Senior Life Matters
Hearing Aid Coverage In The Medicare SystemBy Janell Sluga
As individuals retire or age into Medicare, their insurance situation can change dramatically. There are a multitude of options open to those with Medicare. The terms, prices and products offered are dramatically different each year.
The purpose of this column is to give those who are eligible for Medicare, or soon to be eligible for Medicare, some understanding of their insurance options and how they could impact their health and finances.
These questions and answers are meant as a guide to help you understand the complex questions you are now thinking about. Each individual's specific situation may create a different solution. You shouldn't necessarily do what your friends, family and neighbors do.
iii
Question: I am having a difficult time hearing and all my family recommends getting a hearing aid. Will Medicare cover my hearing aid?
Answer: This question is probably the most commonly asked question I get from individuals. Medicare does not cover the cost of hearing aids. If you have original Medicare and a Medicare supplement policy, the cost of the audiological evaluation will be covered. This is the evaluation that determines your hearing levels or loss of hearing.
This evaluation includes tests of tinnitus, auditory processing and osseointegrated devises. Tinnitus is the perception of noise in the ear and/or head area. Auditory osseointegrated devices are appropriate for patients with ear malformations when hearing aids are medically inappropriate or cannot be utilized due to congenital malformations, chronic disease, severe hearing loss or surgery. This is tends to be a rare type of coverage, which doesn't apply to most Medicare recipients.
Medicare also covers audiological diagnostic tests. This testing and evaluation is covered, but the fitting and modifying of the hearing aid is not covered. Hearing aids are considered audiological treatment, and this category is not covered by Medicare. If you have a disorder of the auditory systems, you have coverage for speech-language pathology services.
If you have a Medicare Advantage plan, HMO, PPO or PFFS plan, you may have very limited coverage of your hearing aids. Remember these plans must give you at least the minimum that Medicare gives you, but they can give you more coverage. Many of the plans give you an allotment for your hearing aid. This is sometimes $50, but I have seen it as high as $300.
That means if you get a hearing aid, you can file a claim with your insurance provider and they will pay you back their dollar amount. This $50 to $300 will certainly not pay for the entire hearing aid, but it will help to offset the cost for you. With a Medicare Advantage plan, be sure to call the plan prior to getting this hearing aid. They may restrict who you go to - provider network - and what type of device they will reimburse you for.
I have also seen employee/retiree plans that cover hearing aids, but not many of them. This is generally an item that you will have to pay for yourself. Be sure to shop around. When looking at hearing aids you are often not comparing apples to apples, it is often apples to oranges to grapes. Each type of hearing aid device has different strengths and weaknesses. Just because a hearing aid is expensive doesn't mean it is the best for you. Just because it is small doesn't mean it will be useful. Try different styles - in the ear, over the ear, etc. I would also recommend seeing an audiologist. This is a medically trained specialist who will be able to diagnose the type of hearing issues you have and therefore recommend the best type for your particular situation.
Janell Sluga is a geriatric care manager certified and works for Senior Life Matters, a program of Lutheran Senior Housing. She has worked in Chautauqua County with Seniors for more than 16 years. She is HIICAP - Health Insurance Information, Counseling and Assistance Program - counselor trained by Office For the Aging.
She does not sell insurance, or represent any insurance company. She is an unbiased source of insurance and education to help seniors choose the best option for them.
You may submit questions to be answered in later columns to Janell Sluga, at Senior Life Matters 737 Falconer St. Jamestown, NY 14701 or by e-mail at janells@lutheran-jamestown.org. Please remember that not all questions can be answered in this format, but as many as can be, will be.
