Medicare insurance currently does not provide coverage for most types of hearing aids that you may require. This means a gap exists for this expense. However, coverage is not excluded for all types of hearing aids. The statute for Medicare states that coverage is excluded for hearing aids, the examination for the prescription or changing of a hearing aid. The good news is that Medicare does provide coverage for prosthetic devices that can aid hearing depending on specific circumstances.
Exclusion in Policy Manual
You can find the exclusion for hearing aid coverage directly in your Medicare policy manual (see Resources). The manual provides a definition for a hearing aid: An amplifying device that compensates for your impaired hearing. This definition indicates that any type of typical hearing aid that you may require is not covered by Medicare. Congress did not intend to have Medicare pay for certain services, which includes routine physical examinations, eyeglasses and hearing aids or other expenses that are related to their purchase.
Even though Medicare does not provide coverage for hearing aids, there is coverage if you are fitted with a prosthetic device to aid hearing. These devices are covered by Medicare depending on certain circumstances. Your prosthetic device must meet the policy manual's definition that is provided for a prosthetic device. The definition included in the policy manual states that the function of the middle ear, cochlea or auditory nerve needs to be replaced by a device that produces the perception of sound. These can include cochlear implants, auditory brain stem implants and an osseointegrated implant, which is a device that is implanted in your skull.
The exclusion for hearing aids from Medicare creates an environment where you may face obstacles to obtain these devices. You may have a low or moderate income and are not able to afford to pay for the cost of a hearing aid. A hearing aid may cost you between $1,000 to $5,000 or more depending on the device that is required. Unfortunately, a Medicare supplemental insurance policy or Medigap policy also excludes coverage for a hearing aid. This means that you will need to pay for your hearing aid yourself unless you happen to have another type of health insurance policy that will cover the cost of the device.
Cameron Easey has over 15 years customer service experience, with eight of those years in the insurance industry. He has earned various designations from organizations like the Insurance Institute of America and LOMA. Easey earned his Bachelor of Arts degree in political science and history from Western Michigan University.