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How Medicare Can Help Your Hearing

by | May 13, 2023 | Insurance, Patient Resources

Hearing insurance is an essential factor in maintaining good health. Medicare covers certain types of hearing care services, such as testing, hearing aids, and other necessary treatments.

However, it’s vital to be aware of the different rules and regulations that are in place to receive coverage.

In this article, I’ll explain how Medicare works regarding hearing insurance. We’ll discuss the different coverage plans and benefits for those eligible for Medicare and any potential limitations on coverage.

I will also provide information on accessing the hearing benefits and what to do if you have any questions or concerns.

We hope that residents of Utah will have a better understanding of Medicare and how it applies to hearing insurance.

Being able to make informed decisions about your healthcare will help you access the coverage you need to maintain good hearing health.

A Brief Overview of Medicare

The main objective of Medicare hearing insurance is to provide coverage for medically necessary hearing-related services and products for seniors and people with disabilities who are eligible for Medicare.

It is designed to help cover the costs associated with hearing exams, hearing aids, and other hearing-related services and products.

Medicare hearing insurance generally covers the cost of a one-time hearing exam and up to two hearing aids per ear per year for those 65 and older.

Who Benefits Most?

Medicare hearing insurance benefits those with difficulty hearing due to age-related hearing loss, as hearing aids can be expensive.

It can also help reduce the cost of other hearing-related services and products, such as cochlear implants, tinnitus devices, and more.

Medicare hearing insurance is designed to help seniors and people with disabilities cover the costs associated with hearing-related services and products.

It can help reduce the financial burden associated with hearing aids and other hearing-related services and products, allowing those who need it to get the help they need.

Are Hearing Aids Covered by Medicare?

Medicare does not cover hearing aids or routine hearing exams. However, there are some exceptions:

Medicare may cover hearing exams if they are considered medically necessary. For example, if a person has a condition that affects their hearing, such as diabetes, a hearing exam may be covered.

Medicare may also cover a hearing exam if it is ordered by a physician to diagnose a medical condition, such as an ear infection or a neurological disorder.

In addition, Medicare Part B may cover certain services related to hearing aids if they are deemed medically necessary. These services may include fittings, adjustments, and maintenance. However, the hearing aid itself is not covered.

Medicare Advantage plans (Medicare Part C) may cover hearing aids in some cases. Each plan is different, so it’s important to check the plan for details.

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Medicare Programs Available

HMO – Health Maintenance Organizations cover the cost of a hearing exam, including any necessary tests, up to once per year. The plan will also cover the cost of hearing aids, including the fitting and follow-up adjustments. The coverage may extend to other services and supplies related to hearing aids, such as batteries and repairs.

PPO – Preferred Provider Organization plans do not require members to select a primary care provider or obtain preauthorization for services. Members are free to choose any hearing care provider within the PPO network and receive the discounted rate. PPO plans also typically offer a wider range of benefits than traditional health insurance plans, such as coverage for hearing aids, hearing exams, hearing tests, and more.

PFFS – Private Fee-for-Service plans are a type of health insurance offered by private companies that allow people to receive health care services from any provider of their choice. The idea is that instead of going through a network of providers, the member pays a set amount for each service they receive. This amount is known as the “fee-for-service” and is usually lower than what they would pay if they went through a network.

SNP – Special Needs Plans are specifically designed for individuals who have specific chronic medical conditions and/or meet certain eligibility requirements. These plans are tailored to meet the needs of individuals with hearing loss, including the provision of hearing loss-specific services, such as hearing aids, hearing tests, and audiology services.

MSA – High-deductible Medical Savings Account plans allow individuals to save for their medical expenses by setting aside money in a special account. The money in the account is tax-deductible and can be used to pay for medical expenses, including hearing care.

How to Get Help Choosing the Best Plan for You

We recommend you match your needs to the insurance plan and not the other way around. We’ve been working closely with Medicare and other insurance providers for years to learn the ins and outs of all their offerings.

Our in-house insurance specialists can help you find a plan that meets your criteria, so the insurance company is working for you. Even if you already have a policy, we can help you read the fine print to ensure you’re maximizing your plan’s potential.

Schedule a consultation online and choose a time that works best for you. We are standing by to help you and your family get the care you need via the path of least resistance. Hearing healthcare doesn’t have to be difficult with the right team behind you.

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Dr. Joshua Luekenga, Au.D., F-AAA, CCC-A, Audiologist

Dr. Joshua Luekenga is an audiologist and founder of The Utah Ear Institute which is comprised of 5 comprehensive clinics throughout Utah and Wyoming. He specializes in vestibular and balance diagnostics. He also evaluates and treats hearing disorders, Tinnitus, Auditory Processing Disorders (APD), Misophonia and Hyperacusis.

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