Millions of people in the United States are affected by hearing loss, and for many, this disability represents a significant financial hardship. Within the general population, seniors and veterans often require hearing aids. Even with health insurance, coverage for hearing aids varies. The cost of prescription devices can be high depending on the type of health insurance and Medicare benefits you have.
This process not only involves medical appointments but also a series of examinations that a specialist, the audiologist, must perform. These appointments, consultations, and examinations can quickly amount to thousands of dollars. For many people, the cost of hearing aids is as challenging an obstacle as hearing loss itself.
People who go this route will have to pay thousands of dollars for custom-programmed hearing aids, which can be expensive if your insurance doesn't reimburse them. Out-of-pocket expenses arise when your doctor or healthcare professional prescribes examinations like a routine hearing assessment, which may include a hearing test or balance tests, which are not always covered. It's not so much the price of the devices themselves, but the process required to obtain a personalized prescription that costs the most.
If you suffer from hearing loss, here's everything you need to know about how Medicare can affect the cost of your hearing aids and medical appointments.
What is Medicare?
Medicare is a government financial aid program for medical needs. It is for people over 65, younger people with qualifying conditions, and people with end-stage renal disease.
This system was launched by President Lyndon B. Johnson, who signed the first laws that later became the Medicare and Medicaid programs we know today. It is funded by taxes from the entire population as well as certain trust funds held by the Treasury and specifically dedicated to Medicare.
In 2017, Medicare helped over 58 million beneficiaries with their healthcare expenses, at a total cost of seven hundred and five billion dollars. This program is ambitious, covering a huge portion of the United States population, and it is very expensive. As the average life expectancy increases, the number of people eligible for this service also increases.
That said, it is necessarily limited in what it can offer to those who are eligible.
How to get Medicare?
Regarding Medicare eligibility, the official government website distinguishes three categories of people eligible for this service:
People over 64 years old
Certain younger people with qualifying conditions
People with end-stage renal disease
Medicare itself is divided into four distinct parts, each covering specific services. While the idea of enrolling in Medicare and all that it entails may seem daunting, the official government website provides general guidelines to help you understand which services may be covered.
Unfortunately, according to the official government website, Medicare does not cover hearing aids. The program does not cover any part of the purchase cost incurred by millions of people, neither for the devices themselves nor for the examinations and appointments necessary to obtain a prescription. A gray area remains regarding the guarantees offered. Before seeking treatment under a Medicare plan, here are the four types of coverage and what you need to know about them.
Medicare Part A plans
Medicare Part A can be seen as hospital insurance. This part also covers some home care. However, Medicare Part A generally covers hospital stays and specialized nursing facilities.
Medicare Part B plans
Medicare Part B can be seen as outpatient care coverage. It covers medical appointments, medical supplies, and certain preventive services. As stated above, hearing aids, which would technically fall under Part B, are not currently considered eligible for Medicare coverage.
Original Medicare
Both Medicare Part A and Part B plans fall under the Original Medicare category. In other words, your hearing aids and all the examinations you will need remain 100% at your expense. This also applies to adaptations and batteries needed to keep your hearing aids in working order. With Original Medicare, you will have to pay an outpatient co-payment at the hospital.
Medicare Part C plans
Medicare Part C is a Medicare plan that partners with private insurance companies. According to this article, Medicare Part C is no longer available to new beneficiaries but remains in effect for those who already have it. This type of plan may include vision, dental, and prescription drug coverage.
Medicare Part D plans
Medicare Part D differs from Medicare Part B in that it covers the cost of prescription drugs themselves. According to the official government website, it does not cover the cost of medical supplies other than prescribed medications.
Financial aid for hearing aids
For those seeking financial assistance to obtain hearing aids, the journey can be daunting. Many private insurances do not cover these costs, and the price of prescription hearing aids amounts to thousands of dollars.
However, since hearing loss is recognized as a disability, it may qualify for financial aid under social security benefits. Hearing loss is a progressive condition that can manifest at different degrees of severity.
How is hearing loss defined?
A person with hearing loss has what is called an elevated hearing threshold, measured in decibels. This threshold manifests at different levels, which correspond to different degrees of hearing loss. These degrees range from very mild and mild hearing loss to severe and profound hearing loss.
Conversely, a person with normal hearing may have a negative decibel threshold. As hearing declines, the intensity, expressed in decibels, at which a frequency is perceived increases. Social security does not provide benefits for many degrees of hearing loss, particularly mild and moderate losses. Moderately severe hearing loss corresponds to a threshold of 51 to 70 decibels, which does not make the person eligible.
The entry threshold in decibels that makes a person eligible for social security benefits for a hearing disability is 90 decibels and above. In other words, only people with severe to profound hearing loss can claim this type of financial aid.
The unfortunate part is that many people have a legitimate need for hearing assistance long before their decibel threshold is high enough to make them eligible for Medicare.
Types of hearing loss
Hearing loss can also have several origins, which influences the degree of impairment of the person. It is in itself one of the most widespread disabilities, which means that millions of people experience it to varying degrees.
The number of people whose hearing loss does not qualify them for social security benefits can therefore be considerable. There are generally three types of hearing loss: conductive, sensorineural, and mixed.
Conductive
Conductive hearing loss corresponds to an obstruction preventing sound waves from naturally reaching our auditory organs. This blockage disrupts the conduction of the sound wave through the three compartments of the ear.
This form of hearing loss can be severe, as in the case of a massive obstruction following trauma, but it can also correspond to very mild to mild hearing loss. For example, earwax buildup acts as a form of conductive hearing loss, simply dulling sounds.
Sensorineural
Sensorineural hearing loss is a form of hearing loss that involves the neurological dimension of the auditory pathway. It usually results from damage to the inner ear or cochlea.
It can have a genetic or traumatic origin and most often leads to more severe hearing loss. Treatment consists of a cochlear implant, which interfaces directly with the neurological dimension of the auditory process and qualifies for social security benefits.
What are your options?
If you've reached a point where the cost of hearing aids seems as challenging an obstacle as the disability itself, you're not alone. Millions of people live with hearing loss, and many lack the financial means to acquire hearing aids that cost thousands and thousands of dollars.
While it may seem daunting, know that you do have options. Some services offer used hearing aids, cleaned and reprogrammed to your specific needs, or over-the-counter hearing aids, without a prescription.
The difficulty with used hearing aids is that those from prescription devices require a precise diagnosis to be reprogrammed to the needs of their new user.
This involves as many doctor and specialist appointments and as many examinations, which constitute the bulk of the financial burden of the prescription hearing aid route. Moreover, prescription hearing aids are designed to fit a specific person's ear. The risks of acquiring a used device that doesn't quite fit are therefore high.
Affordable hearing aids at CLARIA
We are proud to offer a highly reliable and technologically advanced over-the-counter hearing aid that we are confident will support you on your journey with hearing loss. Not only do we use state-of-the-art technology to reduce background noise and help you focus on what matters, but our devices won't break the bank.
"CLARIA hearing aids offer a unique solution for people over 65. They are affordable, easy to use, and reliable." - Drew Sutton, MD, board-certified ENT.
Our hearing aids come with our customer satisfaction guarantee and are recommended by hundreds of satisfied customers worldwide. They are now among the smallest in-ear hearing aids on the market and are available in two models, EV1 and EV3. To learn more about how our over-the-counter hearing aids can help you, click here.
Sources:
Association of Hearing Aid Use With Health Care Utilization and Cost Among Older Adults With Hearing Loss | ncbi.nlm.nih.gov
Degrees of Hearing Loss | asha.org
History | cms.gov
Home About Us How is Medicare funded? | medicare.gov
How to Get Social Security Disability Benefits for Hearing Loss | asha.org
Types of Hearing Loss | hopkinsmedicine.org
