Approximately one in three individuals between the ages of 65 and 74 experience hearing loss, and nearly half of individuals older than 75 experience difficulty hearing. Currently, Medicare does not cover most hearing care services and devices.
What is Medicare?
Medicare is a federal health insurance program for individuals 65 and older and certain younger individuals with disabilities. Original Medicare includes Part A and Part B.
What is Part B of Medicare?
Medicare Part B is medical insurance that helps pay for medically necessary and preventative services. To be considered medically necessary by Medicare, these services must be required to diagnose or treat a medical condition.
Does Original Medicare, Part A and Part B, cover hearing evaluations?
Medicare Part A (Hospital Insurance) does not cover hearing evaluations. Medicare Part B does not cover routine, or annual, hearing evaluations or evaluations for fitting hearing aids. However, if a physician orders a diagnostic hearing or balance evaluation and considers these services medically necessary, Medicare Part B may help pay. The deductible and co-insurance apply.
Does Original Medicare cover hearing aids?
No, Original Medicare does not cover hearing aids or related services.
What is Part C of Medicare?
Medicare Part C, or Medicare Advantage, is an alternative to Original Medicare. Private insurance companies offer plans for Part C that cover both Part A and Part B. These insurance plans may include additional coverage for routine health care.
Does Medicare Part C cover hearing evaluations and hearing aids?
Most Medicare Advantage plans offer access to hearing evaluations and hearing aids. However, most of these plans require providers to contract with their networks. This requirement limits an individual’s selection of providers. Some plans also require a referral from a physician or prior authorization to see an audiologist.
Does my health insurance plan cover hearing evaluations and hearing aids?
Review the Evidence of Coverage or Summary of Benefits document of your plan. These documents are readily available via your insurer’s website. Contact your plan to discuss details. Call the phone number for customer service on the back of your insurance card. For further questions, contact your local audiologist. Information provided by Dr. Kelly Cook, Audiologist, Iowa Hearing Center, 1228 Sunset Drive, Suite B, Norwalk, (515) 416-5990, www.IowaHearingCenter.com. Dr. Cook is a Medicare participating provider.