This week in Audicus blogs, find out about insurance plans and how they relate to hearing aid funding.
Are you aware of how Medicare, Medicaid and other programs can help you to afford hearing aids? These services may seem very complicated and difficult to understand, but a small information summary can help you to find the right programs.
Medicare and Hearing Aid Coverage
Medicare can cover a broad variety of health needs, but its capabilities are limited and it may not pay for every fee accrued under the services it is responsible for. You may be required to do copayments.
In the case that Medicare doesn’t cover certain health costs (which is less likely to happen if you have a Medicare Advantage health plan), then you can either pay out-of-pocket or use an alternate insurance program. Medicare does not cover the following:
- Alternative medicine such as chiropractic treatment or acupuncture. Exceptions to this include chiropractic services to fix spine subluxations
- Cosmetic surgery, except for surgeries like breast prostheses that may fix malformations
- Long-term care like nursing home care, adult day care and debts accrued from assisted living facilities. Medicare pays for up to 100 days of rehabilitation or nursing following a three-day inpatient hospital session
- Hearing Aids: Medicare is not responsible for hearing aids and hearing exams. In some cases, hearing implants required following severe hearing loss will be covered. For more information you can consult the ‘Medicare & You” 2015 booklet found here: www.medicare.gov/pubs/pdf/10050.pdf
Medicaid and Hearing Aids
Medicaid normally offers financial coverage to low-income families and receives financial assistance from state and federal governments. For individuals 21 and younger Medicaid is required to give hearing screenings as well as tests in communication development.
This is due to the service program called Early and Periodic Screening, Diagnostic and Treatment (EPSDT). However, Medicaid’s required hearing service does not apply if individuals are over the age of 21. Medicaid is required by law to provide medical assistance to individuals living below the poverty line.
You can find specific eligibility criteria at http://www.cms.hhs.gov/MedicaidGenInfo/ and assistance locating your state agency at http://www.cms.hhs.gov/MedicaidGenInfo/.
Hearing Aids and Private Insurance
Individuals with Disabilities Education Act (IDEA) can help to supplement some fees associated with audiology, and some private health plans will help cover audiology costs. The Patient Protection and Affordable Care Act (ACA) is geared to making more available health insurance benefits for individuals who are uninsured, such as small business owners.
At least 22 states provide some form of health coverage regarding hearing aids. New York state, for example, covers hearing aids though the ACA.
Online information regarding the act is available at http://cciio.cms.gov/resources/data/ehb.html. The financial limit is $1,500 a year and is limited to a single purchase, including replacement or repair, every three years. This coverage may not extend to bone-anchored hearing aids unless certain criteria are met.
Be sure to learn more about the insurance benefits of your current health plan by inquiring by phone or visiting the program’s website.
Audicus Gives Back
Although Audicus offers more affordable hearing aids than ones at the clinic, there are still many people who cannot afford them. That’s why we’ve partnered with Hearing Charities of America to collect used hearing aids to refurbish for people in need.