Medicare and Hearing Aids: Complete Guide

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The cost of diminished hearing can weigh heavily on the average person’s bank account.

Consider:

• After 60, it’s recommended that people have their hearing checked annually. That cost can run up to $250 when performed by an audiologist.
• According to Consumer Reports, the average out-of-pocket cost for hearing aids in 2017 was $2,710 each. About 71% of those surveyed said they delayed their purchase of hearing aids for two years or longer, most often because of the cost.
• After the initial hearing aid purchase there are also additional service costs for repair and replacement, adjusting and cleaning the devices and the ongoing cost of batteries.

 Does Medicare Cover Hearing Aids?

Original Medicare (Parts A and B) and most Medicare Supplement (or Medigap) plans don’t cover hearing aids, routine hearing exams, or fittings for hearing aids.

Unfortunately, this means that without other insurance, you could pay 100% of the cost for routine hearing exams, fittings, and hearing aids.  This is a problem for many people because the high cost stops many seniors from getting treatment that could improve their quality of life.  Loss of hearing can cause isolation, depression, memory problems, difficulty learning new things and overall poorer health.

Medicare Part B does, however, cover diagnostic hearing tests that your doctor orders for a medical need like a recent hearing loss due to illness or injury.

If your doctor orders a diagnostic hearing test, then you would pay 20% of the amount approved by Medicare, plus the Part B deductible.  Regardless of the outcome of the diagnostic test, Medicare still does not cover the hearing aid itself.

Some Medicare Advantage plans (Part C) cover hearing exams and hearing aids.  This coverage will vary by provider, so if this is an important benefit for you, you’ll need to shop around for the coverage you want.

Hearing aids can cost from hundreds to thousands of dollars. If you have health insurance that covers hearing aids, such as a Medicare Advantage plan, read your plan documents carefully.  You need to make sure about coverage, because you may only be entitled to benefits if you buy your hearing aids from certain suppliers or through a certain process.

Understanding the Different Parts of Medicare

Medicare is divided into four parts:

Part A is hospital insurance.  This covers medically necessary inpatient, hospital, hospice, skilled nursing and home health care costs.

You’re eligible for Part A at no cost if:

• You’re 65 or older and currently receive or are eligible to receive Social Security benefits. In addition, you must have accumulated 40 credits through payroll taxes throughout your working career.  You get one credit for every quarter of a year you work and meet minimum income requirements.  So, 40 credits equals 10 years of work history.  If you don’t have 40 credits then you can pay a monthly premium to be covered.
• You currently receive or you are eligible to receive railroad retirement benefits.
• Your spouse receives or is eligible to receive Social Security or railroad retirement benefits. This applies to spouses who are living, deceased or divorced from the person seeking coverage.
• You or your spouse worked long enough in a government job where Medicare taxes were paid.
• You are a dependent parent of a deceased child who is fully insured.

You’re Part A eligible if you are under 65 years old and:

• You received or you are entitled to receive Social Security disability benefits for at least 24 months.
• You are getting a railroad retirement board disability pension and you meet certain conditions.
• You get Social Security disability benefits because you have ALS (Lou Gehrig’s disease).
• You worked in a government job long enough where you paid Medicare taxes, and you have been entitled to receive Social Security disability benefits for at least 24 months.
• You have kidney failure and you receive dialysis or a kidney transplant, and you meet other certain requirements.
• You’re the child or the widow(er) and you are age 50 or older of someone who worked in a government job long enough where they paid Medicare taxes, and you meet Social Security disability program requirements.

Part B covers doctor’s services.  This includes durable medical equipment, preventative care, outpatient services, lab tests and x-rays, ambulance services and some home health services.

You’re eligible for Part B if you are eligible for Part A coverage at no cost.  You will need to pay a monthly premium that may depend on your current income.  If you are not eligible for Part A at no cost, you can still sign up for Part B if you’re 65 years or older and you are a United States citizen or a lawfully admitted noncitizen who has lived in the country for at least five years.

Part C is private health insurance companies that provides Medicare benefits to patients. These are commonly referred to as Medicare Advantage Plans. Some people choose to get Medicare benefit coverage through a Medicare Advantage Plan instead of through original Medicare Part A and Part B coverage.

The main reason people choose Part C coverage is because these plans may offer additional benefits over and above the level of coverage provided by Part A and Part B.

To be eligible for Part C coverage you must have Part A and Part B coverage.  Part C coverage does require the payment of an additional monthly premium.

Once you have reached the coverage limits that Part A and B covers, you can tap into Part C enhanced benefits.

 Part D provides prescription drug coverage. It is provided only through private insurance companies that have contracts with the government.

If you have Part A and Part B coverage, then you are eligible for Part D coverage.  Because coverage in Part D is optional, you will need to pay an additional monthly premium.  The exact amount may depend on your income level.

Which Medicare Advantage Plans Offer Hearing Aid Coverage?

A few Medicare Advantage plans offer hearing aid coverage.

These plans may also provide coverage for hearing benefits such as exams, fittings for hearing aids and even the cost of hearing aids themselves.

Many Medicare Advantage plans also offer prescription drug coverage which may be used to help cover the cost of medications that might be required for ear infections or other related hearing treatments.

Finding Supplemental Health Insurance

Supplemental health insurance comes in many forms, not just to enhance the benefits of a Medicare Part A or Part B coverage.  Individual plans can cover dental, vision, critical illnesses, disability, long-term care, short-term care and other related life occurrences.

For our purposes, we’ll look at finding insurance that supplements original Medicare coverage.

The first thing you must know is not all Medicare Advantage plans are the same or are created equally.  Before you join, you really need to take the time to find and compare the supplemental insurance plan that is exactly right for you.  Once you understand how various plans work, and their cost, you can start the enrollment process.

If you need help finding a plan that works best for your situation, you can use Medicare’s Plan Finder.  Or you can visit a plan’s website to see if you can join online.

You may also get a plan’s contact information from a Personalized Search (under General Search), or search by plan name.

If you have questions, you can call Medicare’s customer services at 1-800-MEDICARE (1-800-633-4227).

When you join a Medicare Advantage Plan, you’ll have to give this information:

• Your Medicare number
• The date your Part A and/or Part B coverage started
• This information is on your Medicare card.

Medicare plans aren’t allowed to call you to enroll you in a plan, unless you specifically ask to be called. Plans should never ask for your financial information, including credit card or bank account numbers, over the phone.

Changing your Medicare Coverage

If you’re already in a Medicare Advantage Plan and want to switch, simply join the plan you choose during one of the enrollment periods. You’ll be disenrolled automatically from your old plan when your new plan’s coverage begins.

Unless you have other drug coverage, you should carefully consider Medicare prescription drug coverage (Part D). You may also want to consider a Medicare Supplement Insurance (Medigap) policy.

If you have other coverage, talk to your employer or benefits administrator about their rules before you join a Medicare Advantage Plan. In some cases, joining a Medicare Advantage Plan might cause you to lose employer or union coverage. If you lose coverage for yourself, you may also lose coverage for your spouse and dependents.

Important Questions to Ask your Insurance Provider About Hearing Aid Coverage

Here are a few of the things you’ll want to ask when you contact your health insurance provider about hearing aid coverage:

• What is your exact benefit coverage for hearing aids?
• Do I have to use specific providers? (If yes) How can I get a list of providers in my area?
• If the health plan has an allowance or benefit, do I have to pay the provider in full and then submit paperwork to get reimbursed? Can the provider bill the health plan directly?
• Is my benefit limited to specific hearing aid models or technology?
• Are there any criteria or stipulations for coverage? Do you require that my hearing loss be at a certain level to receive benefits?

Alternatives to Pay for Hearing Aids

If you have health insurance, your first step should be to check with the provider to see if any coverage is offered.

For some people, Medicaid may be a source of coverage if you have very limited resources and income.  Medicaid coverage for hearing aids varies by state and eligibility is subject to change. To see if you qualify for Medicaid coverage contact your hearing care provider. You can also contact your state’s Medicaid program or visit Medicaid’s national website for more information.

If you’re a federal employee or a retiree, you may be able to get hearing aid coverage through some insurance plans in the Federal Employees Health Benefits Program. If you’re eligible under this program through Blue Cross Blue Shield, they will cover up to $2,500 for hearing aids every three years.

For veterans, the Veterans Administration provides free hearing aids if you meet certain conditions such as being compensated for any serviced-connected disability or if your hearing loss is connected to military service. Visit the VA website or call 877-222-8387 to check eligibility.

Three states — New Hampshire, Rhode Island and Arkansas — require that insurers provide coverage for adults.

New Hampshire insurance companies are required to cover the cost of no less than $1,500 per hearing aid once every five years.

Rhode Island requires individual and group insurance policies to provide $700 coverage per individual hearing aid every three years for those over age 19.

In Arkansas, insurance companies are required to offer coverage to employers in the state. If a company takes advantage of this, the health plan must provide coverage of no less than $1,400 per ear every three years.

Some states include some coverage for hearing aids and related services under their Affordable Care Act health insurance exchanges. Information is available from the Hearing Loss Association of America and through the Department of Health and Human Services.

Nonprofits That Help with the Cost of Hearing Aids

Depending on your income level, there are various programs and foundations that provide financial assistance for hearing aids to people in need.

Start by calling your state rehabilitation department or the nearest chapter of the Hearing Loss Association of America to find out what city, county or state programs, or local civic organizations can help you.

Several nonprofits also offer hearing aids at deeply discounted prices or for free. Some of those include:

HEAR Now, sponsored by the Starkey Hearing Foundation, provides hearing aids for people with net incomes below $19,058 for a single or $25,743 for couples. Your only costs are a hearing test and an application fee of $125 per hearing aid request.

The Lions Affordable Hearing Aid Project is offered through some local Lions clubs throughout the country.  This program offers the opportunity to purchase new, digital hearing aids manufactured by Rexton for $200 per aid, plus shipping. Most clubs will require your income to be somewhere below 200 percent of the federal poverty level, which is $22,340 for singles, or $30,260 for couples in 2019.

The Gift of Hearing Foundation is a nonprofit corporation dedicated to increasing access to cochlear implant surgery and services for those who have been identified as candidates for this technology.  Visit their website for more details.

Sertoma runs a hearing aid program through its 500 clubs nationwide.  The organization recycles hearing aids by refurbishing and distributing them to local people in need.  Call 800-593-5646 or visit the Sertoma website for details.

The TPA Scholarship Trust for the Hearing Impaired offers financial aid for people with hearing impairments who need help obtaining devices, medical treatment or specialized education or services. There are no age restrictions or requirements for degree of hearing loss; grants are based solely on financial need.

Another option is Audient which helps people purchase new, digital hearing aids at reduced prices ranging from $495 to $975 for one hearing aid or $990 to $1,575 for a pair. Your income must be below $27,075 for a single or $36,425 for couples to meet eligibility requirements.

AARP also has a hearing aid program that offers savings on hearing aids and other hearing healthcare products.

For a list of more programs, visit the Better Hearing Institute and click on “Hearing Loss Resources,” then on “Financial Assistance.”

You can also call the National Institute on Deafness and Other Communication Disorders at 800-241-1044 and ask for a list of financial resources for hearing aids.

Help with Amplified Telephones

Many states have telecommunication distribution programs for people with hearing loss.  These programs provide Text Telephones (TTYs), amplified telephones and other equipment free of charge for people with hearing loss or other related disabilities.

A listing of programs by state can be found at the Telecommunications Equipment Distribution Program Association  using the “State Directory” link.

Contact your state’s program for more information about eligibility and what equipment is provided.

Hearing Aid Financing Options

If you can’t get help to pay for a hearing aid in other ways, you can consider taking out a short-term loan.  Work with your hearing care provider to see what options are available.

You can also look into the following financing options as well.

Assistive Technology Loan Programs

Many states have assistive technology financial loan programs through RESNA Alternative Financing and Telework Technical Assistance Project (AFTAP), which provides grants and is funded by the Rehabilitation Services Administration of the U.S. Department of Education. These programs offer affordable loans to help residents with disabilities purchase assistive technology, including hearing aids and cochlear implants.

Programs specifics will vary from state to state and not all states will have a program to assist you.

CareCredit

CareCredit is just like a credit card but is exclusively used for healthcare services. It is accepted by more than 75,000 providers and provides financing for services including hearing care, vision care, veterinary medicine, dentistry, cosmetic surgery and more.

It offers monthly payment options, no up-front costs to patients, no prepayment penalties and no annual fees. Short-term, no-interest plans are available as well as longer term plans with fixed interest rates.  You can go to its website or call 1-800-677-0718 for more information.

New Legislation Promises More Affordable Hearing Aids

In August 2017, President Trump signed Medicare Hearing Aid Coverage Act of 2017.

This new law directs the Food and Drug Administration to establish and regulate a new category of hearing aids for seniors by allowing certain kinds of hearing aids to now be sold over-the-counter.  No prescription is required.  People will be able to buy products without consulting an audiologist or hearing aid dispenser.  Standards for online sales will also be tightened.

These kinds of hearing aids are designed for people with mild to moderate hearing loss.  It is designed to help people who suffer from hearing loss but cannot afford the costs associated with prescription hearing aids.

The agency has three years to develop safety and other consumer protection standards before actual sales can start.

Although it should improve access, the new law doesn’t deal with one of the biggest barriers faced by the nearly 50 million people with age-related hearing loss, and that is insurance coverage.