Hearing aids fit Medicare’s description of durable medical equipment (DME) to a T – they treat a medical condition, are expected to last several years, and withstand repeated use. But hearing aids didn’t make Medicare Part B’s DME list. Unfortunately, hearing aids aren’t considered DME and are therefore not covered under Medicare. In fact, it would take an act of Congress to get hearing aids covered under Medicare.
For aging adults who think they might be losing some hearing, this could be a big hit to the pocketbook. Hearing aids cost from about $1,500 to more than $4,000 per device, and most people can’t afford a sudden $3,000 health bill.
Read on to understand what Medicare covers and how to make hearing care more affordable.
Medicare Part B coverage of hearing care
Medicare doesn’t cover hearing aids, but there are some things it will help you pay for if you need hearing care. If you have symptoms of a hearing issue, Part B covers a diagnostic hearing and balance exam when prescribed by your doctor. Symptoms that might indicate you have hearing loss include:
- Sounds being muffled,
- Trouble hearing others speak,
- Difficulty hearing consonants,
- Asking people to repeat themselves a lot,
- Turning up the TV volume,
- Avoiding social settings that have a lot of background noise,
- Having ringing in the ears.
If your doctor recommends a hearing exam, Medicare will cover 80% of the cost after you meet your annual deductible. Part B covers a visit to an audiologist once a year without an order from your doctor if you need services related to implanted hearing devices. Medicare also pays for an annual hearing and balance test without a doctor’s approval if you’ve had an issue for more than a year.
Medicare also covers cochlear implants – electronic devices that stimulate the nerve related to hearing – if you’ve tried hearing aids and they didn’t work for you.
The reality of Medigap coverage gaps
Medicare doesn’t cover hearing aids or visits to a doctor to get them fitted. Your Medicare Supplement plan won’t cover the out-of-pocket costs for hearing aids because Medigap only covers the 20% coinsurance for covered Medicare services and DME. However, your Medigap will cover out-of-pocket costs for the diagnostic exam.
Retail alternative: Over-the-counter (OTC) hearing aids
Over-the-counter (OTC) hearing aids are an affordable, reliable option if you have mild or moderate hearing loss. These devices are approved by the U.S. Food and Drug Administration and can be purchased without a prescription from your doctor.
Some OTC hearing aids include wireless features, can provide hearing tests, and can connect to apps on your smartphone. When comparing OTC hearing aids, it’s important to think about factors like:
- Battery life,
- Bluetooth compatibility,
- Noise cancellation,
- Style – behind-the-ear, completely-in-the-canal, or in-the-ear,
- Length of time to charge the battery,
- Comfort and fit,
- Sound clarity features like feedback cancellation, noise reduction, and directional microphones,
- Maintenance,
- The duration of the warranty and what it covers.
Note: You shouldn’t use OTC hearing aids if you have severe hearing loss. You may have more severe hearing loss if you can’t hear people well, even in quiet rooms, or you can’t hear loud noises well, like a lawnmower or power tools.
If you suspect your hearing loss is severe, talk to your doctor about prescription options.
Standalone dental, vision, and hearing (DVH) insurance
Many major insurance carriers offer dental, vision, and hearing insurance (DVH) plans. This insurance typically has a reasonable monthly premium and covers these areas not included in Medigap, but which are important to most aging adults.
On top of covering dental exams and cleanings, eye exams, and some eyeglass benefits, these plans often provide an annual hearing exam at no cost to you. They also offer steep discounts (as much as 50% or more) on hearing aids through associated providers.
The good news about DVH plans is that you can enroll in them outside of the normal Medicare open enrollment period. As with other insurance, when choosing a plan, you’ll want to consider cost factors including:
- The monthly premium and copayments,
- Maximum benefit caps (the amount the plan will pay out annually/or over your lifetime),
- Waiting periods before the plan covers products and services,
- Network provider coverage,
- Plan exclusions.
Hearing loss can increase your risk of cognitive decline, social isolation, and falls. If you’ve noticed ringing in your ears, frequently ask people to repeat themselves, or find yourself turning the TV volume up more, it may be time to see your doctor.
Ensuring you have good hearing is an important part of aging well, and being proactive can prevent high out-of-pocket costs when it’s time for hearing care. Contact a United Medicare Advisors agent to compare standalone DVH policies that seamlessly protect your retirement savings.
