Everything You Need to Know About Medicare Advantage and Hearing Aids

If you’re thinking of changing to a Medicare Advantage (MA) plan, we want to make sure that you have everything you need to make a well-informed choice when it comes to changing your coverage. 

The differences between Medicare Advantage and Original Medicare

Medicare Advantage plans have many advantages, such as lower premiums and broader coverage, compared to Original Medicare. 

Medicare Advantage plans include both vision and dental coverage, whereas Original Medicare doesn’t. They’re also a lot easier to understand and navigate than Original Medicare. 

Many plans under Medicare Advantage put all of your care into one package. 

This includes:

• Hospitalization
• Doctor care
• Prescription drugs
  

The Original Medicare plans had everything separated. For example, prescription drug coverage (Medicare Part D) had to be purchased separately. 

Looking at the surface, Medicare Advantage seems to be a lot easier to deal with. But we want to make sure you know exactly how it works, especially when it comes to your hearing aids and doctor's appointments. 

Does Medicare Advantage restrict you to their network of doctors?

The majority of people who use Medicare Advantage are with a Health Maintenance Organization (HMO). Meaning you’re only allowed to see the doctors within your HMO network. 

If the Medicare Advantage plan you’re using has a broad network, this can work out great for you. However, if it doesn’t, you might end up with expensive and unexpected fees. 

If you’re healthy today, the closed network might not seem like such a big deal. We encourage you to think about what would happen if you needed specialized care in the future. 

With Original Medicare, any specialist who accepts Medicare will be covered. Medicare Advantage limits you to the specialists within your HMO network. 

Is switching to Medicare Advantage irrevocable?

If you decide to choose a Medicare Advantage plan, you can technically switch back to your Original Medicare plan during the open enrollment. 

However, it only covers Part A (hospitalizations), Part B (doctor and treatment bills), and you can enroll in Medicare Part D. But this is all you’ll be able to enroll in. 

Does Medicare Advantage cover hearing aids?

Your Medicare Advantage plan might state that you have a hearing aid benefit. However, your plan only allows you to go to the providers within your HMO network. 

Unfortunately, there are no audiologists in the Sacramento area within the network. This means that if you live in the Sacramento area and switch to the Medicare Advantage plan, you may not have access to an audiologist.

Why is this?

There aren’t any audiologists contracted in the Sacramento area because insurance companies make a profit on hearing aids and only reimburse the provider (such as an Audiologist) a small amount. 

Audiologists such as The Hearing Solution wouldn’t be able to keep their doors open if they accepted only what the insurance reimbursed. 

What is a hearing aid discount program?

A hearing aid discount program buys hearing aids from manufacturers in bulk. They are usually discounted, but as the saying goes: you get what you pay for. 

If you sign up for a discount program (EPIC, TruHearing, Hearing Care Solutions, Hi-Health Innovations) you’re sacrificing the gold standard and best practices of hearing healthcare. These programs dictate how many appointments you can have and what kind of appointment you can have. 

They don’t provide real-ear verification measures or booth testing in noise to check the performance of your hearing aids. 

You don’t have a lot of choices when it comes to manufacturers and you don’t get to test drive different hearing aids. You also won’t be able to get unlimited follow-ups to fine-tune your hearing aid fitting which is a necessity for a lot of people. 

Sometimes with these discounted hearing aid programs, you don’t even get to choose the highest level of technology offered by a particular manufacturer - even if you want to pay extra. 

It’s incredibly important that you take all these factors into account if you’re considering switching to a Medicare Advantage plan, whether you need hearing aids now or in the future. The cost of the hearing aids isn't just about the device itself. It's the experience and knowledge of the provider who is perfecting your hearing aid fitting just for you. 

We want to help you make an informed decision and help ensure that you have the best care for your hearing. If you have questions, please give us a call at (916) 646-2471.