Medicare Advantage Hearing Aid Coverage: An Audiologist’s Perspective to Help You Through Medicare Open Enrollment
by Tom Goyne, Au.D., and Gil Kaminski on October 15th, 2024
With the annual Medicare open enrollment period starting today, October 15th, and ending on December 7th, now is the perfect time to review your Medicare options. During this period, individuals with Medicare can adjust their coverage, which will take effect on January 1st of the following year. These changes may include switching from traditional Medicare to a Medicare Advantage plan (or vice versa) or choosing a different Medicare Advantage plan.
As you explore your options, one critical aspect to consider is the hearing aid coverage offered by some Medicare Advantage (MA) plans. We’ve prepared a series of resources to help you make informed decisions about your hearing health. In this article, we’ve teamed up with Dr. Tom Goyne, adjunct professor at Salus at Drexel University and Chief Audiology Officer at Aberdeen Audiology, to provide key insights into hearing aid benefits in MA plans and ensure you're asking the right questions as you compare options.
According to the Johns Hopkins Cochlear Center for Hearing and Public Health, half of people over 60, and nearly three-quarters of those over 70, experience hearing loss. This makes it important for Medicare beneficiaries to test their hearing to establish a baseline, and to make a financial plan for hearing care. As part of this planning, understanding your hearing aid coverage can help you make more informed decisions and ensure you receive the care you need.
Why Do Medicare Advantage Plans Matter for Hearing Care?
One of the differences between traditional Medicare and Medicare Advantage (MA) plans is that MA plans often include additional benefits like hearing aids. However, it’s important to look beyond the bullet points that mention "hearing aid coverage" and understand the specific details of what’s actually included. Often, these plans can be appealing on the surface, but digging into the fine print reveals limitations in coverage and additional costs down the line.
For example, some plans may offer steep discounts on hearing aids but provide only limited follow-up care. Others might have smaller discounts but include comprehensive aftercare with an audiologist. Understanding the trade-offs is critical to getting the most value from your plan, and to choosing a plan that is right for you.
Why Should I Care About Hearing Aid and Hearing Care Coverage, and How Does It Relate to My Overall Health?
Earlier, we mentioned that half of people over the age of 60 are affected by hearing loss. But why does that matter? Why is hearing so important?
Hearing is more vital to overall health than many realize. Untreated hearing loss has been linked to an increased risk of dementia, accidental falls, loneliness, anxiety, and depression. By addressing your hearing health early and ensuring you receive proper follow-up care, you can enhance other aspects of your health and well-being, helping you stay active, engaged, and connected to those around you.
Why Reading the Fine Print on Medicare Advantage Plans is Crucial for Hearing Aid Coverage
Hearing aid care involves two key components: the device itself (the hearing aid) and the clinician overseeing your care, known as an audiologist. The audiologist plays a crucial role in understanding your personal needs and specific hearing profile, ensuring the hearing aid is fitted to address both your hearing loss and your daily lifestyle. When reviewing Medicare Advantage plans, it’s important to consider both the technology and the professional care provided, ensuring you receive comprehensive support tailored to your needs. The main items to consider are:
Device Costs: How much of the cost of hearing aids is actually covered? Are there discounts, or is it full coverage? How much out-of-pocket expense should you expect?
Audiologist Visits: How many follow-up visits are included? Hearing care isn’t a one-time fix—hearing aids require adjustments, reprogramming, and regular check-ins with your audiologist, which may or may not be fully covered by the plan.
Duration of Coverage: Is the coverage valid for just a few months, or will it extend for a full year or more? This can significantly impact your long-term costs of hearing care.
What Does Good Hearing Aid Aftercare Involve? What to Look for in Your Medicare Advantage Hearing Aid Coverage?
Aftercare is an essential part of hearing health. It’s not just about receiving hearing aids; it’s about ensuring they are properly fitted to meet your specific needs and making sure they remain appropriate as your hearing changes over time. Here’s what you should expect:
Initial Evaluation: Your first visit typically involves a hearing test and an in-depth conversation with your audiologist about what type of hearing aids will best suit your lifestyle.
Fitting and Programming: Once your hearing aids are chosen, the next visit focuses on fitting and programming them to your specific hearing profile as well as orienting you on their proper care and use.
Follow-Up Appointments: Most people will need at least two follow-up appointments in the first month to fine-tune the settings. After that, you should expect regular check-ins at least once a year to ensure your devices are still functioning optimally.
Troubleshooting and Support: Hearing aids typically require adjustments as you adapt to using them. Many patients find they need several visits within the first year for troubleshooting, fine-tuning, or to address questions that arise—whether they are new hearing aid users or experienced users adjusting to a new type of hearing aid.
What Hearing Aid Coverage Do Medicare Advantage Plans Typically Include?
Most Medicare Advantage (MA) plans provide hearing care benefits through third-party administrators. This means you’re technically purchasing your hearing aids from these companies, not directly from your audiologist. These third-party administrators partner with various hearing aid manufacturers and the level of discount on hearing aids can vary. However, most major hearing aid brands are typically available.
While some MA plans may include only 90 days of aftercare, others may extend this coverage for up to three years. It’s essential to compare these options carefully. Additionally, hearing tests are generally only covered if there’s a medical reason, such as an ear infection. Routine hearing care may not be included in your hearing benefit, and you might need to plan for those costs out-of-pocket.
Key Takeaways on Medicare Advantage Hearing Aid Coverage
When considering Medicare coverage, whether you're choosing between traditional Medicare and Medicare Advantage, or comparing different Medicare Advantage plans, it’s essential to think about your hearing health and financial plan for hearing aid coverage. Traditional Medicare does not currently cover hearing aids, so it’s important to consider the out-of-pocket costs.
When evaluating Medicare Advantage (MA) plans, make sure to assess the full picture to ensure you're making an "apples-to-apples" comparison. Ask yourself: How much will the hearing aids cost? How much aftercare is included? What’s the long-term value for you? Hearing care is an ongoing process, so selecting a plan that supports you throughout your hearing journey is crucial. Make sure you read the fine print and plan for the follow-up care you’ll need to get the most out of your hearing aids. Prioritizing your hearing health not only improves your daily communication but also contributes to your overall wellness and quality of life, helping you stay active and engaged.
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