Does Medicare cover hearing exams?

Approximately 38 million American adults aged 18 and over report some kind of difficulty with hearing. Hearing aids are a life-changing investment for many individuals and families, but the costs can be substantial and covering the financial burden attributed with hearing aids is a difficulty faced by many.

Insurance plans can help cover some, if not all, of these costs, and at the bare minimum, make hearing aid treatment a more universally accessible option. Many companies offer health insurance plans to their employees and certain states make it a requirement to include hearing aid specific coverage within health insurance policies.

However, for some, their access to health insurance is limited and are left wondering where they can acquire the financial aid required to cover the costs of hearing aid usage.

There are federal and state programs that help with medical costs for some people with limited income and resources. One such program that has helped many seeking financial relief is Medicare.

What is Medicare?

Medicare is a federal health insurance program that covers people aged 65 or older, as well as certain younger people with disabilities or serious diseases and individuals with end-stage renal disease.

Medicare is split into four parts; A, B, C and D. Each part provides specific coverage: A refers to hospital insurance, B refers to medical insurance, C refers to a more comprehensive insurance plan (inclusive of part A, B and often D) and D refers to prescription drug insurance.

Medicare does not cover all costs of medical services however, and the costs which are covered are depending on a number of factors, most notably where you live. If you’re unsure as to whether Medicare covers your specific needs speak to your doctor or other health care provider for clarity.

Does Medicare cover Hearing Aids?

Traditional Medicare coverage does not include hearing aids, or tests to have hearing aids fitted. This is specified clearly on its website.

Under certain circumstances, however, Medicare covers diagnostic hearing and balance exams. An example of this would be if your doctor or other health care provider orders it to see if you need medical treatment. In this instance you’d pay 20% of the Medicare-approved amount for your doctor's services for covered exams.

Why isn’t hearing aid coverage provided in Medicare?

The rationale behind Medicare not covering hearing aids in its insurance policies is extremely dated. The Medicare Act of 1965 statutorily excluded coverage of hearing aids under the premise that they were 'routinely needed and low in cost', suggesting that consumers would be responsible for their purchase. We know this is not the case in many instances and many hearing aids cost in excess of $1,000.

Life expectancy and elderly populations were also not as great in number as they are now and so the number of people requiring hearing aids was significantly lower. The research surrounding hearing aid treatment was also poorly understood/researched at that time and since then the body of evidence has grown substantially.

There is an argument to be made that the hearing aid Medicare policies need to be revised for present-day demand. Working with your doctor, healthcare provider or even scheduling in a free consultation with one of our trusted experts can help you work out the best route to take financially when exploring the insurance related options to make your hearing aids more affordable.

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