There are more than twenty-six million people ages fifty and older with hearing loss in the United States. Despite this, only about 25 percent of people with moderate-to-severe hearing loss use hearing aids.
However, lack of access to hearing health care and high costs of treatment prevent some older adults from obtaining and using hearing aids.
The National Institutes of Health found that the average price of a digital hearing aid is about $1,500, while more advanced models can cost up to $5,000.
Moreover, up to 80 percent of people suffering hearing loss, have it in both ears, meaning they’d need two hearing aids, doubling the cost.
While some Medicare Advantage plans offer limited hearing aid coverage, many health insurance plans for seniors, including Medicare Part B, don’t cover routine hearing assessments that determine if someone is a candidate for hearing aids, or the testing needed to program hearing aids.
Currently, there are no federally mandated services related to hearing health care for adults and hearing loss benefits for those covered by Medicaid vary from state to state.
In New York, some Medicare beneficiaries with low incomes are eligible for Medicaid, and some state-run Medicaid plans do cover hearing aids for older adults.
Common Ways to Pay for Hearing Aids
Medicare – Medicare does not cover hearing aids. However, if your doctor believes you have a medical condition requiring treatment that can be diagnosed with a balance test or diagnostic hearing exam, Part B may cover 80 percent of allowable charges for these tests (after deductible). Under Original Medicare, you usually pay 100 percent of the costs associated with routine hearing exams and hearing aids.
Medicaid – Medicaid often covers hearing aids for adults and always pays for hearing aids for children. You may qualify for Medicaid if you have a disability or a low income. New York offers hearing aid benefits for eligible Medicaid beneficiaries ages 21 and older, and covers hearing aids for patients with mild to severe hearing loss.
To be more specific, New York covers hearing aids if a beneficiary’s better-ear pure tone average is greater than 30 dB HL or his or her hearing thresholds at 2000 Hz and higher are greater than 40 dB HL in both ears (consistent with moderate hearing loss). The state of NY also covers batteries for the life of the hearing aid.
Medical flexible spending accounts (FSAs) – The cost of a hearing aid and batteries is considered reimbursable for those with these accounts.
Health Savings Accounts (HSAs) – As with FSAs, these accounts may cover the cost of hearing aids and batteries. Unlike FSAs, money in your HSA accumulates from year-to-year, allowing you to save toward the cost.
Veteran benefits – If your hearing loss is linked to your military service or connected to a medical condition treated at a VA hospital, you are likely covered. You may also qualify for hearing aids through the VA if your hearing loss is severe enough to interfere with daily activities.
Private Insurance – Some private health care plans pay for part or all of your hearing aids. To determine eligibility, check with your individual plan by calling the toll-free number for member services listed on your insurance card.
What to Ask Your Insurance Company About Hearing Aids
- What is my health plan benefit for hearing aids?
- Am I required to use specific hearing aid providers? If so, can you provide me with a list of providers in my area?
- Can the hearing aid provider bill the health plan directly? Or do I have to pay the full amount and then submit paperwork to get reimbursed?
- Is the benefit limited to specific types of hearing aids?
- How do you define “routine” hearing aids?
- Are there any criteria or stipulations for coverage?
- Do I have to have a specific degree of hearing loss in order to receive benefits?
For those without insurance coverage, private purchase is the primary option for obtaining hearing aids.
Untreated age-related hearing loss is associated with an increased risk of social isolation, falls, hospitalizations, and cognitive decline, making the lack of hearing aid adoption a public health concern.
Your health care plan, Medicare, or Medicaid may cover costs for a hearing test and hearing aid evaluation, but very few health insurance policies cover the cost of hearing aids. At New York Hearing Center, 60 percent of our patients use some form of insurance to pay their bill. We bill your insurance directly and work with the following providers:
- United Healthcare
- Empire BCBS
- The Empire Plan
If you do not see yours listed, please contact us to see how we can help you.