So you've started to notice your hearing isn't quite as sharp as it used to be. The TV volume seems to creep up higher and higher. You find yourself asking people to repeat themselves. Your loved ones complain you're not listening like you used to. These are all signs pointing to age-related hearing loss. And worst of all: you're worried about the costs of getting treatment.
The big question on your mind is likely: Does Medicare cover hearing aids? Unfortunately, there isn't a yes or no answer as it's different for every Medicare plan. Below you will not only find out if your Medicare plan covers hearing aids in 2023, but also how else you can get them in case they're not covered by your plan.
What Is Original Medicare
Before we get into hearing aid coverage, we need to understand what Original Medicare means. Original Medicare is a federal health insurance program and is typically what most Medicare participants are enrolled in. It is also sometimes referred to as Medicare Parts A and B.
- Part A helps pay for inpatient care in hospitals, skilled nursing facilities, hospice, and home health care. Most people automatically get Part A coverage without paying a monthly premium.
- Part B helps pay for doctors' services, outpatient care, durable medical equipment, and other medical services. To enroll in Part B you have to pay a monthly premium, but this plan is optional.
Does Original Medicare Cover Hearing Aids in 2023?
Unfortunately, Original Medicare (Parts A and B) does not cover hearing aids or exams for hearing aids. This can be frustrating news if you're experiencing hearing loss and these two are your only medical insurance coverage. Yet the good news is there are many other Medicare coverage plans apart from Original Medicare that offer extra benefits like hearing aids. These are called Medicare Part C plans (or Medicare Advantage Plans).
What Is Medicare Part C (Medicare Advantage Plans)
Medicare Advantage Plans, also known as Medicare Part C, are health plans offered by private companies but are approved by Medicare. These plans provide an alternative way to get your Medicare benefits. Unlike Original Medicare (Parts A and B), Medicare Advantage Plans bundle Part A (Hospital Insurance) and Part B (Medical Insurance) together in one plan.
Medicare Advantage Plans must cover medically necessary services that Original Medicare covers except for hospice care. But, they can charge different out-of-pocket costs and have different rules for how you can get services. Most plans offer extra benefits that Original Medicare doesn’t cover, like vision, dental, and prescription drug coverage.
Types of Medicare Advantage Plans
There are many different types of Medicare advantage plans. But here are a few of the most popular:
- Health Maintenance Organization (HMO) Plans: You generally must get your care from doctors and hospitals in the plan’s network.
- Preferred Provider Organization (PPO) Plans: You pay less if you use doctors and hospitals in the plan's network. You can use out-of-network providers for covered services, usually at a higher cost.
- Private Fee-for-Service (PFFS) Plans: You can go to any Medicare-approved doctor or hospital that accepts the plan's payment terms. The plan determines how much it will pay doctors and hospitals as well as how much you must pay for co-insurance and deductibles.
- Special Needs Plans (SNPs): Only people with special health care needs or institutional conditions can enroll for this one. Plans tailor their benefits to best meet the specific needs of groups they cover.
Do Medicare Advantage Plans Cover Hearing Aids?
When it comes to Medicare Advantage plans, hearing aid benefits vary depending on the specific plan. Some Medicare Advantage plans offer additional benefits like routine hearing care and hearing aid coverage. The way to find out if a Medicare Advantage plan covers hearing aids is to check with the plan's provider directly. Some plans may cover certain hearing aid costs such as:
- Routine hearing exams to test your hearing and see if hearing aids are needed.
- Coverage for some or all hearing aid device expenses.
- Follow up appointments for adjusting and fitting hearing aids.
Some Medicare Advantage plans cover specific name brand hearing aids, while others allow you to choose from a selection. Certain plans may require you to stick to hearing care providers and services in their network.
Compare Medicare Advantage Plans
If your current Medicare Advantage plan does not cover hearing aids, you have the option to switch. Compare plans in your area to find one that offers hearing health benefits that meet your needs. Things to consider when comparing plans include:
•Premiums, deductibles, and out-of-pocket maximum costs
•Covered hearing aid brands and models
•In-network vs. out-of-network coverage
•Coverage for hearing tests, fittings, repairs, and follow up care
•Additional benefits like dental, vision, transportation, etc.
Medicare Advantage plans that cover hearing aids and related services can provide savings and make hearing care more affordable and accessible for those with hearing loss. With the variety of plans available, you have many options to choose from to find coverage that suits your needs and budget.
What To Consider With Medicare Advantage Plans
When considering a Medicare Advantage plan, there are a few important things to keep in mind. These private insurance plans offer coverage that replaces original Medicare Part A and Part B. While they may provide some additional benefits, you'll want to weigh the pros and cons carefully based on your needs and priorities.
Limited Provider Choice
With a Medicare Advantage plan, you can only get coverage with certain doctors and at healthcare facilities in the network of the insurance company. The insurance company also has to approve any treatment before you can receive it, which could cause delays. With original Medicare, all of your healthcare decisions stay between you and your doctor. If having flexibility and control over provider choice is important to you, Medicare Advantage may not be the best choice.
Medicare Advantage plans typically have lower out-of-pocket costs like deductibles and copays, though they often charge higher monthly premiums. You'll need to calculate whether the lower cost-sharing offsets the higher premiums based on your expected medical needs for the year. Plans can also change benefits, providers, and costs each year.
Many Medicare Advantage plans provide extra benefits not covered under Original Medicare like dental, vision, hearing, and wellness programs. If these additional benefits are appealing to you, an Advantage plan could save you money. But, again, benefits can change each year with the plan.
Most Medicare Advantage plans only provide coverage for emergency and urgent care when you travel outside the U.S, while Original Medicare covers you in any hospital or healthcare provider that accepts Medicare around the world. So if you travel frequently or live part of the year abroad, the latter may suit you better.
When it comes time to choose between the two, think about what matters most in your retirement health coverage. Weigh all of the factors carefully and determine what combination of plans and supplemental insurance will provide you the benefits you need at a cost you can afford. The choice is personal for each Medicare recipient.
How to Enroll or Switch to a Medicare Advantage Plan
You can join or switch Medicare Advantage plans during the Medicare open enrollment period from October 15 to December 7 each year. Changes you make during open enrollment take effect on January 1 of the following year. Some exceptions apply if you're newly eligible for Medicare or meet certain special needs.
How to Find and Apply to Medicare Advantage Plans
The easiest way to compare Medicare Advantage plans and enroll is on Medicare.gov. Just enter your zip code and the site will show you all of the plans available in your area along with details about costs, benefits, and coverage. You can also call 1-800-MEDICARE or your State Health Insurance Assistance Program (SHIP) for help.
Once you choose a plan, you enroll directly with the insurance company that offers it. They will have instructions on their website for how to join, usually involving filling out an online or paper application and providing information like your Medicare number. The company will then send you plan details including a membership card, summary of benefits, and information on accessing care.
- Premiums, copays, deductibles, and other costs will vary based on the plan you choose. Compare carefully.
- You must continue to pay your Medicare Part B premium. Some plans may have an additional monthly premium.
- Not all doctors, hospitals and providers may be in the plan's network. Check that your doctors participate before joining.
- You can leave a Medicare Advantage plan and switch back to Original Medicare during the Medicare Advantage Open Enrollment Period from January 1 to March 31 each year.
Following these steps will help ensure you find and enroll in a Medicare Advantage plan that suits your needs and budget. Once joined, be sure to use your plan coverage for all medical services to avoid unexpected costs. Let your doctors know you have a Medicare Advantage plan so they can properly bill for your care.
How Much Do Hearing Aids Cost Without Medicare?
Now, you may be wondering if you can just pay for your hearing aid up front. Let's take a look at how much it would cost to buy out-of-pocket. Hearing aid costs can vary greatly depending on the type and technology. But the average cost of a pair of basic hearing aids in the U.S. is around $4,500. High-end devices with advanced features like Bluetooth connectivity or rechargeability can cost $6,000 per year or more.
- Behind-the-ear (BTE) hearing aids are the most common and typically range from $1,000 to $3,500 per ear.
- In-the-ear (ITE) hearing aids that fit completely in the ear are usually a bit more expensive, from $2,500 to $4,000 per ear.
- The smaller, nearly invisible in-the-canal (ITC) and completely-in-the-canal (CIC) hearing aids tend to cost the most, from $2,500 up to $5,000 per ear or higher due to their small size and high-tech components.
What About Additional Fees?
The total cost for a pair of hearing aids also includes the audiologist’s fees for testing and fittings, which can add another $500 to $1,000 or more to the total bill. The good news is that most audiologists offer payment plans to make hearing aids more affordable, with the option to pay over 6 to 24 months with no interest. Some even offer discounts if you pay for the hearing aids in full upfront.
Shopping around at different audiologists and hearing clinics in your area is the best way to compare prices and find affordable options. Popular stores like Costco, Sam’s Club and Walmart also provide quality hearing aids at lower prices. You can often save thousands of dollars for the exact same hearing aid models sold by private audiologists. Also, non-profit organizations like the Hearing Loss Association of America offer ways to get discounted or donated refurbished hearing aids for those on fixed incomes or with limited means.
Do You Need Hearing Aid Coverage?
If hearing aid coverage is important to you but your current plan doesn't cover it, it's never too late to switch! Not all Medicare plans are created equal, That's why we're here to help you find a plan that's perfect for you.
EASY Insurance is a team of experienced agents that are dedicated to helping you find the health plans that best suit your needs. Whether you need a plan offered by the government or a private insurance company, we are always happy to take the time to sit down and discuss.
We're here for you and can't wait to help you live an EASY and stress-free life!