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Why doesn't medicare cover hearing aids?

C. Scott Mills, AuD

Doctor of Audiology

14 January 2019 - 986 Views

Only Medicare can answer that question but the theories have been along 3 different lines: 

  1. "It's too expensive." Only in the last 15 years has Medicare paid for prescription drugs, delaying so long because of expense. 
  2. "Hearing aids are not a traditional medical 'treatment' for the underlying cause of hearing loss, nor is it one that leads to restoration of normal function in the ear." While this is true it ignores the reality that there are many health benefits that people enjoy when they improve their hearing. Also, there are many treatments that Medicare covers that will never lead to a cure of the problem but allows one to live life despite having the condition; diabetes, high blood pressure, and heart disease immediately come to mind. 
  3. "Hearing loss is a standalone problem, it doesn't lead to any other medical issue." In the last 10 years this has roundly been proven to be false. Untreated hearing loss can lead to innumerable medical issues: dementia, cognitive decline, falling, depression just to name a few. 

Because of an avalanche of research showing the negative consequences of untreated hearing loss, and the enormous health benefits and improvements that come from hearing improvement, I predict that in 10-12 years Medicare will be covering hearing aids. (use your best JFK voice when reading that last sentence :) ). 

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Charles Darby PhD, MA, BC-HIS, BC-HIS

Hearing Healthcare Provider

01 February 2019 - 894 Views

Excellent question and one that should be asked of your legislators.  We can only assume that when the Medicare program was established, hearing was way down on the list of issues that required treatment.  Since those days, hearing loss has been associated as a causative issue affecting many other health conditions.  Depression, Hypertension, Cognitive Decline, Balance, and Isolation are just a few of the issues related to hearing loss.  There are many studies indicating that hearing loss is associated with early onset Alzheimer's Disease and Dementia.  Should Medicare/Medicaid (and health insurance, in general) help with the cost of hearing treatment?  Im my opinion, YES!  It is absolutely essential for the betterment of healthcare of our aging population.  I've worn aids for 11 years now and can personally validate the life changing improvements and reduced health risks.  Talk with your legislator and let them know what you need and the importance of good hearing in your life.  
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Audiologist in Hickory

16 January 2019 - 930 Views

As everyone else has pointed out it is a cost issue. Too many people need help and lets face it Medicare is having trouble supplying enough money for the retired as it is. However, insurance companies are starting to see the importance for covering hearing aids. Call your insurance company and they will send you to the specialist that works with their network. Your supplement will be the one who may provide you with help on hearing instruments. 

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Sheri Gostomelsky, AuD

Doctor of Audiology

14 January 2019 - 968 Views

Medicare provides so little in the way of dental, vision and hearing care.  Unfortunately, this is the way Medicare was set up and offering hearing aids as a benefit would make premiums unaffordable.   What is not realized is the high cost of untreated hearing loss! 

Medicare will pay for your initial hearing evaluation, any evaluation that is medically necessary and a variety of implants.  

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Julie Norin, AuD

Doctor of Audiology

14 January 2019 - 988 Views

Good question! While Medicare does not cover hearing aids, providers can bill Medicare for a hearing evaluation once a year, provided the patient submits a referral for the test from his or her primary care physician, and provided that referral only refers for testing to monitor hearing. Anything referring to hearing aids or treatment will incur a denial of payment.

Currently, new legislation in many states does provide coverage for hearing aids through Medicaid, but not Medicare. If you are a Medicaid recipient, you will need to meet certain criteria in order to qualify for hearing aids. It's best to reach out to a provider who accepts Medicaid to determine eligibility. 

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Danny L Ahrens

Hearing Healthcare Provider

14 January 2019 - 989 Views

When medicare was first put into place in the United States, hearing aid technology was in its infancy.  The technology was limited mostly to those with an extreme loss and the sound quality was not the best, not as natural, no where close to what it is today.  Therefore, hearing aids were not considered a good solution for the aging populace to be included in the coverage. This traditional approach has continued to some degree in the general medical field.  And then there is the added cost of including coverage for the millions who quality for medicare.

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Wendy Hanson

Hearing Healthcare Provider

14 January 2019 - 1.01K Views

While Medicare does not cover hearing aids, it does cover comprehensive hearing testing. Many Medicare supplements have hearing aid discount plans and some even a $ benefit. Check with your Medicare supplement to see what may be available to you. 
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Justin Brader

Hearing Healthcare Provider

14 January 2019 - 988 Views

Medicare, and many insurance programs don't cover hearing aids because they are difficult to cover.  Hearing is very subjective.  So from an insurer's standpoint, how do you know if the audiologist or dispenser is fitting an appropriate hearing instrument, and how do you verify that the selected devices are providing the correct benefit?  All you have to go off is their word.

Hearing is not like breaking your arm, where everybody knows that you set the break, cast the arm, and then let it heal.  Or like strep, where everybody knows you take an antibiotic until its gone, and then you will most likely not have strep anymore.

Hearing care is more like therapy.  It doesn't matter who the manufacturer of the gym equipment was.  It is more important that the therapist knows what to do and how to coach you through the use of the equipment to help you get back to the best you can be, which is subjective.  In the case of hearing technology, should Medicare cover the very BEST devices?  Even if your life only consists of watching TV and reading the newspaper?  Or should Medicare cover just basic devices, and then let you pay for optional upgrades?  If that's the case, you can get basic devices out there for as low as $700.  But if you are unhappy with those, are you going to badmouth and complain about Medicare only covering the basics?

As a hearing care provider, I totally get why it is hard for insurance companies (Medicare included) to figure out exactly how to cover hearing aids.  They are not a simple, one-size-fits-all treatment.

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