by Russell Noga | Updated May 19th, 2023
If you’re struggling to hear, it can cause issues with your mental health. Seniors who can’t listen to what people around them are saying stop communicating and withdrawing from society. The TV gets turned up to max volume, neighbors become angry, and families become frustrated.
Many seniors with hearing problems usually protest when the doctor tells them they need a hearing aid. When they reluctantly agree to use the device, they find themselves amazed at what they are missing out on. But a hearing aid can cost up to $2,300, which is sometimes too much for seniors living on a fixed income.
Medigap and Hearing Aid Coverage
Unfortunately, Medicare doesn’t cover the costs of hearing exams and hearing aids. But will your Medicare Supplement cover them?
Sadly, no. However, all is not lost as there are some situations where you can possibly get coverage.
Does Medicare Cover Hearing Aids?
Original Medicare Parts A & B doesn’t offer coverage for hearing exams and hearing aids. As a result, you’ll have to pay out of pocket for these devices and the costs of setting them up with an audiologist. Medicare Advantage plans will replace Original Medicare Parts A & B, sometimes offering coverage for hearing aids and exams.
Why Doesn’t Original Medicare Cover Hearing Aids?
When Medicare launched in 1965, it excluded hearing benefits from its mandate via Section 1862 of Title XVIII of the Social Security Act. When drafting the legislation, hearing aids were somewhat of a new technology and still unproven as effective. The first fully wearable hearing aid only reached the market in 1980.
Hearing aid technology changed a lot over the last four decades, and today’s devices are incredibly effective. However, Medicare hasn’t caught up to the progress, and they still don’t cover hearing exams and hearing aids in Original Medicare Part B benefits.
Do Medicare Advantage Plans Cover the Cost of Hearing Aids?
While Original Medicare Parts A & B don’t cover hearing exams or hearing aids, some Medicare Advantage Plans (Also known as Medicare Part C) do. There are over 300 options for Medicare Advantage plans, all sold by private health insurance companies in America. When you take a Medicare Advantage plan, it replaces your Original Medicare Parts A & B.
Over 88% of Medicare Advantage plans offer hearing exams as benefits. As a result, seniors with Medicare Advantage have coverage for maintaining their hearing as they age. However, coverage varies between plans and providers since there are so many options. If you don’t have the right Medicare Advantage plan, you could incur out-of-pocket costs for hearing services and devices.
On average, Medicare Advantage beneficiaries still pay approximately 79% of the cost of hearing aids. So, if a hearing aid costs $2,300, you’ll pay $1,817 for the device. MA plans also have coverage specifics regarding appointments with the audiologist. For instance, 57% of MA beneficiaries require pre-authorization for routine hearing exams.
Does Medigap Cover Hearing Aids?
Medigap plans are available in ten options (A, B, C, D, F, G, K, L, M, & N). Each plan has different coverage for Part A & B benefits. Some plans are more comprehensive than others, so it pays to understand the best choice for your hearing care.
Private healthcare insurers offer Medigap plans, such as Mutual of Omaha and Allstate. Each Medicare Supplement plan letter offers different benefits. All Medigap policies provide the following benefits.
- Part A coinsurance and hospital costs for up to 365 days after using up Medicare benefits.
- Part A hospice care coinsurance or copayment.
- Part B coinsurance or copayment.
- Blood transfusion costs for the first three pints of blood.
Plans F, G, and N offer additional Medicare Parts A & B benefits.
- Part A deductible.
- Part B excess charges (Plan N doesn’t cover these charges).
- Skilled nursing facility care coinsurance.
- 80% of emergency healthcare costs when traveling outside the US for 60 days. ($250 deductible and $50,000 maximum apply).
- Unlimited coverage for all out-of-pocket costs.
Original Medicare Part B covers some audiologist services if the health care provider orders it as part of a medical treatment plan. These services include diagnostic hearing and balance exams. However, Medicare Part B only pays for 80% of the costs associated with these medical treatment plans, leaving the beneficiary with a 20% financial responsibility.
A Medigap plan offering Part B supplemental coverage absorbs this 20% out-of-pocket cost, leaving you with nothing to pay. However, the treatment must have approval by Original Medicare to qualify for coverage.
Your Medigap plan benefits regarding Part B coinsurance determine the out-of-pocket costs. For example, the most comprehensive Medigap plans, Plans G & F*, offer 100% coverage for coinsurance responsibilities.
So, these plans provide free hearing exams if Medicare qualifies for the procedure, and you’ve already met your Part B deductible. (Plan F covers the Part B deductible while Plan G doesn’t*). Medigap Plan K covers half of this coinsurance cost, while Plan L covers 75%. This reduces the cost of hearing assessments from $10 to $5 and $2.50, respectively.
*Medigap Plan F is only available for beneficiaries eligible for Medicare before January 1, 2020. If you qualify for Medicare after this date, you must use Plan G for your policy.
Some Medigap Insurers Provide Supplemental Hearing Coverage
You have other options if your healthcare provider or doctor doesn’t approve your hearing treatments. Some Medigap insurers offer vision, dental, and hearing service coverage with additional plans or as perks in their policies.
For instance, some insurers might offer you a discounted rate (between 20% to 60%) on hearing exams and hearing aids if you use their in-network partners for your treatment and device. Others might sell you an add-on policy covering hearing exams and hearing aids for a small monthly fee of $20 to $40.
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What is the relationship between Medicare and hearing aid coverage?
Original Medicare, which includes Part A and Part B, unfortunately, does not provide coverage for hearing aids or routine hearing exams. It is generally considered a form of “custodial” care, which is not included in Medicare’s scope of benefits.
What does Medicare cover when it comes to ear problems?
While Medicare does not cover hearing aids, it does cover the diagnostic hearing and balance exams if they are ordered by your doctor for a medically necessary reason, such as symptoms of hearing loss, vertigo, or balance issues. Medicare Part B will cover these services.
Does a Medicare Supplement Plan cover hearing aids?
A Medicare Supplement Plan, also known as Medigap, covers gaps in Original Medicare, such as copayments, coinsurance, and deductibles. However, since hearing aids are not covered by Original Medicare, they are not covered by Medicare Supplement Plans either.
Can a Medicare Advantage Plan cover hearing aids?
Yes, some Medicare Advantage Plans (Part C) may offer additional benefits not covered by Original Medicare, including coverage for hearing aids. The specifics of what is covered and the costs will vary by plan and by the insurance provider, so it’s important to read the plan’s details carefully.
Are cochlear implants covered by Medicare?
Yes, cochlear implants are covered by Medicare Part B under certain conditions. They are considered prosthetic devices and can be covered when deemed medically necessary by a physician.
Is there a hearing test coverage by Medicare?
Medicare Part B does cover diagnostic hearing exams if your doctor or other health care provider orders them to see if you need medical treatment.
Is there any form of hearing coverage included in Medicare Part B?
While Medicare Part B doesn’t cover routine hearing exams or hearing aids, it does cover diagnostic hearing exams if they’re ordered by a physician for the purpose of creating a treatment plan for a condition that could affect your hearing.
How can I get my hearing aids covered when I have Medicare?
To get coverage for hearing aids, you can either opt for a Medicare Advantage Plan that includes hearing aid coverage or purchase a separate, private insurance plan designed specifically to cover hearing care.
Are hearing aid fittings covered by Medicare?
Fittings for hearing aids are generally considered part of the hearing aid purchase and, as such, are not covered by Original Medicare or Medicare Supplement Plans.
What’s the best way to get coverage for hearing aids if I have Medicare?
The most effective way to get coverage for hearing aids with Medicare is to choose a Medicare Advantage Plan that includes hearing aid benefits. These plans often cover routine hearing exams and offer hearing aids at a reduced cost. Always remember to verify the specifics with your plan provider.
Reach Out to Us to Find Medigap Providers with Hearing Benefits
If you want more information on Medigap policies and hearing aids, call our team at 1-888-891-0229. Our Medigap and Medicare experts will find you a plan and provider offering you the best deal on hearing exams and hearing aids.
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.