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Does Medicare Cover Hearing Aids?

According to the World Health Organization (WHO), about 5% of the population has disabling hearing loss. Disabling hearing loss is defined as a hearing loss of more than 40 decibels in adults and 30 decibels in children.1 Hearing loss has a strong, but not exclusive, association with aging. Government statistics2 record that:

  • 18% of people age 45 to 64 have hearing loss
  • 30% of those age 65 to 74 have hearing loss
  • 47% of those 75 and older have hearing loss

Alongside formal loss of hearing is the related issue of tinnitus. Tinnitus is a ringing (or other sound) continually perceived by the ear. The National Institute on Deafness and Other Communication Disorders notes "Of adults ages 65 and older in the United States, 12.3 percent of men and nearly 14 percent of women are affected by tinnitus. Tinnitus is identified more frequently in white individuals and the prevalence of tinnitus is almost twice as frequent in the South as in the Northeast."3

For those enrolled in Medicare and have disabling hear loss, Medicare does not cover traditional hearing aids or routine hearing exams. Consequently, Medicare beneficiaries must pay 100% out-of-pocket for these services unless they have alternative insurance that covers hearing exams and hearing aids. With respect to alternative insurance, some Medicare Advantage plans cover hearing exams and hearing aids but this is not standard across all Medicare Advantage plans.

Reducing Out of Pocket Costs for Hearing Aids

Some Medicare beneficiaries are also enrolled in Medicaid. These individuals are sometimes referred to as ‘dual eligibles.’ Depending on the state, a dual eligible Medicare beneficiary may be able to receive coverage for hearing exams and hearing aids through their state Medicaid program. For example, both Alaska and California provide Medicaid coverage for medically-necessary hearing aids.

Certain nonprofit organizations also offer assistance for those with hearing disabilities

Alternatives to Traditional Hearing Aids Covered by Medicare

If you have a hearing disability and require assistance, an alternative to a traditional hearing aid is a bone-anchored hearing aid (BAHA). These devices are typically used by those with middle ear problems or deafness in one ear. Medicare classifies a bone- anchored hearing aid as a prosthetic device. As a result, Medicare will typically cover the costs of a BAHA4 if the beneficiary meets Medicare coverage policies.

Another alternative to a traditional hearing aid covered by Medicare is a cochlear implant device. Like a BAHA, Medicare classifies cochlear implant devices as a prosthetic and will typically cover the costs.

Both bone-anchored hearing aids and cochlear implant device require surgery so you should consult your physician about the risks and benefits before considering these alternatives to traditional hearing aids.



Sources:

1 http://www.who.int/mediacentre/factsheets/fs300/en/
2 http://www.nidcd.nih.gov/health/statistics/Pages/quick.aspx
3 http://www.nidcd.nih.gov/health/statistics/Pages/quick.aspx
4 http://www.nidcd.nih.gov/health/hearing/pages/hearingaid.aspx#hearingaid_11


 

 

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