Does Medicare Cover Hearing Aids and Tests?
A guide to what hearing care costs Medicare Covers.
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According to the NIDCD, around 28.8 million U.S. citizens could benefit from a hearing aid. But the same organization estimates that fewer than a third of people over 70 who’d benefit from them use one.
Original Medicare doesn’t generally pay for hearing aids. This means people who need one will have to pay for the costs themselves.
Key Points about Medicare, Hearing Aids, and Tests
Original Medicare does not cover hearing aids.
It covers hearing and balance tests in some situations.
Some Medicare Advantage Plans offer hearing coverage and other benefits.
Hearing aids start at around $500 per ear but can go up to thousands of dollars.
Medigap plans don’t cover hearing aids.
What Is Medicare?
The federal Medicare program provides health insurance for those over 65, individuals with End-Stage Renal Disease (ESRD), and some younger people with disabilities.
The program has several parts or sections, each of which covers different types of medical services, items, and treatment. You can also buy private plans with additional benefits.
Here is a rundown of the different kinds of Medicare:
Original Medicare: This is made up of Part A (hospital insurance) and Part B (Medical insurance). Part A covers inpatient stays in a hospital, care in a nursing facility, hospice care, and some home care. Medicare Part B covers some doctors' services, outpatient care, medical supplies, and preventive services.
Medicare Advantage Plans (Part C): These are Medicare plans offered by private insurers. They include Medicare Part A and B and often also have Medicare Part D.
Medicare Part D is an optional Medicare supplement that covers the costs of some prescription drugs.
Medicare Supplement Insurance (Medigap): These are optional plans offered by private insurers that cover out-of-pocket expenses associated with Medicare Part A and B, such as the deductible. You can’t get a Medigap plan if you have a Medicare Part C plan.
(Source: Pixabay)
Does Medicare Cover Hearing Aids?
Unfortunately, Original or basic Medicare does not provide any coverage for hearing aids. This means you will have to pay 100% of the cost if you decide to get a hearing aid without additional coverage.
Terms You Need to Know
Medicare-approved amount:
This is the amount Medicare will pay for a specific treatment or doctor’s services. Sometimes, it may be less than the actual amount a doctor or supplier charges you, and you will have to pay the difference.
Deductible:
The amount you must pay per period before Medicare starts to contribute to costs.
Does Medicare Cover Hearing Tests?
Medicare covers diagnostic hearing and balance exams under Medicare Part B coverage. But it will only cover hearing exams if your doctor or registered health care provider orders it. It does not cover routine hearing exams.
Medicare won’t cover the entire cost, though. You pay 20% of the Medicare-approved amount for diagnostic hearing exams and your Medicare Part B deductible if you haven't met it yet. In 2022, this is set at $233.
For example, if your hearing exam is $250 and you haven’t had any treatment in the year, you will pay the entire deductible of $233 plus 20% of the remaining $17 for a total of $236.40.
If your hearing exam is $250 and you have already paid more than $233 for medical treatment this year, you won’t have to pay anything towards your deductible. Instead, you will just pay 20% of $250. Therefore, the bill for the treatment would be $50.
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Why Doesn't Medicare Pay for Hearing Care?
Medicare doesn’t cover all health issues. Instead, it only covers treatments that it defines as medically necessary. Hearing aids don’t meet this criterion, so they aren’t covered.
What Will I Pay for Hearing Aids with Medicare?
If you have Original Medicare or your Medicare Advantage Plan doesn’t have hearing aid coverage, you will have to pay the full price for hearing aids out of your own pocket.
The cost of a hearing aid varies significantly, and the amount you might pay will depend on the specific technology you want or need.
The type of hearing aid you buy makes a big difference to the final price. You can buy everything from those that fit behind the ear to those you wear in your ear canal.
The technology you choose will also affect the costs.
Modern aids have features like:
Control your device remotely.
Connect it to a smartphone.
Rechargeable batteries.
Water resistance.
Artificial intelligence that automatically adapts settings to your environment.
The ability to suppress background noise.
Prices start at around $500 per ear. But you can spend thousands of dollars on a set of high-end hearing aids.
Terms You Need to Know: Bundled vs. Unbundled Hearing Aids
When you buy a hearing aid, you can pay a complete package that includes tests, appointments with specialists, and consultations for fitting hearing aids. This brings the price of the hearing aid up, but the extra services may be worth it.
Unbundled hearing aid pricing is when you just choose what you need. This may result in a lower overall cost.
(Source: Unsplash)
Will My Medicare Advantage Plan Pay for Hearing Tests?
Coverage for hearing exams is common in Medicare Advantage Plans. The plan may cover the cost of a hearing test entirely, or it may offer to pay a percentage of the total cost. It may also pay for hearing aids and other hearing equipment.
But plan specifics can vary significantly. Check your plan’s details or contact a representative to get a definitive answer.
If you don’t have a Medicare Advantage plan but are interested in signing up for one, click here to compare plans.
Do Medicare Supplement Plans Cover Hearing Tests?
Medicare Supplement Insurance plans, also known as Medigap plans, are plans that can be bought from a private insurance company. They help Medicare beneficiaries pay for out-of-pocket costs associated with Medicare Part A and B.
Some Medicare Supplement plans will cover your Medicare Part B deductible and coinsurance amount for hearing tests covered by Original Medicare.
But they don’t offer coverage for services that Medicare doesn’t cover. If Medicare doesn’t pay for your hearing test or hearing aids, a Medigap plan won’t help.
(Source: Unsplash)
How Can I Find Out More About My Health Care Options?
Hearing problems are widespread, and hearing aids are an effective fix. But Medicare Part A and B don’t cover the cost of these devices.
If you want to use one, you either have to pay for the costs out of pocket or sign up for a Medicare Advantage Plan with additional coverage.
At PolicyScout we have many resources you can use to find out more:
Check out our Medicare Hub to learn more about the program.
Compare relevant Medicare Advantage Plans with our comparison tool.
Call 1-888-912-2132 to speak to a trained Medicare consultant.