A doctor with a sign asking if Medicare covers hearing aids.
Unfortunately, when it comes to facial, dental, and hearing care, traditional Medicare doesn’t offer much coverage for older adults.
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However, if you have additional insurance, it may pay for some or all of these services, depending on your plan.
What is Medicare?
Medicare is a federal health insurance program that covers people age 65 or older, as well as younger people with disabilities or serious illnesses. However, Medicare does not cover: all costs of medical services, where the rules get tricky. There are some factors affecting coverage, so it is imperative that you consider the different types of coverage that are available.
Are hearing aids covered by Medicare?
New. Medicare It is very clear about this on their website:
Medicare does not cover hearing aids or hearing aid fitting exams. You pay 100% for hearing aids and exams. Some Medicare Advantage Plans (Part C) offer additional benefits that Original Medicare does not cover — such as vision, hearing, or dental. Contact Us the plan for more information.”
What about Medicaid?
This depends on your age and your state of residence. All children with hearing loss who are on Medicaid can receive hearing care and hearing aids anywhere in the US. For adults, however, Medicaid coverage for hearing care depends on the state you are in. This page contains state-by-state coverage information for adults.
Does Medicare Cover Hearing Tests?
In some cases yes, but only if recommended by your GP or other doctor. In other words, you can’t go to a hearing clinic without a referral and expect Medicare to pay for it.
This is how Medicare explains it: hearing exam coverage: “Medicare Part B (Medical Insurance) covers diagnostic hearing and balance exams if your doctor or other health care provider orders them to see if you need medical treatment. You pay 20% of the Medicare-approved amount for the services from your doctor for covered exams, and the Part B deductible applies. Medicare does not cover hearing tests, hearing aids, or hearing aid fitting studies.”
Why Does Medicare Not Reimburse Hearing Care?
if this clinical assessment explains, “The Medicare Act of 1965 statutory excluded coverage of hearing aids under the assumption that they were ‘routinely needed and inexpensive,’ suggesting consumers would be responsible for their purchase.” Also, at that time, many seniors did not live as long as they do now, and so fewer people had age-related hearing loss. There was also little understanding of the importance of treating hearing loss reduce depression and social isolation.
Will hearing aid coverage change?
Over the years, many organizations and lawmakers have attempted to update Medicare to cover vision, hearing, and dental costs for seniors.
Many people would like to see Medicare evolve into dental, vision and hearing care. AN Commonwealth Fund report details the financial and health burdens these gaps place on older adults. The report said:
“Of Medicare beneficiaries, 75 percent of people who needed hearing aids did not have one; 70 percent of people who had difficulty eating because of their teeth did not visit the dentist in the past year; and 43 percent of people with problems seeing hasn’t had an eye exam in the past year.”
So far, however, no one has been able to make changes to this portion of Medicare coverage. In the summer of 2019, several US representatives introduced HR 4056, a bill that Medicare would have to pay for certain audiology services. Time will tell if this bill is passed.
What do all Medicare “components” mean?
Here’s a breakdown:
Medicare Part A: Hospital Insurance
- Hospital care
- Nursing home care
- home care
- Skilled Nursing Care
Medicare Part B: Medical Insurance
Medicare Part B includes two types of services: medically necessary and preventive services. Preventive services include early detection of a disease. Most of these services are offered for free to those with Part B coverage.
- Ambulance services
- Durable medical equipment
- Inpatient, outpatient and partial hospitalization for mental illness
- Seeing a second doctor before surgery
- Some outpatient prescription drugs
- Clinical research
Medicare Part C: Medicare Advantage Plans
This plan is a health care option administered by a private insurance company that has a contract with Medicare. The Advantage Plan usually includes coverage of all components of Medicare. In some cases, the private insurer may pay for hearing tests. You must contact your plan provider if you have Part C coverage. If you also have additional coverage not related to Part C, you will need to contact your carrier again.
Medicare Part D: Drug Plan Coverage
Medicare prescription drugs each have a list of available drugs. The drugs are divided into different levels based on your out-of-pocket cost for each. Drugs listed in the lower tiers will cost you less than a drug in a higher category. The drug plans have specific coverage rules that should also be considered.
What other items are not covered by Medicare?
in addition hearing aids and appropriate exams, there are many other medical expenses that are not paid by Medicare. They contain:
- foot care
- Cosmetic surgery
- eye care
- false teeth
- Long-term or custodial care
What about screenings covered by Medicare?
Medicare covers screening services and preventive testing under the Medicare Part B plan. These include injections for the flu, hepatitis B, and pneumococcal disease. In addition, it covers an annual wellness visit.
Other services covered by Medicare (this is not a complete list):
- Abdominal Aortic Aneurysm Screening
- Bone mass measurements
- Cardiovascular disease screening and behavioral therapy
- Cervical and Vaginal Cancer Screening
- Diabetes screening and self-management training
- Glaucoma Tests
- HIV screening
- Prostate Cancer Screenings
- Sexually Transmitted Diseases Screenings and Counseling
Medicare Part B also includes health screenings for alcohol abuse, obesity, nutritional therapy, and depression.
Applying for Medicare?
For convenience, you can apply for Medicare at the Social security website. You can use the online form to sign up for Medicare coverage even if you’re not ready to retire yet.
Medicare and other insurance
If you have questions about hearing loss and how to pay for hearing aid services, a hearing care professional near you may be able to help you.