If your sense of hearing has become diminished, either due to injury or the natural rigors of age, and you happen to be enrolled in Medicare, you may be wondering whether or not any part of it can cover the cost of a hearing aid or the examination necessary to be fitted for one. While Original Medicare will not cover the costs of purchasing a hearing aid and there is only a narrow range where Medicare Part B might cover a nearing aid exam, there is a very good chance that your Medicare Advantage Plan (Part C) might cover costs related to treating hearing issues.
Why Would Medicare Part B Cover the Exam?
If you require a bone-anchored hearing aid (BAHA) or a cochlear implant, these sorts of hearing aids are what Medicare will help with. This is because both of these forms of technology are classified as “prosthetics” instead of hearing aids and it is that distinction that makes a world of difference. Should you fall within the guidelines of the relevant procedure, the devices and any outpatient care can be handled with Part B, Medigap, or a Medicare Advantage plan.
What About a Hearing Policy Add-On?
Many people will consider a Medigap plan or private insurance companies for hearing-related coverage but this will incur additional costs. Considering how widely the benefits of such plans can get, it is in your best interest to fully understand your needs when shopping around.
How Likely Is It That Medicare Advantage Would Help With Hearing Aid Costs?
Roughly 97% of all Medicare Advantage enrollees can get coverage for hearing. Among that percentage, 95% have a plan that not only covers hearing aids but will also intervene upon the cost of an exam. Often, a Medicare Advantage enrollee will save about 1/5th of the cost to buy a hearing aid. This means that a $2,300 device would only wind up costing you $1,820.
A Medicare Advantage plan is similar to traditional insurance in that it combines multiple varieties of coverage between medical costs, hospital costs, and often medications and other prescriptions. Medicare Advantage plans will often feature add-ons for aural, dental, and optical coverage.
The exact benefits of a given Medicare Advantage plan can vary from company to company because every company likes to decide what perks it wants to offer. Since partial coverage could still leave you in the lurch for soaring out-of-pocket expenses, you must compare and contrast different Medicare Advantage plans so that you can choose one best suited to your needs. Furthermore, different plans are going to have different requirements regarding hearing exams; some may demand that you get a routine hearing exam preapproved before you can pursue an exam to get fitted for a hearing aid. Always check your policy for specifics on what it covers and when that coverage will stop or start.
What About Over-the-Counter (OTC) Devices?
OTC devices can cost around $800 per aid, well under half the cost of a standard device. While a serious hearing condition may require a standard model of hearing aid, the OTC devices available for sale on retail shelves are intended for patients with only mild or moderate loss of hearing. Furthermore, these devices do not require a prescription or hearing exam.
It should be worth mentioning that since Medicare can help with the cost of exams, it would be in your best interest to get a hearing assessment before putting down money on a hearing aid. Nobody wants to pay several hundred dollars on something, only to soon learn that the severity of their problem means the purchase was a waste.
Why Doesn’t Original Medicare Care About Hearing?
Medicare was born in the 1960s, when hearing aid technology was nowhere as prolific as it is today. At the time of the program’s creation, hearing aids were specifically mentioned as an exclusion from the benefits of the Social Security Act (Section 1862 of Title XVIII). The first digital wearable hearing aid would not exist until the late 1980s. Today, roughly one-third of Americans over the age of 65 have some level of hearing loss and the need for hearing aids has only grown.
Sadly, Medicare legislation is still lagging behind the needs of patients suffering from diminished hearing. While the Medicare Hearing Aid Coverage Act was introduced in the House of Representatives in 2021, and reintroduced two years later, the bill, if passed, would add hearing aids to Medicare but, at the time of this writing, it remains undecided whether Part A or Part B would handle the coverage.
How Much Does a Hearing Test Cost?
A basic hearing exam will cost around $33, or $7 on average if you have Part B, or it might cost you nothing with a Medigap plan. There are only a few hearing exam service costs that Original Medicare will intervene upon, provided they are taken in the pursuit of a treatment plan. Medicare Part B will cover four-fifths of any approved Medicare cost for a given service, such as diagnostic hearing or balance exams.
● A hearing balance test would cost you $9 with Part B and $47 without assistance. This sort of procedure is used to assess any conditions related to dizziness or a loss of equilibrium.
● A pitch-test hearing exam would cost $15 with Part B and around $73 without assistance. This sort of exam exposes the patient’s ears to different tones and a technician will ask which ear the patient hears a specific tone from.
● Testing the cochlear nerve, the nerve connecting the brain to the ear, would cost $22 with Part B and around $112 without assistance. This sort of text is necessary for anyone needing a cochlear implant as it can inform how diminished the patient’s hearing has become.
It is worth remembering that these costs are without accounting for Medicare Advantage. There is a good chance that your Medicare Advantage plan could help you save even more money on a hearing test.