May 1, 2018

Ask the Audiologist

By Ellen Verlo, M.A., CCC-A
Audiology Consultants, P.C.

Does Medicare Cover Hearing Aids?

This question is asked more than any other. The answer is NO. There is no simple explanation. A quick overview of Medicare and coverage reveals some complicated answers. Hearing aids are considered to be elective. They are Class I medical devices, NOT durable medical devices. They are not medically necessary, prescribed by your physician or regulated by the FDA.

Medicare began as healthcare insurance for military family dependents in 1956. Medicare expanded to include people 65 and older when President Johnson signed the Medicare Act in 1965. In the late 50’s and early 60’s, roughly 40 percent of those over 65 could not afford health insurance. Medicare provided basic healthcare services and hospital coverage.

Insurance companies, Medicare included, consider hearing aids to be elective medical devices, not medically necessary. If you are someone with hearing loss, hearing aids may not seem elective but they are not viewed as medically necessary

Coverage of a medical device can vary depending on how it is classified by the insurance industry. Healthcare products are either durable medical devices or classified medical devices. Insurance companies cover some durable medical devices (ex. Blood sugar monitors, canes, crutches). A durable medical device is described as durable (long-lasting), used for a medical reason, not usually useful to someone who is sick or injured, used in your home and expected to last at least three years. Durable medical devices must be medically necessary and be prescribed for you by your physician for use in your home. Hearing aids are NOT considered durable medical devices.

Hearing aids are Class I medical devices, exempt from FDA review and clearance before marketing. The hearing aid companies do not have to prove a health benefit before they can sell the product. Class II devices such as bone conduction hearing aids and tinnitus maskers gain FDA clearance by demonstrating equivalence to an existing product without conducting clinical trials. Class III medical devices, Cochlear Implants, have to be proven safe and effective through expensive and comprehensive clinical trials. Cochlear Implants can be covered by Medicare if certain qualifications are met. Insurance companies want demonstrated health benefits, obtained in those expensive and comprehensive clinical trials, before coverage can be considered.

The explanation for why Medicare does not cover hearing aids has many components. Coverage for hearing aids is not likely to be included in a new healthcare plan, whether you are Medicare eligible or not. The best way to obtain hearing aid coverage is to look at your supplemental plan. If you don’t have hearing aid coverage, you can shop around to find a plan that does provide coverage. Beware of what you find. Not all hearing aid coverage is equal. Some plans provide internet sales, not recommended. Others provide coverage through third party payments at offices like Audiology Consultants. Medicare will not pay for your hearing aids.

Best advice…Read carefully and shop around.

Ellen Verlo is an audiologist at Audiology Consultants, P.C. For more information consult our ad in this publication for store locations and phone numbers.

Filed Under: Finance, Health & Wellness