternative

Medicare Part C, otherwise known as Medicare Advantage, often provides some coverage for hearing care, including hearing aids.

Medicare Advantage is an insurance alternative to Original Medicare. To qualify for Medicare Advantage, you must first enroll in Parts A and B. Most individuals eligible for Original Medicare are also automatically eligible for Medicare Advantage.

Medicare Advantage plans vary significantly, and many require the use of in-network providers. However, a significant percentage of these plans include a hearing aid discount or funded benefit.

Medicare Advantage plans typically include hearing aid coverage at no extra charge. Many of these plans are available for a $0 monthly premium. However, the specific coverage and out-of-pocket costs vary from plan to plan.

There is one significant downside of working with Medicare Advantage and that is that patients are forced to use a limited selection of 3rd party providers. Patients would need to see one of the limited number of in-network providers and the follow-up services will likely be limited. Your hearing care provider is an important determinant of your success with hearing aids, so choose wisely. Here are some resources to help you learn more about our practice. 

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You can apply for Medicare through their website. The process allows you to sign up for Medicare coverage, whether you are ready to retire or not. If hearing loss is affecting your ability to work, you might also want to look into Social Security disability benefits.

What if Your Medicare Doesn't Cover Hearing Aids?

If you're not eligible for a Medicare Advantage plan, if the plan doesn't provide sufficient coverage, or if you want more choice in your hearing care provider,  there are other ways to pay for hearing aids. There are various financial assistance options available, like Medicaid for eligible individuals, hearing aid subsidies from the VA for veterans, or using funds from a health savings account (HSA) or flexible savings account (FSA).

Congress Fails to Pass Medicare Hearing Coverage in Build Back Better Act

If you were hoping that congress would eventually help you pay for hearing aids, you may be waiting a while. 

In a significant setback for the hearing-loss community, the 117th Congress recently failed to expand Medicare to include hearing services. The provision, part of the original Build Back Better Act, would have covered hearing evaluations, treatments, and hearing aids. However, the Senate removed this section, and it was not part of the final law. The setback leaves many still advocating for comprehensive hearing coverage under Medicare.

Final Thoughts

Navigating healthcare and insurance can be daunting, especially when dealing with hearing loss. It's important to research extensively, understand your options, and consult with a healthcare professional. As an audiologist, I am here to help guide you through the process and ensure you receive the care you need.

Remember, treating hearing loss is not just about improving your hearing but also about enhancing your overall health, social life, and well-being. If you have any questions regarding hearing loss and hearing aid services, please feel free to reach out to us at the Hearing Solution Center.

Until next time, keep taking care of your hearing health!

Dr. Goutham Gosu has been practicing Audiology for the past 18 years and specializes in pediatric and adult hearing healthcare. He completed his graduate degree at Ohio University and received his doctorate in Audiology from AT Still University.

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