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Hearing Aids and Medicare

March 1, 2019

12:30 pm

Both hearing aids and Medicare can have life-changing effects on a person’s health.

Hearing aids can restore the full spectrum of sounds for those with mild, or even significant hearing loss, transforming a person’s quality of life. Meanwhile, Medicare has supplied crucial financial aid for Americans aged 65+ – as well as those with selected disabilities – since 1966.

Unfortunately, hearing aids and Medicare rarely meet. In no uncertain terms, the cost of hearing aids is not covered by Medicare. However, Original Medicare (Hospital and Medical Services Insurance) can cover up to 80% of diagnostic hearing test costs.

In other words, if your healthcare provider (who participates in the Medicare program) orders a diagnostic hearing test to see if further medical treatment is needed – for example, after a recent injury or illness – up to 80% of the costs may be covered. But any further tests, or hearing aids that may be required as a result of the testing, will not be covered.

Hearing Aids and Medicare – Alternatives

Although Medicare does not cover hearing aid technology, you will be glad to know that there are many alternative ways to access financial assistance, and help take care of your hearing. The best choice will depend on who you are, where you live, and what your health situation is. Below you will find some of the available options:

Book an appointment with a specialist near you today, and Tech.co will cover the cost of your initial hearing test.

Medicare Advantage Plans (Medicare Part C)

Hearing Aids ChildMedicare advantage plans offer benefits not available on Original Medicare. However, not all Medicare advantage plans are created equal – some may choose to offer additional benefits, such as Health Maintenance Organizations (HMOs).

  • If your Medicare Advantage Plan includes an HMO, it could cover hearing aids and routine hearing services. However, you may be restricted to certain hearing aid providers in the plan’s network.
  • You could also qualify for a low-cost HMO (Special Needs Plan) for individuals with certain medical conditions, and who are eligible for both Medicare and Medicaid.
  • Some plans pay a percentage of your hearing aid costs, while others pay a fixed amount which goes towards the cost of your hearing aid.
  • Premiums will vary depending on your plan of choice, as well as where you live.

There are search tools available to help you see if any Medicare Advantage plans in your area will cover hearing aid services.

Medicaid

Medicaid offers health coverage to certain categories of people, including low income families, pregnant women, children, and people with disabilities. Beneficiaries under the age of 21 can get access to audiological assessments, hearing aid evaluations and hearing aids.

As Medicaid is a joint Federal-State program, the extent of coverage for other categories of people is dependent on where you live. For example, Vermont offers one hearing aid per ear every three years for specific degrees of hearing loss, while Maryland offers replacement of a unilateral hearing aid once every five years. By contrast, members in Kentucky are limited to a maximum of $800 every 3 years.

You can find more state-to-state information here.

Employer Assistance

Some employers run accounts which employees can draw on for reimbursement of medical expenses, including hearing aids.

A Health Reimbursement Account (HRA) is funded entirely by your employer. A Health Care Flexible Spending Account (FSA) or Health Savings Account (HSA) sets aside a percentage of your salary (pre-tax) to pay for eligible health care expenses.

The difference between an FSA and an HSA is that accrued funds in a Flexible Spending Account do not roll over. If you are an eligible employee, you must enroll on this program every year during the Federal Benefits Open Season (November/December). Funds must then be used in that calendar year as reimbursement for healthcare-related expenses, such as hearing aids. A Health Savings Account (HSA), by contrast, accumulates from year to year, allowing you to save toward the cost of your hearing aid.

It is best to check with the benefits department of your employer to clarify which accounts are available, and what you are entitled to.

Insurance

As with Medicare, many private insurance companies do not extend their cover to hearing aids.

There are some state to state differences, though. In New Hampshire, Connecticut, Illinois, Rhode Island and Arkansas, insurance companies must offer cover for hearing loss in adults and children, by law. In these states, policies may cover between $700 – 1,500 per ear every 3-5 years, for those over 19 years old. In around 20 other states, insurance companies are mandated to cover hearing aids for children.

Federal employees and their families can receive coverage on certain insurance plans, which pays for a basic hearing aid every three years. You would have to pay for extras and upgrades. Other health insurance plans, or union benefits, may at least partially pay for hearing aids, so it’s always worthwhile to check your coverage.

Hearing Aids for Veterans

Hearing Aids VeteransAs a country, America has a fairly good reputation for looking after veterans. This includes covering the cost of hearing aids, through the U.S department of Veteran Affairs. There are many ways for veterans to qualify for financial support towards hearing aids.

Without a doubt, if the hearing loss is a result of service-related activity, your costs will be covered in full. Where hearing loss is caused by another factor, such as disease or a medical condition, you can still access financial aid if your everyday activities are being affected. Both veterans who have received previous treatment at a hospital, and those who have not, are eligible to seek help. Ultimately, any veteran with a hearing impairment that affects their quality of life should get in touch with Veteran Affairs.

Hearing Aid Provider Financing Plans

If you qualify for financing, you can pay off your hearing aid in chunks, over 3-60 months. Many hearing aids providers offer this service, at interest rates ranging from 10-30% APR.

Occasionally, providers will offer interest-free financing options. This means you get to spread the cost of the hearing aid, without having to pay any additional amount on the initial price of the hearing aid.

Even if your credit score is poor, selected providers will still provide financing, so long as you have 30% of your hearing aid value to begin with. There may be hefty fees to pay if you default on your payment plan, so be certain you can meet the schedule before choosing this as an option.

Non-Profits

If you’re living in a low-income household and none of the above options work for you, there are a number of foundations and organizations which can lend support in securing a hearing aid. For example, there is a Scholarship for the Hearing Impaired that is supported by the Travelers Protective Association.

There is also the Starkey Hearing Foundation, which runs a Hear Now program where you only pay for an evaluation plus $125 per hearing aid. The Salvation Army and Lions Club have also been known to offer assistance in one form or the other.
Some parts of the country will have hearing aid loan banks and recycling programs.

Contact your state vocational rehabilitation department to find out about financial assistance from non-profit organizations within your city or state. You can also contact the National Institute on Deafness and Other Communication Disorders (NIDCD) for more specific information.

Frequently Asked Questions

How much does a hearing aid cost?

Hearing aids can range from $1,000 to $4,000. The final cost will depend on what you need, and the features you will benefit from. You can find out more here.

Are hearing aids covered by Medicare?

No, but the rules governing this are subject to change. Make sure you check back here for any updates regarding this subject, or check the Medicare site.

What does Medicare cover in relation to my hearing loss?

Although Medicare does not cover the cost of the hearing aid itself, it can partially cover diagnostic hearing tests ordered by your doctor. However, your doctor must accept Medicare assignment – if not, you might have to pay the full price.

Do I have to pay more for a Medicare Advantage Plan?

You may have to pay a monthly premium in addition to your regular Part B premium. You may also have a copayment or coinsurance amount required in order to claim.

What is a copayment or coinsurance?

Both copayment and coinsurance are types of cost sharing agreement. They mean you will have to contribute a part towards the cost of the hearing aid you are asking the Medicare Advantage plan to pay for.

What is the difference between copayment and coinsurance?

For a copayment, you will be required to contribute a fixed amount towards your hearing aid, while for coinsurance you will be required to pay a percentage of the cost of the hearing aid. So the amount you have to contribute towards your hearing aid with a coinsurance plan will depend on the cost of your hearing aid while the cost does not matter with a copayment plan.

What does Medicaid cover in my state?

Since Medicaid is a joint Federal-State program, the extent of coverage is dependent on where you are situated. You can find more state to state information here.

I am a veteran – do I have any special privileges?

The VA covers a wide range of health conditions, including hearing aids – especially if you have a disability that is related to your service time.

Get Started with Hearing Aids Today

There are plenty of options available to children and the elderly when it comes to assistance obtaining a hearing aid. However, if you are a working-age adult, do not fear – a 2014 survey found that up to 40% of people who bargained received a discount on the cost of their hearing aid. There are still some options out there to ease financial strain, such as financing and non-profits.

The cost of your hearing aid should deter you from seeking out the help you need to better your quality of life. Speak to a local specialist – they will help you assess your needs, as well as talk you through your options for payment plans.

Book an appointment with a specialist near you today, and Tech.co will cover the cost of your initial hearing test.

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Thomas Tagoe is a neuroscientist and science communicator affiliated to the University of Ghana. He holds a PhD in Neuroscience from the University of Leicester (UK) and his research into how exposure to loud sound causes hearing deficits has been published in international journals and major news outlets including the BBC, CNN and The Conversation. Aside research, Thomas has a passion for sharing his love of everything science and does this through an organisation he co-founded to build capacity in individuals through outreach activities. Outside his scientific pursuits, Thomas is an avid reader and enjoys a good game of basketball.