Does Medicare Cover Hearing Aids?

The relationship between hearing aids and health care coverage is complex, with a lot of confusing and inconsistent information out there.

For example, only 1 in 10 children in California wears hearing aids that are covered by private health insurance. At The Hearing Solution, we are part of a larger movement to correct this glaring gap.

For adults, however, the landscape isn’t much better. In fact, one of the most popular questions we receive is whether hearing aids are covered by insurance – which is why we’ve written an article that covers this very topic.

But what about Medicare?

You’d think that hearing aids would be covered under this Federal program. This is especially true since Medicare targets seniors – a demographic group that is disproportionately dependent on hearing aids and other assistive hearing technologies.

Surely retirees would qualify for hearing aid coverage under Medicare.

But sadly, the short answer is “no” – they’re not.

Hearing Aids under Medicare – What Is and Isn’t Covered

To say that Medicare does not cover hearing aids at all is misleading. The program actually does cover up to 80% of diagnostic hearing tests performed by licensed audiologists. 

These exams typically include:

• Tinnitus screening
• Auditory processing
• Osseointegrated hearing aids

But diagnostic screening is only covered if you are referred to that audiologist by a licensed physician first.

The hearing aids themselves, however, are not covered under Medicare.

Worse still, any tests conducted during the hearing aid fitting and customization process must also be paid entirely out-of-pocket. This is true whether you go through an audiologist or a hearing aid dispenser.

Other Ways to Cover Hearing Aids

Hearing aids are essential for healthy living. But the average retiree on a limited income can’t easily shell out the thousands of dollars required to receive, fit and customize the right hearing aid solutions.

So what does this mean for you and your family? 

The good news is that you still have options.

1. Medicare Advantage

Medicare Advantage is a paid supplemental program that retirees can add to their primary Medicare coverage. It comes with a host of benefits and restrictions – depending on the exact plan you choose.

If your Medicare Advantage coverage includes HMOs, for example, your policy may cover a small portion of hearing aids and routine audiological services. However, you will be restricted to certain hearing aid providers within the network. Having access to a limited selection of hearing aids and tests could prevent you from receiving the full benefit of corrective hearing treatment.

We can work with your HMO to determine the exact extent of your coverage. But as a general rule, we discourage our patients from using these plans because of the built-in limitations outlined above.

2. Private Health Insurance

Another popular option is to use private health care insurance to cover the cost of hearing aids. Note, however, that this coverage isn’t automatic. It depends on which provider and policy you choose. And even then, navigating the landscape isn’t easy, given all the exclusions and exemptions embedded in many health care plans.

At The Hearing Solution, we can help you explore some of the different health insurance plans out there to find the best fit for your needs. Just keep in mind that we don’t currently accept HMO coverage at our Sacramento clinic.

3. California Medicaid (Medi-Cal)

Medicaid is a federal-state program designed for low-income families and people with disabilities. It also provides long-term care for seniors.

Because Medicaid is partially run at the state level, it goes by different names and rules – depending on where you live.

In California, the program is officially known as Medi-Cal. And eligible patients qualify for up to $1,510 of hearing aid coverage per year.

We can help determine your eligibility under the program. However, The Hearing Solution is not currently a Medi-Cal provider.

Let Us Help You Find the Hearing Aid Coverage You Need

Because the ability to hear is so fundamental to healthy and happy living, hearing aid access and coverage should be automatic – whether you are a newborn baby or a retired pensioner.

But sadly, it isn’t. And as a result, many patients have no choice but to explore over-the-counter hearing aid solutions – often with terrible results.

We don’t want this to happen to you. 

Although we can’t force policymakers or insurance providers to do the right thing, we can help you navigate the health care market to ensure you receive the best coverage possible.

If you need hearing aids and want to begin exploring your health care options, schedule an appointment with us today.