Monday, May 16, 2022

Does Social Security Cover Hearing Aids

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Hearing aid coverage varies based on the type of Medicare. Hearing aids are not covered by Original Medicare or Medigap plans. However, most Medicare Advantage plans have some coverage for hearing aids. Even with these plans, enrollees pay an average of $1,817 per hearing aid, a discount from the typical cost of $2,300.

For those who are dual-enrolled in Medicare and Medicaid, hearing aids are covered through Medicaid in 28 states. There is broader coverage across all types of Medicare for hearing exams and implantable hearing devices.

Medicare Part B May Cover Diagnostic Hearing Exams

While Part B wont cover hearing aids, it will cover diagnostic hearing and balance exams if your doctor or other health care provider orders these tests to see if you need medical treatment for a recent injury or illness, such as vertigo or other balance problems.

If you do have an exam covered by Medicare, youll still have to pay the Part B deductible and 20 percent of the Medicare-approved amount for the doctors services. If you have testing done in a hospital outpatient setting, you will also be responsible to pay a hospital copayment.

If your doctor recommends you get other hearing-related services Medicare doesnt cover, you may have to pay some or all the costs. Before you do anything, be sure to ask why your doctor is recommending certain services and whether Medicare will pay for them.

Spider Silk Could Help Build A Better Hearing Aid Heres How

Medicare would likely reimburse manufacturers at prices lower than they currently receive, as it does for other health care goods and services. The Department of Veterans Affairs has had success paying just $400 per hearing aid, about $2,000 less than the private market. Further research is needed into how the VA policy affects veterans access and health outcomes, as well as manufacturer contracts. This policy could go two ways: lower prices could slow innovation in hearing aid technology, or an expanded market could increase innovation because it raises potential revenue even at Medicare prices.

Medicare coverage for hearing aids could be structured in several ways. For example, The Commonwealth Fund proposes that Medicare beneficiaries pay a $25 monthly premium for bundled vision, hearing, and dental services. Others may recommend the services simply be added under the umbrella of Medicare Part B. Should Roybal-Allards bill pass, the regulations that emerge from it will greatly influence the laws impact on access.

The Eyes, Ears, and Teeth Act doesnt address Medicaid or private insurance coverage for hearing aids. But changes to Medicare coverage might prompt other types of insurance to reassess their own coverage of these necessary devices.

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How Much Do Hearing Aids Cost With Medicare

With Original Medicare, you are responsible for 100% of the costs for hearing aids and exams. The average out-of-pocket cost without insurance for a pair of hearing aids is around $2,500, but can range from several hundred dollars to several thousand. If you need hearing aids, there are other ancillary costs to consider as well, such as batteries and money spent for on-going fittings and adjustments.

With a MA plan that has hearing aid coverage, you will be responsible for either a copay for their in-network hearing aids, or you will be given a maximum allowance that goes toward paying for hearing aids. MA plans have set maximum out-of-pocket costs however, your cost sharing expenses for hearing aids do NOT count toward this limit. When you are considering your healthcare budget, know that hearing aid expenses will be in addition to your potential out-of-pocket expenses for your medical care.

Hearing aid costs vary widely depending on the type and severity of hearing loss. Most often, hearing aid coverage that is available through MA plans is helpful, but limited in scope and choice of providers. Most MA plans offer some coverage versus comprehensive coverage for hearing benefits including hearing exams and hearing aid fittings, plus a limited number of hearing aid adjustments.

For examples of hearing aid costs through MA companies, see the comparison chart below.

Do You Need A Hearing Aid

Does Medicare Pay for Hearing Aids, Hearing Exams, or ...

The following are some signs of when to consider having your hearing tested, according to the Food & Drug Administration:

  • You hear better out of one ear than the other.
  • People say you are shouting when you talk.
  • You often ask people to repeat themselves.
  • You canât hear a dripping faucet or high-pitched musical notes.

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Q: Is There Any Chance That Dental Vision And Hearing Coverage Will Be Covered By Medicare In The Future

A: There is always a possibility that coverage will increase, but right now it seems unlikely. Most politicians are talking about restricting Medicare coverage, not increasing it.

With this in mind, the best course of action is to save enough money to cover these additional expenses out of pocket, if possible.

What Else Should I Know About Medicare Advantage And Hearing Aid Coverage

Here are some things you should know about Medicare Advantage and hearing aid coverage:

  • 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.
  • With many Medicare Advantage plans, you may need to use a doctor or audiologist in the plans network in order to access benefits for your routine hearing services and hearing aids.
  • You may also have a copayment or coinsurance amount. Some plans pay a percentage of your hearing aid costs while others pay a set amount you can apply toward the purchase of a hearing aid.
  • There may be an annual limit on the amount of money your plan will pay each year toward your routine hearing care and hearing aids.

Its important to note that not all Medicare Advantage plans include these extra benefits for hearing aids and routine hearing care, and not all plans may be available in all areas. Your premium may vary depending on where you live and the type of plan you choose.

If you would like more information about Medicare coverage for hearing aids, Im happy to help. To request information via email, or to schedule a telephone call, click one of the links below. You can view a list of plans in your area you may qualify for by clicking the Compare Plans button.

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Can Seniors Get Help With Hearing Aids

Eligible seniors, pensioners and veterans can obtain a range of products and services to meet your needs, many of which are entirely free: Your hearing assessed by a qualified audiologist at Expert Hearing Care, at no cost.

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Hearing aids provide a unique opportunity to continue living an independent and rewarding lifestyle without skipping a beat.

We want our patients to experience the incredible benefits hearing aids provide, so Inland Hearing goes the extra mile to help you get the financial help you need for your hearing aid investment.

Our insurance experts know exactly how to navigate and communicate with insurance companies, such as LEOFF 1, to determine the level of benefits included in your coverage.

Submit our insurance coverage form to learn more about your benefits, or call us at your local office by

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What Is The Best Inexpensive Hearing Aid

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What About Medicare Advantage

By law, Medicare Advantage must provide at least as much coverage as Original Medicare though it can come with additional costs and network restrictions. However, since Medicare Advantage is private insurance contracted through the federal government, the benefits of each individual policy are unique.

The good news is that many Medicare Advantage plans do cover hearing aids, although they may limit the maximum amount theyll pay and a deductible may also apply. Your initial hearing exam may even be free if you use an in-network doctor.

Copays for hearing aids vary dramatically among insurers, ranging anywhere from $0 to a few thousand dollars. For this reason, its important to examine and compare all available plans carefully before making your choice.

If you have Original Medicare and want to switch to Medicare Advantage, you can make the move during the annual Medicare Open Enrollment period from Oct. 15 to Dec. 7. During the Medicare Advantage Open Enrollment period from Jan. 1 to March 31, you can switch from one Medicare Advantage plan to another.

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Why Doesn’t Medicare Cover Hearing Aids

Original Medicare, and even many private insurance companies, elect not to cover hearing aids due to their cost. In Medicare’s case, federal law prevents Medicare from covering hearing aids. That could change in the future, though. Several pieces of legislation introduced in 20213, including the Medicare Hearing Aid Coverage Act of 2021, would expand Medicare to cover hearing aids if passed.

Does Medicare Cover Hearing Aids

Can I Receive Hearing Aids with Original Medicare

En español | Original Medicare does not cover hearing aids.

It might cover a physician-ordered hearing test or treatment of a hearing-related medical condition, but Medicare will not pay for devices to improve hearing or exams to fit them. You are responsible for 100 percent of these costs.

The average price of a pair of digital hearing aids is about $1,500, according to the National Institutes of Health. High-end devices can be as much as $5,000.

The same holds true if you have a Medicare Supplement plan. These plans, also known as Medigap, generally have no hearing-aid coverage.

But if you have a Medicare Advantage plan from a private insurance company, it might cover some of the cost of hearing aids. Check with your plan provider.

If youre a veteran, you have another route to take in searching for help to pay for hearing aids: the Department of Veterans Affairs . If you qualify for VA health benefits, you may qualify for hearing testing and paid-in-full hearing aids.

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What Determines Hearing Loss

A person who suffers from hearing loss is affected by what is known as a raised decibel threshold. This manifests itself at different levels, which can cause various degrees of hearing loss. Those degrees range from slight and mild hearing loss to severe and profound hearing loss.

In contrast, a person who has normal hearing can have a negative decibel threshold. As they lose their hearing, the force, or decibel, at which a frequency is recognized goes up. Social security is not eligible for many degrees of hearing loss, including mild and moderate. Moderately severe hearing loss is categorized as a decibel threshold of 51 to 70 decibels, which does not make an individual eligible.

The entry decibel threshold that makes a person eligible for social security for a hearing loss disability is a 90 degree plus threshold. That translates to the fact that only individuals with severe to profound hearing loss can be eligible for this kind of financial assistance.

The unfortunate part of this is that many people will have a legitimate need for hearing assistance far before their decibel threshold is high enough for them to be eligible for medicare.

Medicare And Hearing Aid Costs

Probably the first question will be, “Does Medicare offer any coverage for hearing aids?”. The real battle will then begin. Like many seniors, you may be financially challenged, having little more than Social Security to cover your expenses. Must you avoid social interaction or just deal with the frustration of not being able to hear normal conversations?

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Medical Eligibility With Hearing Loss

The SSA maintains its own criteria for disability eligibility, known colloquially as the Blue Book. If your condition matches a listing in the Blue Book, you could be approved for Social Security disability.

Hearing loss is listed in Section 2.00 of the Blue Book.

With a cochlear implant:

Qualifying will vary depending on whether you have a cochlear implant. If youve had a cochlear implantation, you will qualify for at least 12 months after your surgery.

After a year has passed, you will maintain eligibility if you have a word recognition score of 60% or less using the HINT.

Without a cochlear implant:

Without a cochlear implant, there are two ways to qualify:

  • You have an average air conduction hearing threshold of 90 decibels or greater in the better ear, and an average bone conduction hearing threshold of 60 decibels or greater in the better ear
  • A word recognition score of 40% or less in the better ear determined using a standardized list of phonetically balanced single-syllable words.

The entire Blue Book can be found online so you can review the hearing loss listings with your audiologist to determine if you will qualify.

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Momentum Builds For A Legislative Solution

Representatives McBath and Dingell arent the only legislators addressing the hearing loss problem. In the U.S. Senate, Elizabeth Warren and Rand Paul , are another political duo promoting hearing assistance. Their Medicare Audiologist Access and Services Act of 2019 ensures seniors and people with disabilities on Medicare have access to a full range of hearing and balance health care services provided by licensed audiologists.

Among other things, it eliminates the requirement that patients get a referral from an MD before accessing audiology services. Rep. Tom Rice introduced identical companion legislation in the House of Representatives.

Seniors who suffer from hearing conditions shouldnt have to jump through hoops to see their preferred audiologist, said Rice. The Medicare Audiologist Access and Services Act cuts through the red tape to help Medicare patients access quality, affordable care. I will continue to reach across the aisle to find straightforward solutions to health care problems.

In the meantime, the FDA is currently writing rules to implement the Over-the-Counter Hearing Aid Act, which will enable manufacturers of hearing aids to sell lower-cost hearing aids directly to consumers. Warren sponsored that bill along with Republican Sen. Chuck Grassley of Iowa.

Do Any Medicare Supplement Plans Cover Hearing Aids

Medicare Supplement Insurance plans, also called Medigap, do not provide coverage for hearing aids. In fact, these plans dont provide coverage for any health care services or items at all.

Instead, Medigap plans provide coverage for out-of-pocket costs associated with Original Medicare, such as Part A and Part B deductibles, coinsurance and copayments.

Learn more about Medicare Supplement Insurance plans.

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Legislation To Help With Hearing Aid Costs

Congress passed the Over-the-Counter Hearing Aid Act in August 2017, making hearing aids more accessible to patients with mild-to-moderate hearing loss. After the Food and Drug Administration composes updated regulations that assure the safety of these products, the OTC hearing aids will become more widely available for purchase without a doctor’s prescription. This legislation is a step in the right direction to help people who cannot afford to pay the high price of hearing aids, but for many people, the price will still be restrictive. The goal of the new law is to continue to reduce hearing aid prices in the future to make them accessible to more people.

Lack Of Access To Dental Vision And Hearing Benefits Affects Enrollees Health

Medicare coverage of hearing loss and hearing aids

Untreated oral health problems or hearing or vision loss can pose serious risks for overall health. Absence of routine dental care can delay diagnosis of some serious health conditions such as HIV and certain infections and cancers and thereby lead to complications and more costly treatments later. Untreated cavities and gum disease can result in infections, tooth loss, and chronic pain. Lack of teeth, in turn, makes eating difficult, reduces quality of life in other ways, and often causes poor nutrition and related health problems. Gum disease is associated with increased risk of heart disease and stroke, higher mortality for those with kidney disease, higher risk of cancer, and more difficult diabetes management.

Individuals with a range of chronic conditions are more susceptible to oral disease, which can contribute to complications from these chronic conditions and exacerbate their symptoms, including diabetes and respiratory conditions. Untreated periodontal disease in pregnant people may also affect pregnancy outcomes.

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