WE GET ASKED THIS QUESTION all the time when hearing aids are recommended to a patient. The answer is “yes” and “no” and “maybe in the future.” It really all depends on your Medicare plan. Medicare Part A and Part B do not cover hearing aids, but Medicare Part C (Medicare Advantage Plans) does have some hearing aid coverage.
Medicare Part A and Part B offer limited coverage. These plans may cover a hearing screening if you have hearing loss symptoms, but they do not cover a complete audiological evaluation unless there is a referral or an order from a physician, either primary or specialist. If you have tinnitus or another medical issue with your ears beyond standard hearing loss, you need a complete audiological evaluation as a screening is not a diagnostic test. They do not pay for any hearing aids. Medicare Part B may pay for a cochlear implant. A cochlear implant is a device for people who are deaf or very hard of hearing and get no benefit from hearing aids.
There are several Medicare Advantage plans that now have some hearing aid benefit or discount attached to them. These are called third-party plans because it is not the insurance company covering the hearing aids, but a third party contracted by the insurance company. These plans are readily available; you just need to shop around for the best plan for you.
Usually, the Advantage plan will cover a hearing test, the hearing aid consultation, and the fitting. Advantage plans rarely cover hearing aids in full, but you are offered a discount on the cost of the hearing aids or you are required to pay a copay over and above what your benefit is. For example, if you have a hearing aid benefit of $3,000 and you choose hearing aids that are more than $3,000, then you are required to pay the balance or copay that is listed by the insurance company. Many of these plans cover the first year of service with the provider. After that, the provider may charge you an office-visit fee for each appointment. Some third-party plans will cover hearing aid batteries if you need them, but most hearing aids that we fit now are rechargeable. Usually in the end, the hearing aids offered are at a lower cost than what they would be if you didn’t have the Advantage plan.
Sometimes, it can be difficult to find a hearing-care professional who is a provider for your hearing aid plan, and you may have to change providers if you want to use the plan. Your insurance company or the third-party plan will let you know of any participating providers near you.
Recent legislation called the Build Back Better Act has hearing aid coverage written into it. If passed, it will provide not more than one hearing aid per ear during a five-year period for people with severe to profound hearing loss. This excludes any over-the-counter, FDA-approved hearing aid. It will require a written recommendation from a physician, audiologist, hearing aid professional, physician assistant, nurse practitioner, or clinical nurse. Finally, the person fitting the hearing aid must be a qualified hearing aid professional, audiologist, licensed hearing aid dispenser, or hearing aid specialist. As of this article, this act passed in the House but is awaiting vote in the Senate. If passed, it will provide this coverage to your Medicare part B starting October 1, 2023.
Knowing if your Medicare covers the cost of hearing aids for you can be difficult. As a patient of ours, we will check on your hearing aid coverage and let you know what it is. We can then discuss your options with you and decide on the best amplification for you. Please call our office to schedule.
Dianna Randolph, AuD, CCC-A, is a Doctor of Audiology with Northwest Ohio Hearing Clinic, located at 1125 Hospital Dr., Suite 50 in Toledo (419- 383-4012) and 1601 Brigham Dr., Suite 160 in Perrysburg (419-873-4327).
