Even though age-related hearing loss is most common among individuals 65 and older, ironically, if you have original Medicare, you usually pay 100 percent of the costs associated with routine hearing exams and hearing aids.
However, if your physician orders testing because he or she suspects you may have a medical condition requiring treatment that can be diagnosed with a diagnostic hearing exam or a balance test, Medicare Part B may cover 80 percent of allowable charges.
Medicare Advantage Plans
Medicare Advantage Plans, sometimes called “Part C” are an “all-in-one” alternative to original Medicare. They are offered by private companies approved by Medicare. If you have a Medicare Advantage Plan, you still have Medicare. These “bundled” plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug coverage (Part D).
Medicare Advantage plans must cover everything that original Medicare covers, which means medically necessary diagnostic hearing and balance tests. However, some Medicare Advantage plans may also offer additional benefits, such as coverage for routine hearing care, and in some cases, hearing aids may be partially covered. These plans typically fall into one of two categories, Health Maintenance Organizations, or HMOs, and Preferred Provider Organizations, or PPOs.
Medicare Advantage Payment Plans
According to Medicare.gov, when you enroll in a Medicare Advantage plan with hearing aid coverage, you may have to pay a monthly premium in addition to your regular Part B premium for coverage.
With many Medicare Advantage plans, you may need to use a doctor of audiology in the plan’s network in order to access benefits for routine hearing services and hearing aids.
You may also have a copayment or co-insurance amount you have to pay. Some plans pay a percentage of your hearing aid costs, while others pay a set amount you can apply toward the purchase of hearing aids.
There may be an annual limit on the amount your plan will pay each year toward your routine hearing care and hearing aids.
Make Sure to Read the Fine Print
Please note that it’s important to read the fine print carefully when selecting a Medicare Advantage plan. Some include extra benefits for hearing aids and routine hearing care, but not all do. In some cases, they simply offer low-cost devices which are also available privately, but with more choice.
If you are relying on your Medicare Advantage plan to help fund the purchase of hearing aids, contact Associated Audiologists for more information. Our staff has the expertise to check and verify your coverage, as well as provide detailed estimates of hearing aid recommendations and costs.