Hearing loss affects millions of people worldwide and can significantly impact daily life. To mitigate the consequences of hearing loss, many individuals rely on hearing aids. However, these devices may not fit into everyone’s budget, leading many to seek insurance coverage.
In this article, we will explore how insurance for hearing aids works, focusing on two major insurance providers in the United States: Medicare and Medicaid.
Understanding Hearing Aid Insurance
Hearing aid insurance helps cover the cost of hearing aids and related services, such as fitting, adjustments, and maintenance. Insurance coverage varies depending on the provider, the specific plan, and the state in which the policyholder resides.
In general, insurance for hearing aids may cover part or all of the costs associated with these devices. To understand how Medicare and Medicaid cover hearing aids, we must first examine each program individually.
Medicare for Hearing Aid Insurance
Medicare is a federal health insurance program that primarily serves individuals aged 65 and older, as well as some younger individuals with certain disabilities.
There are four parts to Medicare: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage).
Original Medicare (Part A and Part B)
Unfortunately, Original Medicare does not cover hearing aids or related examinations and fittings. However, Part B may cover diagnostic hearing tests that are ordered by a doctor to determine the need for medical treatment.
Medicare Advantage (Part C)
Medicare Advantage plans, offered by private insurance companies, provide an alternative to Original Medicare. These plans must cover all services provided by Part A and Part B, and they may also offer additional benefits. Some Medicare Advantage plans cover hearing aids and related services. Coverage and costs vary by plan, so it is essential to carefully review each plan’s specific benefits before enrolling.
Medigap (Medicare Supplement Insurance)
Medigap policies are supplemental insurance plans designed to cover out-of-pocket costs associated with Original Medicare, such as deductibles and copayments. However, Medigap policies do not provide additional benefits, like hearing aid coverage, beyond what Original Medicare offers.
Medicaid for Hearing Aid Insurance
Medicaid is a state and federal program that provides health coverage to low-income individuals and families. Unlike Medicare, Medicaid’s coverage for hearing aids varies significantly from state to state. In general, Medicaid is more likely than Original Medicare to provide coverage for hearing aids.
Children’s Coverage for Hearing Aids
Under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, Medicaid must cover hearing aids for children under the age of 21. This includes diagnostic evaluations, hearing aid fittings, and necessary adjustments.
Adults’ Coverage for Hearing Aids
For adults, hearing aid coverage varies by state. Some states offer comprehensive coverage, while others provide partial coverage or none at all. To determine whether Medicaid covers hearing aids in your state, contact your state’s Medicaid program or visit their website.
Children's Coverage for Hearing Aids
Under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, Medicaid must cover hearing aids for children under the age of 21. This includes diagnostic evaluations, hearing aid fittings, and necessary adjustments.
Adults’ Coverage for Hearing Aids
For adults, hearing aid coverage varies by state. Some states offer comprehensive coverage, while others provide partial coverage or none at all. To determine whether Medicaid covers hearing aids in your state, contact your state’s Medicaid program or visit their website.
Insurance for Hearing Aids in Washington State
Navigating insurance for hearing aids can be complex, particularly when it comes to Medicare and Medicaid. While Original Medicare does not cover hearing aids, some Medicare Advantage plans do offer coverage.
On the other hand, Medicaid’s coverage for hearing aids varies by state, with more comprehensive coverage typically available for children. It is crucial to research and compare plans to find the best option for your individual needs.
Sound Audiology is a professional audiology clinic with three locations in Washington. Being based in Washington means our patients may be able to qualify for free hearing aids thanks to a passed legislation.
You can find out more about legislation ESSB 5179 and how it affects you here. If you’re looking to invest in hearing aids or just get a checkup, you can visit one of our clinics in Prosser, Kennewick, or Walla Walla.
To begin your hearing care journey, don’t hesitate to get in touch today!
