How To Get Better Medicare Hearing Coverage

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Medicare Benefits

Aug 30, 2021

If you’re on Medicare and you’ve been paying too much for hearing exams, hearing aids, and related services, you’re not alone. Visiting your primary care doctor or an audiologist for hearing problems can lead to unexpectedly high medical bills. Thankfully, some Medicare Advantage (MA) plans may help cover these costs. Switching to an MA plan with better hearing coverage can be an easy process and may save you money, now and in the future.

Thankfully, some Medicare Advantage (MA) plans may help cover these costs. Switching to an MA plan with better hearing coverage can be an easy process and may save you money, now and in the future. Medicare Advantage plans vary, but you may find an MA plan in your area that offers more hearing coverage without costing more in monthly premiums.

Switching to a Medicare Advantage plan with better hearing coverage

The MA plan you’re currently enrolled in may only cover a small portion of your hearing aid expenses (or none at all). A different plan may offer you more coverage for the same (or just a slightly higher) monthly premium. Some plans may cover 100% of hearing aid costs and any associated visits to an audiologist for fittings.

There may be different types of MA plans available that may offer you better hearing coverage. For instance, an HMO may have lower premiums, but higher copayments. An HMO may also require you to visit a doctor or specialist within the plan’s network and purchase your hearing aids from an approved network supplier. A PPO, on the other hand, may have a higher monthly premium, but lower copays. A PPO may also allow you to visit a specialist (like an audiologist) without a referral from your primary care doctor.

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How much does hearing care cost?

If you currently have Original Medicare Part A and Part B, you already know that its limited hearing coverage may leave you paying out-of-pocket for regular hearing exams, hearing aids and fittings. For instance, Medicare Part B only helps cover diagnostic hearing and balance exams.

Your doctor can order medically necessary exams to see if you need medical treatment, but you’ll still be responsible for 20% of the Medicare-approved cost of those diagnostic tests and you will have to pay the Part B deductible before your benefits kick in. If you are an inpatient in a hospital or skilled nursing facility during these exams, you may also have a copayment for these tests. If your doctor recommends hearing aids, they can cost anywhere from $1000- $6000 per device, which you’d have to pay yourself.

When you can switch Medicare plans

If you are currently enrolled in a Medicare Advantage plan that doesn’t give you enough hearing coverage, you may be able to switch to another MA plan during any of the following enrollment periods:

  • The Annual Election Period runs from October 15 to December 7 every year. Coverage under your new plan starts on January 1.
  • The Medicare Advantage Open Enrollment Period goes from January 1 to March 31 annually. During this period you can switch one time to a different MA plan if you’re enrolled in one.
  • You may qualify for a Special Enrollment Period if you experience certain life events, such as moving out of your current plan’s service area.

Why Medicare hearing care coverage is important

Statistics from The National Institute on Deafness and Other Communication Disorders* show that one in three people between the ages of 65 and 74 experience hearing loss. Almost 50 percent of adults over 75 have diminished hearing.

Hearing loss can come on gradually with age, making it more difficult for someone to realize their hearing is diminishing until there is a significant loss. Left untreated, hearing loss can lead to social isolation, cognitive decline, dementia, memory issues, and a lack of concentration. These conditions can be delayed or avoided by wearing hearing aids.

By getting regular hearing exams through Medicare, your healthcare provider can stay on top of conditions that might negatively affect your hearing. These conditions are much easier to catch and treat when diagnosed early on. With Medicare hearing insurance for seniors, you can be more proactive in your overall health.

* More information: Age-Related Hearing Loss

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