Age-related hearing loss is one of the most common conditions found among those who are 65 and over and it carries with it side effects like social isolation and can even put seniors into potentially dangerous situations.
Unfortunately for those seniors suffering from hearing loss, original Medicare (Parts A and B) does not cover the cost of hearing aids, nor does it cover the cost of routine hearing examinations, nor exams for fitting hearing aids. In fact, hearing aids and associated services make the list of items specifically excluded by Medicare:
“Section 1862(a)(7) of the Social Security Act states that no payment may be made under part A or part B for any expenses incurred for items or services “where such expenses are for . . . hearing aids or examinations therefore. . . .” This policy is further reiterated at 42 CFR 411.15(d) which specifically states that “hearing aids or examination for the purpose of prescribing, fitting, or changing hearing aids” are excluded from coverage.”
However, under some circumstances you might obtain coverage for certain hearing related expenses. For example, Part B of Original Medicare will sometimes cover a portion of hearing loss treatment. And Medicare Part B might cover diagnostic hearing and balance exams if you have suffered hearing or balance loss from an illness or accident and your doctor or other health care provider orders these tests to see if you need medical treatment. Under these circumstances the usual Part B deductibles and co-pays would apply.
Medicare Advantage Options for Obtaining Hearing Aid Coverage
While Original Medicare – Parts A and B – does not directly provide coverage for the cost of hearing aids (and their related fitting exams), you may be able to obtain this type of coverage through a Medicare Advantage plan. Some Medicare Advantage plans, also known as Medicare Part C, will offer some coverage for hearing aids, with the coverage usually quite limited and subject to a terms and conditions regarding how much they’ll pay for a hearing aid and how often. As one example, the 2015 Summary of Benefits for AARP®’s MedicareComplete® Secure Horizons® plan in several California counties lists a hearing aid benefit that includes:
$20 co-pay for hearing and balance diagnosis
$10 co-pay for one yearly hearing exam.
$330-380 co-pay for a hearing aid, “depending on the type.”