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Wondering if hearing aids are right for you, but discouraged by the confusion surrounding insurance coverage? Hearing loss can be a major problem that goes unchallenged for many people, often due to the high cost. It is estimated that more than 28 million adults in the US could benefit from a hearing aid, especially older adults, but many of us don’t do it because we are on a limited budget.
But there are certain insurance plans and benefits that can reduce the cost of new hearing aids – both prescription hearing aids and their newer counterparts that you can buy directly: over-the-counter or OTC hearing aids. If you want to learn more about the best brands and models, you can start here. Many of them cost one lot less than models you would get through a doctor, eliminating the need for insurance.
Does insurance cover hearing aids?
The short answer is that insurance companies don’t typical cover hearing aids. However, exceptions exist depending on a number of personal factors. One of these is your location: Health care laws in five states currently require coverage by insurance companies for adult hearing aids:
- Arkansas
- Connecticut
- Illinois
- New Hampshire
- Rhode Island
This requirement can be applied to individual and group health plans, as well as employers who can opt out (as is the case in Arkansas). If you have any questions about the details or limitations of insurance coverage for hearing aids in your state, please contact your insurance company directly for more information.
Is hearing aid coverage offered by Medicare and Medicaid?
Medicare and Medicaid may offer some hearing aid coverage, but whether this applies to you may be determined by factors such as the state in which you live. For Medicaid recipients, some covered services may be covered for adults who require hearing aids, depending on your state of residence. , included:
- Hearing exams
- Repair and replacement of hearing aids
- Hearing tests for cochlear implants
- Hearing aid fittings
- Hearing aid accessories
- Select hearing aid brands and devices
Basic Medicare does not cover most types of hearing aids or hearing aid fittings. That includes Original Medicare (Parts A and B). Although Medicare Parts A and B do not cover hearing exams specifically for purchasing a new hearing aid, they do Doing cover exams for diagnostic purposes, including a physician referral. In this case you pay 20% of the final amount, after deduction of the deductible and any personal contributions.
There may also be some limited exceptions for Medicare Advantage plans (Part C).
Medicare consists of four parts, with Parts A and B being part of what is known as Original Medicare – a federally provided healthcare plan with more traditional medical and hospital insurance coverage options. Parts C and D are a little different and exist independently of Original Medicare. Here’s an overview of the Medicare plans and services available today:
- Medicare Part A: Hospital insurance. This can cover costs associated with hospital stays, nursing home care, hospice care, and some additional health care benefits.
- Medicare Part B: Medical insurance. This covers the things you would expect with most health insurance plans, including select physician services, outpatient care, medical supplies, and some preventive services.
- Medicare Part C: Medicare Benefit. These Medicare coverage plans are provided by private companies that contract with Medicare and are not federally provided. These plans still include Parts A and B, but may include additional benefits (see below).
- Medicare Part D: Prescription drug coverage. This Medicare Supplement plan covers the cost of prescription drugs, as well as many recommended shots and vaccines.
Some Medicare Advantage Plans offer additional benefits not covered by Original Medicare. This includes coverage for hearing aids and related services, such as a hearing examination by an audiologist. Talk to your doctor to find out what you might need in terms of hearing aid devices and services, then consider browsing the different types of Medicare Advantage Plans, such as a health care organization (HMO), a preferred provider organization (PPO), and more .
What coverage options do private insurance companies offer?
Most private insurance companies consider hearing aids optional, so insurance coverage may not be part of your insurance plan. Some notable exceptions include:
- Etna: Some plans may offer payment assistance or reimbursement for OTC hearing aids that are deemed medically necessary by an audiologist.
- Blue Cross Blue Shield: Some plans may offer coverage for hearing aids, but this varies by state. However, the Federal Employee Program (FEP) offers a $2,500 grant every five years that can go toward hearing aid devices and accessories. FEP members can also benefit from lower hearing aid prices through the Blue365 Discount offer.
- Cigna: Certain insurance plans may include hearing benefits.
- Human: Humana Medicare Advantage plans can come with hearing aid coverage through Humana Extend, a program that bundles benefits including vision, dental and hearing options.
- United Healthcare: United Healthcare, one of the top insurance companies for hearing benefits, offers plans that typically include full coverage for major prescription hearing aids. A hearing test by a certified audiologist is usually required.
Ways to save on hearing aids without insurance coverage
If you’re not covered by Medicare, Medicaid, or a provider that offers hearing benefits, there may still be a few ways to avoid paying full price for a new, high-quality hearing aid. U.S. veterans who have health care coverage through the Department of Veterans Affairs may be eligible for free access to certain hearing aids, supplies and hearing exams.
Some other alternative options for hearing aid insurance coverage include:
An increasingly popular way to… Save money on hearing aids is to buy them directly. OTC hearing aids like the impressive Jabra Enhance Select 50R ($995 and up) are a relatively new category where customers can get their hands on decent devices at a much lower cost – typically less than $1,000 per pair. Compare this with the average out-of-pocket costs for prescription hearing aids and you’ll discover the potential for significant savings, with or without insurance coverage.
