Jeffrey Wade
Hearing loss is a common issue, affecting 23% of people over the age of 12 and 75% of those over 70 in the US. While Medicare does not typically cover hearing aids, there are some exceptions and alternatives to consider. For example, Medicare Advantage (MA) plans, also known as Part C, are offered by private insurance companies and must cover everything included in Parts A and B, and some plans may offer hearing aid coverage. Additionally, some private insurance providers like Aetna, Blue Cross Blue Shield, Cigna, Humana, and United Healthcare offer hearing aid benefits, but these can vary depending on your state and medical condition. It is important to review the details of your plan to understand what is covered.
| Characteristics | Values |
|---|---|
| Medicare coverage for hearing aids | Medicare Advantage (MA) plans, also called Part C, may cover hearing aids and related services, but this varies by plan and insurer. |
| Original Medicare coverage | Original Medicare (Parts A and B) does not typically cover hearing aids or exams for fitting hearing aids. However, Part B may cover diagnostic hearing and balance exams if ordered by a doctor. |
| Medicare supplemental plans | Medigap plans can help cover out-of-pocket costs associated with Original Medicare, but they do not cover additional benefits beyond those included in Original Medicare. |
| Private insurance coverage | Aetna, Blue Cross Blue Shield, Cigna, Humana, and United Healthcare offer certain hearing aid benefits, but these vary by plan, medical condition, and state of residence. |
| Medicaid coverage | Medicaid in some states covers hearing aids for eligible individuals. |
| Financial assistance | Government benefits, vocational rehabilitation programs, and hearing aid charities may provide financial assistance for hearing aids. |
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What You'll Learn
- Medicare Advantage plans may cover hearing aids
- Medicaid may cover hearing aids in some states
- Eargo and NationsBenefits partnered to help customers pay for hearing aids
- MDHearing partnered with Medline to increase Medicare Advantage and Medicaid coverage
- Medicare covers cochlear implants for severe hearing loss
Medicare Advantage plans may cover hearing aids
Medicare Advantage (MA) plans, also known as Part C, are private insurance plans that combine your Medicare Part A and B coverage. They can offer additional benefits, like hearing aid coverage, which Original Medicare does not provide.
While Original Medicare does not cover hearing aids or exams for fitting hearing aids, some Medicare Advantage plans may offer hearing aid benefits. However, it is important to note that coverage varies by plan and insurer, so it is essential to compare options and check the specifics of each plan. Some plans may provide payment for prescription or over-the-counter (OTC) hearing aids if they are deemed medically necessary.
The majority of major insurers that offer Medicare Advantage plans have at least one plan that covers hearing aids. These insurers include Humana, Aetna, and Blue Cross Blue Shield. However, some seniors may not be eligible for these plans, and the plans may have higher premiums than those that do not offer hearing aid coverage.
Medicare Advantage plans that offer hearing coverage will cover some or all of the cost. The actual amount covered depends on the specific plan and may vary based on factors such as the premium amount, deductible level, and how much the insured has already paid out-of-pocket for co-pays and other expenses. Some plans may also offer discounts on hearing aids and associated services.
Medicare Advantage plans may also impose limits on the frequency with which hearing aids can be purchased. Some plans may only cover one set of hearing aids every year or every two years, and there may be different copayments based on the level of digital technology.
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Medicaid may cover hearing aids in some states
Hearing loss is a prevalent issue in the United States, affecting 23% of people over the age of 12 and 75% of those aged 70 and older. However, despite the far-reaching implications for overall health and quality of life, only about one in seven people with hearing difficulties seek treatment. While many other health conditions are typically covered by private health insurance, Medicaid, or Medicare, hearing loss is not always included, which may deter people from seeking hearing care.
Medicare Parts A and B do not cover hearing aids or routine hearing exams, leaving most hearing-related costs to the individual. Nevertheless, Medicare may cover diagnostic hearing exams if they are ordered by a doctor to address medical conditions like vertigo or balance issues. Medicare Advantage (Part C) plans, on the other hand, are private insurance plans that can offer additional benefits, such as hearing aid coverage. These plans may cover some of the costs for hearing aids and related services, but specific details like copayments and coverage caps vary by plan and insurer. Therefore, it is essential to compare options to find a plan that meets your needs.
Medicaid, a government-sponsored health insurance program for low-income individuals and families, may provide hearing aid coverage in certain states. The Hearing Loss Association of America (HLAA) provides a directory of state-specific coverage information. According to the HLAA, Vermont Medicaid is required to cover medically necessary hearing aids and audiology services, including examinations, hearing screenings, hearing aid fittings, and prescriptions for hearing aid batteries. Additionally, Missouri law mandates Medicaid coverage for infant hearing screening, re-screening, audiological assessment, and initial amplification, including hearing aids. Other states with similar requirements include Minnesota, Montana, and Arkansas, which mandate coverage for children under the age of 18 or 19.
While Medicaid may provide hearing aid coverage in some states, it is important to note that eligibility requirements and specific benefits may vary by state. Therefore, individuals seeking hearing aid coverage through Medicaid should consult the HLAA directory or contact their state for more specific coverage details.
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Eargo and NationsBenefits partnered to help customers pay for hearing aids
Hearing loss is a common issue, affecting 23% of people over the age of 12 and 75% of those aged 70 and older. However, despite the prevalence of hearing loss, insurance coverage for hearing aids can be sparse. Original Medicare (Parts A and B) does not cover hearing aids or routine hearing exams, leaving most hearing-related costs to the individual. Medicare Advantage (Part C) plans may offer hearing aid benefits, but coverage varies by plan, so it is important to compare options.
Some private insurance plans, such as Aetna, Blue Cross Blue Shield, Cigna, Humana, and United Healthcare, offer certain hearing aid benefits, but these can depend on an individual's medical condition and state of residence. Some health insurance companies may cover over-the-counter (OTC) hearing aid devices from brands like Eargo and MDHearing.
In December 2022, Eargo and NationsBenefits formed a partnership to help customers pay for hearing aids. NationsBenefits administers supplemental benefits for various insurance providers. The partnership allows health plan members served by NationsBenefits to use their plan benefits to purchase Eargo OTC hearing aids. Eargo is a medical device company aiming to improve the quality of life for people with hearing loss. Their innovative products address the major challenges of traditional hearing aid adoption, including social stigma, accessibility, and cost. Eargo's sixth-generation device, Eargo 6, is an FDA Class II exempt hearing device featuring Sound Adjust technology, which automatically optimizes the soundscape as the user moves between environments.
NationsBenefits is a leading member engagement, benefits administration, and healthcare company that partners with managed care organizations to provide innovative healthcare solutions. Through its comprehensive suite of supplemental benefits, payments platform, and member engagement solutions, NationsBenefits helps health plans deliver high-quality benefits to their members, improving health outcomes and satisfaction.
Through their partnership, Eargo and NationsBenefits aim to create a pathway for individuals with hearing loss that lowers barriers to care and offers increased access to high-quality, technology-advanced hearing aids. This partnership ensures that people have access to the right products for their individual needs, enhancing the overall experience for health plan members.
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MDHearing partnered with Medline to increase Medicare Advantage and Medicaid coverage
Hearing loss is a prevalent issue in the United States, affecting 23% of people over the age of 12 and 75% of those aged 70 and older. Despite the far-reaching implications for overall health and quality of life, only about one in seven people with hearing difficulties seek treatment. While many other health conditions are typically covered by private health insurance, Medicaid, or Medicare, hearing loss has not historically been included, which may deter individuals from pursuing hearing care.
MDHearing, an over-the-counter (OTC) hearing aid company, recently partnered with Medline, a healthcare company that manufactures, distributes, and provides solutions to improve the operating performance of healthcare, to address the issue of limited insurance coverage for hearing aids. By joining forces, MDHearing and Medline aim to increase Medicare Advantage and Medicaid coverage for MDHearing devices, making it more affordable for individuals to access hearing aids.
Medicare Advantage, also known as Part C, is a private insurance add-on that combines the benefits of Medicare Parts A and B with additional coverage, including hearing aids. The partnership between MDHearing and Medline allows Medicare Advantage plan participants to use their OTC supplemental benefit allowances to receive MDHearing's affordable, FDA-registered hearing aids. MDHearing's hearing aids are priced within the range of most hearing aid coverage limits, typically ranging from $300 to $700 per pair, compared to the average cost of $4,600 for hearing aids bought at a clinic.
Through this partnership, Medline is working with insurance providers to include hearing aids as part of their OTC supplemental benefit offerings. This creates an opportunity to improve member outcomes and retention by providing benefit dollars for OTC hearing aids, which can save individuals thousands of dollars while still offering support from licensed hearing professionals. MDHearing is the only OTC hearing aid company that offers a phone hearing screening test and a simple online hearing screening test, ensuring easy access to hearing care.
The collaboration between MDHearing and Medline demonstrates their shared commitment to providing high-quality customer service and improving the member experience. By increasing Medicare Advantage and Medicaid coverage for MDHearing devices, they are making hearing aids more accessible and affordable for individuals with hearing loss, ultimately improving their quality of life.
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Medicare covers cochlear implants for severe hearing loss
Hearing loss is a common issue, affecting 23% of people over the age of 12 and 75% of those aged 70 and older in the US. While hearing loss can significantly impact overall health and quality of life, only about one in seven people with hearing difficulties seek treatment. Medicare generally does not cover hearing aids or routine hearing exams, leaving most hearing-related costs to the individual. However, it does cover one annual visit to an audiologist without a provider's order for non-acute hearing conditions, such as gradual hearing loss.
Medicare has expanded its coverage for cochlear implants, a surgical procedure that can significantly improve hearing for individuals with severe to profound hearing loss. This expansion is expected to benefit millions of individuals with hearing loss, particularly those who have not benefited from traditional hearing aids. Medicare now covers cochlear implants when deemed medically necessary for severe hearing loss that cannot be adequately addressed with hearing aids.
The expanded coverage criteria for cochlear implants under Medicare, effective from September 26, 2022, include the treatment of bilateral pre- or post-linguistic, sensorineural, moderate-to-profound hearing loss in individuals who show limited improvement with amplification devices, such as hearing aids. Limited improvement is defined by test scores of 60% or less in sentence recognition tests.
To be eligible for Medicare coverage for cochlear implants, individuals must meet specific requirements. These include a diagnosis of bilateral moderate-to-profound sensorineural hearing impairment, the ability to participate in post-surgery training and rehabilitation, a cochlea suitable for implantation, and the absence of lesions in the auditory nerve and acoustic areas of the central nervous system.
While Medicare covers the cost of cochlear implants for eligible individuals, there may still be out-of-pocket expenses, such as deductibles and coinsurance. The costs can vary depending on factors such as the type of implants, location, health condition, and other individual factors. It is recommended to consult with a healthcare professional to understand the expected costs and coverage for cochlear implants under Medicare.
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Frequently asked questions
Original Medicare (Parts A and B) does not typically cover hearing aids or exams for fitting hearing aids. However, Medicare Advantage (Part C) plans may offer hearing aid benefits, but coverage varies by plan and insurer.
Some examples include plans from Aetna Medicare Advantage, Blue Cross Blue Shield, and Humana.
Some private insurance plans such as Aetna, Blue Cross Blue Shield, Cigna, Humana, and United Healthcare offer hearing aid benefits, but they vary depending on your medical condition and state of residence.
Government benefits, vocational rehabilitation programs, and hearing aid charities may be able to help. Medicaid in some states also covers hearing aids for eligible individuals.
Medicare allows one annual visit to an audiologist without a provider’s order for non-acute hearing conditions, such as gradual hearing loss over time. It also covers diagnostic services related to surgically implanted devices and diagnostic hearing exams if they are ordered by a doctor to treat medical issues such as vertigo or balance disorders.
