Medicare does not cover hearing aids or exams for adult hearing aid fittings. The clear-cut language at Medicare.gov briefly hammers the point home with one additional sentence: “You pay 100% for hearing aids and exams.”
On the other hand, some Medicare Advantage Plans (Part C) are increasingly willing to supply partial payment for hearing aids and hearing care services. If you have one, call your plan and investigate. Many are now offering hearing aid benefits, and this can substantially cut your costs when purchasing hearing aids.
Medicare does cover hearing tests in some cases, but only if recommended by your primary care doctor or another physician. As healthyhearing.com puts it, “In other words, you can’t go to a hearing clinic without a referral and expect Medicare to pay for it.”
Medicare’s specific wording on hearing exam coverage is as follows: “Medicare Part B (Medical Insurance) covers diagnostic hearing and balance exams if your doctor or other health care provider orders them to see if you need medical treatment. You pay 20% of the Medicare-approved amount for your doctor’s services for covered exams, and the Part B deductible applies. Medicare doesn’t cover hearing exams, hearing aids, or exams for fitting hearing aids.”
On the other hand, the Department of Veterans Affairs (VA) is the world’s second-largest supplier of hearing aids (England’s National Health Service is first) and all qualified veterans are entitled to free hearing aids. According to the American Speech-Language-Hearing Association, it is national VA Policy that hearing aids are furnished to eligible veterans in accordance with restrictions defined in VA Directive 2002-039, released July 5, 2002.
Specifically, the Directive explains: “Eligibility for hearing aids is currently limited to veterans with a documented service-connected hearing loss, veterans receiving a disability rating of 10% or more (for a condition other than hearing loss), and some veterans with very special needs. With the exception of veterans with documented service connection for hearing loss, an eligible veteran must be currently enrolled in and receiving healthcare from a VA Medical Center or VA Outpatient Clinic. Hearing aids are not customarily provided to non-service connected veterans. However, if there is a medical reason, a VA Physician can refer a non-service connected veteran for a hearing evaluation.”
While the VA guidelines are clear, it’s also true that many veterans do not take advantage of the benefit, reflecting a reticence throughout society that routinely puts off needed hearing care. In some cases, it comes down to geography.
“Some veterans who don’t take advantage of the benefit say it has to do with location,” says Wayne J. Staab, PhD, a Utah-based audiologist. “They are too far from the VA facility, so it’s a pain to travel. Others object to the way that they’re being evaluated to be able to qualify for it. Some of it has to do with finances, and some just aren’t really interested in giving the VA information about their finances.”
Whether you’re a veteran or not, you might benefit from the bipartisan Over the Counter Hearing Aid Act signed into law by President Trump in 2017. According to a report in Hearing Review, the act was designed to provide greater public accessibility and affordability with over-the-counter (OTC) hearing aids.
As reported in Hearing Review, the OTC Hearing Aid Act is designed to enable adults with perceived mild-to-moderate hearing loss to access OTC hearing aids without being seen by a hearing care professional. The law came on the heels of the elimination of the “physician waiver” system which had required consumers first to seek a physician for a medical evaluation, or sign a waiver prior to obtaining a hearing aid.
At the time, Hearing Review reported that the legislation “will require the FDA to create and regulate a category of OTC hearing aids to ensure they meet the same high standards for safety, consumer labeling, and manufacturing protection that all other medical devices must meet.”
Image: © Andrii Yalanskyi