by Russell Noga | Updated January 21st, 2024
Are hearing aids covered by Medicare in 2024? Our guide cuts through the complexity, giving you the latest on “Medicare hearing aid coverage 2024”. Discover the impact of key legislation like the H.R.5376 Build Back Better Act and how Medicare Advantage plans might offer the support you need. With straightforward insights, this article provides clear answers and actionable information on Medicare hearing aid coverage 2024.
Key Takeaways
- Original Medicare (Parts A & B) does not cover hearing aids or routine hearing exams, but diagnostic hearing and balance exams for medical purposes are covered.
- Medicare Advantage plans (Part C) offer varying levels of hearing aid coverage beyond Original Medicare, with benefits and costs varying significantly between plans.
- Medicaid hearing aid coverage varies by state and is often mandated for children, while over-the-counter (OTC) hearing aid options are growing due to recent and pending legislation.
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Exploring Medicare and Hearing Aid Coverage in 2024
Medicare, the federal health insurance program, provides various types of Medicare coverage, which is divided into four parts:
- Part A
- Part B
- Part C (Medicare Advantage)
- Part D (prescription drug coverage)
Each part offers different types of health coverage, with Part B covering diagnostic hearing and balance exams for non-acute hearing conditions and services associated with surgically implanted hearing devices. However, will Medicare cover hearing aids in 2024? The answer depends on the fate of the H.R.5376 Build Back Better Act. If sanctioned by the Senate, Medicare will start to cover hearing aids and hearing care from October 2023.
Notably, Original Medicare (Part A and Part B) excludes hearing aids from their coverage. The focus of Original Medicare is on medically necessary services, and hearing aids, while essential for many, are considered as devices for improving hearing rather than medical necessities.
Original Medicare’s Stance on Hearing Aids
Original Medicare consistently excludes hearing aids from coverage across both Parts A and B. This lack of coverage stems from the emphasis of Original Medicare on covering medically necessary services. Considering hearing aids as devices for improving hearing rather than medical necessities, their cost is not covered by Original Medicare. Consequently, millions of beneficiaries bear the hefty financial burden of hearing aids.
While Original Medicare does not cover hearing aids, it does cover the cost of diagnostic hearing and balance exams if they’re ordered by a physician to assess function and determine if medical treatment is needed. However, this coverage does not extend to routine hearing exams or the purchase of hearing aids.
What coverage options are available for beneficiaries seeking to offer hearing aid coverage for hearing aids?
The Role of Medicare Advantage Plans
Medicare Advantage plans, also known as Part C, offer an alternative. Offered by private health insurance companies, these plans serve as an alternative to Original Medicare and have the potential to provide supplementary benefits, including coverage for hearing aids and associated services. So, while Original Medicare might not cover hearing aids, beneficiaries can turn to Medicare Advantage plans for potential coverage.
It should be noted that Medicare Advantage plans vary in their provision of hearing aid benefits. Certain plans may offer specific hearing aid benefits, encompassing additional hearing, vision, and dental coverage not part of Original Medicare.
When selecting a plan that aligns with one’s hearing requirements, it’s also wise to consider:
- the scope of coverage
- related expenses
- restrictions
- prerequisites
To ascertain if a plan includes coverage for hearing aids, individuals can reach out to their insurance provider or seek guidance from Medicare representatives.
Deciphering Medicare Advantage Plan Benefits for Hearing
Upon closely examining Medicare Advantage plans, one would realize that hearing aid coverage significantly varies from one plan to another. In 2024, a staggering 97% or more of individual Medicare Advantage plans offered comprehensive coverage for hearing aids. With such a wide array of plans providing varying levels of hearing aid coverage, it’s essential to compare the benefits across plans and ensure the chosen plan aligns with one’s hearing requirements.
From HMOs to PPOs to PFFS plans, Medicare Advantage plans may offer differing levels of coverage for hearing aids, with some plans covering just the cost of hearing aids, while others also encompass the fitting of the hearing aids. However, keep in mind that these plans typically come with limitations, such as a maximum dollar limit for annual payment towards hearing aid coverage and a restriction to one set of hearing aids per year or every three years.
Comparing Hearing Aid Benefits Across Plans
A comprehensive comparison of hearing aid benefits across Medicare Advantage plans reveals that in 2024, 98 percent of these plans offer hearing benefits beyond the scope of Original Medicare. These benefits often cover a portion of the expenses related to hearing aids, providing a significant relief for beneficiaries.
Indeed, the majority of Medicare Advantage plans provide coverage for hearing exams and hearing aids for seniors, a benefit not covered by Original Medicare. Certain plans, like the 2024 Anthem BCBS Medicare Advantage Plans, are known for their comprehensive coverage, which includes routine hearing care and hearing aids.
Additional Costs Associated With Hearing Coverage
Though Medicare Advantage plans provide some hope for hearing aid coverage, one must account for the additional costs inherent to this coverage. Copayments for hearing aid coverage can vary significantly, including:
- as little as $5
- up to an astonishing $3,355
- copays for advanced-level hearing aids starting around $699
- for premium-level hearing aids, the starting point may be approximately $999.
Premium expenses for plans offering hearing aid coverage are also diverse, with an average cap of $960 per year, but can range from as little as $66 to as much as $4,000 annually. On average, enrollees in Medicare Advantage plans pay approximately 79% of the cost for a hearing aid, meaning for a hearing aid priced at $2,300, an enrollee might pay around $1,820 out-of-pocket.
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Medicaid and Hearing Assistance
Moving our attention from Medicare to Medicaid, it becomes apparent that Medicaid cover hearing aids is often accessible for adults and mandated for children, with restrictions such as being accessible once every 24 rolling months, and there might be constraints on the quantity of batteries provided.
However, Medicaid coverage for hearing aids is not uniform across the country. Instead, it varies based on state and age group. Generally, Medicaid programs cover hearing aids for children under 21 years of age, with some states offering coverage for adults, contingent upon the severity of hearing loss.
State Variations in Medicaid Hearing Aid Coverage
The extent and nature of Medicaid hearing aid coverage vary significantly across states. In 22 states, there is no provision for hearing aid coverage, while the remaining 28 states offer coverage depending on factors like the extent of hearing loss and the types of benefits offered.
For instance, 12 of the 28 states with some hearing aid coverage, including California, Illinois, and New York, extend coverage to patients with ‘mild’ or greater hearing loss. Additionally, 28 states provide some type of coverage for older adults who are dually eligible for Medicaid and Medicare.
For a comprehensive state-by-state comparison, individuals can refer to online resources that offer extensive details about coverage specifications in each state.
Navigating Non-Medicare Options for Hearing Aids
Apart from Medicare and Medicaid, other options exist for hearing aid coverage. Many leading health coverage providers such as:
- Aetna
- Blue Cross Blue Shield
- Cigna
- Humana
- United Healthcare
offer benefits for hearing aids. Additionally, the market for over-the-counter (OTC) hearing aids has been growing, with these devices designed for individuals with mild to moderate hearing loss and utilizing less complex technology.
Recent legislation also impacts the availability and affordability of these OTC hearing aids. The FDA established a new category for OTC hearing aids in 2017, and there is pending legislation aimed at directing the FDA to relax restrictions on the purchase of these aids. This legislation could potentially prompt individuals to address their hearing loss at an earlier stage.
The Impact of Legislation on OTC Hearing Aids
The impact of this legislation on OTC hearing aids is significant. If this is approved, it could lead to greater accessibility and affordability for these devices in comparison to traditional hearing aids. Traditional hearing aids often need consultation with an audiologist for fitting and adjustments, adding to their expense and complexity..
This development in the hearing aids market can be a game-changer, particularly for individuals with mild to moderate hearing loss. By offering an alternative avenue for seeking care, OTC hearing aids could potentially prompt individuals to address their hearing loss sooner, without the need for a prescription or professional fitting.
Strategies for Reducing Hearing Aid Costs
While OTC hearing aids could reduce costs, there are other strategies to consider for managing hearing aid expenses. One such approach is the unbundling of services, which means separating the costs of the device, accessories, and services associated with the device and paying for them individually. This can potentially lower the costs of hearing aids by enabling individuals to pay only for the device if they do not need additional services.
Another strategy to consider is exploring basic hearing aid models. These models provide low-cost alternatives and essential functionality for individuals with hearing loss, without the premium features that can increase prices. By exploring these options, individuals can potentially manage their hearing care expenses more effectively.
Selecting the Right Hearing Aid for Your Needs
Selecting an appropriate hearing aid is a pivotal step towards managing hearing loss. The selection of a hearing aid is influenced by the severity of hearing loss as the effectiveness of hearing aids varies for different levels of hearing impairment. As of 2024, the available types of hearing aids include:
- Behind-the-Ear (BTE)
- In-the-Ear (ITE)
- In-the-Canal (ITC)
- Completely-in-Canal (CIC) hearing aids.
Consideration of features like volume control, handling ease, battery life, sound quality, style, Bluetooth connectivity, and specific listening challenges is vital during the selection of a hearing aid. Also, consider the choice of provider, price, battery type (rechargeable or not), and its effectiveness in addressing hearing loss severity and speech understanding in noisy environments.
Evaluating Features and Types of Hearing Aids
In-the-ear (ITE) hearing aids and Behind-the-ear (BTE) hearing aids comprise the two fundamental types of hearing aids. BTE hearing aids usually offer greater power and a wider range for severe hearing loss, while ITE hearing aids are more appropriate for individuals with arthritis or challenges in handling small objects.
Another type worth considering is the Completely-in-canal (CIC) hearing aids. These aids are virtually invisible, facilitate phone usage, and provide natural ear wind protection and sound conduction. However, they might pose challenges in volume adjustment and require increased maintenance due to moisture and earwax ingress.
What’s more, digital technology has enhanced the functionality of modern hearing aids by incorporating auto programs that adapt to various environments, thereby improving the quality of hearing.
Considering the Total Cost of Hearing Care
Though the cost of the hearing aid itself is significant, one must also account for the costs of audiology services and device maintenance in the total cost of hearing care. The cost of audiology services generally ranges from $150 to $200 per visit, while prescription hearing aids can vary from $4,000 to $8,000 for a pair. Over-the-counter alternatives may be priced between $200 and $3,000.
Hearing aids should be maintained at least annually, with a recommendation for monthly maintenance. The maintenance costs typically range from approximately $60 for services included in a manufacturer’s warranty to $100 to $200 for out-of-pocket repairs. Insurance coverage for these services can vary, with many insurance plans considering hearing aids to be optional and not covering the costs. However, Medicare may cover audiologist visits once annually for non-acute conditions with a provider’s order.
Hearing Loss Resources and Support
Assistance for individuals with hearing loss extends beyond just hearing aids. There are several online platforms that offer free hearing tests, such as:
- Miracle-Ear
- AARP National Hearing Test
- Starkey
- ReSound
- Beltone
Although online hearing tests can offer an accurate portrayal of one’s hearing ability, they may not detect all possible medical complexities or recognize underlying issues.
In addition to hearing tests, digital hearing aid apps can support individuals with hearing loss. Notable digital hearing aid apps include:
- Nagish
- MDHearing
- myPhonak
- Oticon ON
- ReSound
- Signia
These apps offer various features aimed at managing and improving hearing capabilities.
Online Tools and Hearing Tests
Online hearing tests serve an essential function in identifying potential hearing issues, as they provide an initial assessment of an individual’s hearing ability. These tests can determine:
- The faintest sound a person can hear at various pitches or frequencies
- The extent and pattern of hearing loss in each ear
- The individual’s capacity to perceive low or high frequencies
While online hearing tests offer convenience, their accuracy can be influenced by the testing set-up and environment. However, research from 2019 suggests that online hearing tests have the potential to be equally accurate as in-person assessments. Among the various online hearing tests available in 2024, the Mimi hearing test app is widely regarded as the top choice due to its multiple test types and user-friendly interface.
Summary
To navigate the world of hearing aid coverage, one needs to understand the intricacies of Medicare and Medicaid plans, explore alternative options like private insurance and OTC hearing aids, and be aware of the potential changes due to pending legislation. Knowing the specifics of hearing aid benefits offered by different Medicare Advantage plans, comparing benefits across plans, and understanding the additional costs associated with hearing aid coverage are key in making an informed choice.
Moreover, it’s crucial to evaluate the features and types of hearing aids available, consider the total cost of hearing care, and make use of available resources and support such as online hearing tests. Regardless of the avenue of coverage one chooses, the end goal remains the same: to ensure access to quality hearing care that meets individual needs and improves the quality of life.
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Frequently Asked Questions
How often will Medicare pay for an audiogram?
Medicare will pay for an audiogram once every 12 months without a referral for non-acute hearing conditions or diagnostic services related to hearing loss treated with surgically implanted hearing devices.
Does Medicare cover hearing aids?
No, as of now, Medicare does not cover hearing aids. However, there is a possibility that it may be covered in the future if the H.R.5376 Build Back Better Act is sanctioned by the Senate.
Do Medicare Advantage plans cover hearing aids?
Yes, Medicare Advantage plans can provide coverage for hearing aids and associated services. You may receive this benefit as part of your supplementary coverage.
What are some strategies to reduce hearing aid costs?
Consider unbundling services and exploring basic hearing aid models to reduce costs. These strategies involve separating the costs of the device, accessories, and services, and considering simpler device models.
Speak to the Professionals about Medigap Plans and Original Medicare Deductibles
If you find understanding the benefits involved with Original Medicare and Medigap Plans challenging, you’re not alone. Whether it’s a Medigap plan, or you want to know more about Medicare coverage for Hearing Aid, we can help. Call our team at 1-888-891-0229 for a free consultation or complete the contact form on this site, and an expert will call you back at a convenient time.
We have decades of experience advising our clients on the complexities of Medicare and Medigap plans, the benefits, cost and deductibles. We’ll ensure you get the best rate in your state and advice you can trust.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.