Traditional Medicare doesn't cover hearing tests or hearing aids, and it can be tough to get coverage even through private insurance plans. That's news most Medicare recipients may not be happy to hear.
Medicare is the insurance program for U.S. residents 65 and older, as well as some younger residents with kidney failure or other disabilities. Anyone who's eligible for Medicare has two options: traditional Medicare from the federal government or Medicare Advantage, in which you get Medicare benefits through a plan from a private insurer.
Traditional Medicare does not cover routine hearing tests, hearing aid fittings or hearing aids, according to Medicare.gov. And Medigap insurance, which Medicare recipients buy to cover some gaps in traditional Medicare, also lacks that coverage.
However, you may be able to find a Medicare Advantage plan from a private insurer that covers part of the cost hearing loss testing and treatment.
When does Medicare cover hearing loss?
If you're concerned about hearing-loss treatment, you should first know what traditional Medicare does and doesn't cover. In fact, there are a few important exceptions to the Medicare-doesn't-cover-hearing-loss rule.
First, Medicare may cover a hearing test when a doctor orders the exam to see if you need medical treatment for an underlying condition, according to Medicare.gov. One example of a covered diagnostic hearing test is a test to look for the cause of balance problems or tinnitus, which is a sound such as buzzing, ringing or whistling in the ears, according to The American Speech-Language-Hearing Association.
If you've met your deductible for your Medicare Part B medical insurance, which is $166 a year in 2016, you'd pay 20 percent coinsurance for the test. And your Medigap supplemental insurance may pick up that out-of-pocket cost.
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Second, Medicare may cover hearing loss treatments that include some types of implants, according to the Hearing Loss Association of America. These include:
- Cochlear implants — A cochlear implant is an electronic device that stimulates the auditory nerve to provide a sense of hearing for patients with ear damage. A cochlear implant has two parts, one of which is surgically placed in the inner ear, and another that sits above the ear.
- Auditory brain stem implants — An auditory brain stem implant is similar to a cochlear implant, but it bypasses the auditory nerve and sends signals directly to the brain. An auditory brain stem implant may be used to treat patients who have lost hearing due to tumors on the auditory nerve.
- Bone-anchored implants — A bone-anchored implant is a device that can be surgically implanted into the bone of the ear for treating several types of hearing loss, according to the University of Maryland Medical Center (UMM). The device uses "direct bone conduction," meaning that the sound travels through the bone rather than the middle ear, according to the UMM. The implant may be used to treat patients who have trouble hearing due to chronic ear infections or a narrowing of the ear canal, or for patients who have hearing loss on one side from surgery for tumors on the auditory nerve.
In 2014, the Center for Medicare and Medicaid Services (CMS) announced that those three types of implants are not considered hearing aids, so they're not excluded from Medicare coverage.
How can Medicare patients get hearing coverage?
If you have hearing loss that requires routine hearing tests and standard hearing aids, you may have options for getting care covered by insurance.
A hearing aid is a device that contains an amplifier, microphone and speaker, and it slips in or over the ear. Hearing aids are used to treat patients with hearing loss from damage to cells in the inner ear, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). This type of hearing damage may be caused by aging or loud noises, according to the Mayo Clinic.
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You can buy an inexpensive pair of hearing aids for under $300, but a quality, custom-made pair from an audiologist will cost from over $2,000 to $7,000, with an average price tag around $4,000, according to the AARP. Expect these to be out-of-pocket costs.
So, if you have hearing problems or are concerned that you may in the future, consider shopping for a Medicare Advantage plan from a private insurer that offers some hearing care coverage.
If you need hearing aids and don't have adequate coverage through Medicare, you might want to check national and community programs that offer affordable hearing aids to seniors. For example, the Lions Clubs International Foundations operates an affordable hearing aid program.
Start by calling some nonprofit organizations in your local community. For example, you can contact local clinics or groups that help the deaf, according to the Hearing Loss Association of America.