Hearing Aids and Medicare

Your aging parents may need hearing aids and Medicare may or may not cover their needs.

Hearing aids are worn by millions of seniors to help improve their ability to not only hear voices, but engage in the world around them.

However, many seniors and their immediate family members aren't sure if Medicare will help cover costs of hearing exams, hearing enhancements and even cochlear implants, a relatively new hearing technology that utilizes an electronic stimulator, receiver and electrode array design to aid the profoundly deaf or hard of hearing.

Understanding what's covered and what's not will help guide you when comparing hearing models and technologies, discuss them with your doctor and make the best and most effective decision regarding care for yourself or a loved one.

Hearing Loss

Seniors experience a number of sensory changes as they age, a natural part of the aging process as our body parts wear down or become less effective through decades of use. Eyesight fades and so does hearing for many.

Seniors who have to concentrate or strain to hear others, or those that have to practically read lips to understand what is being spoken should talk to their doctor about a hearing test.

If you or a loved one can't hear a doorbell, the telephone or are constantly asking people to repeat themselves, talk to your doctor about this. Hearing exams usually offer two choices; preventive or regular hearing exams and a diagnostic hearing aid exam.

What's Covered by Medicare?

Medicare doesn't cover the cost of a regular hearing exam, or one that's conducted during yearly check-ups. However, Medicare does cover a diagnostic hearing exam, which is based on an actual medical need. Consumers can tell roughly what Medicare will or won't cover by asking this question: "Is this service/product medically necessary?" If your answer is yes, then it's likely it will be covered by one of the many aspects of Medicare.

Certain standards need to be met in order for Medicare to pay for a diagnostic hearing exam. These standards specify that the hearing aid specialist:

• Is certified and licensed.
• Has a sound-control room and the right kind of testing equipment.
• Offers patients a selection of hearing aids to choose from.
• Is willing to discuss trial periods, warranties and costs of each.

Of course, you want to choose a specialist who you feel is happy to answer all your questions and offers post-purchase support. Medicare doesn't cover the "regular" hearing exam, and in many situations, won't cover the actual cost.

The diagnostic hearing exam may be covered under Medicare Part B when ordered by a doctor. If you've received hearing damage due to an accident or disease process, Medicare may pay for the hearing test and perhaps even a hearing aid.

Bottom line: Consumers pay 100% for regular hearing exams and aids. If your doctor has ordered the diagnostic hearing exam and you're covered by Medicare, you may pay 20% of the costs following your deductible for Medicare Part B services or supplies.

Medicare and Cochlear Implants

Cochlear implants are considered by Medicare to fall under the category of Durable Medical Equipment.

Medicare Part A or Part B may cover the costs of the implant surgery, but this will depend on whether or not the procedure is an in-patient or outpatient procedure. Part B usually pays more in these situations than Part A. For this reason, doctors opt to perform cochlear implant surgery on an outpatient basis and request reimbursement under Medicare Part B.

For in-patient services, the hospital purchases the implant from the manufacturer and submit claims directly to Medicare for reimbursement, though the hospital itself will lose money as Medicare Part A nor B reimburse for the full amount.

Conclusion

If you feel your hearing is fading or you sense a change in your spouse or parent's hearing ability, talk to them about visiting their doctor. Then compare costs of hearing diagnostics and recommended hearing enhancement themselves.

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