Coverage Archives - SeniorNews

As you get older, you start to think about your health in new ways. Things you never were too concerned about before now become a top priority. One of these things is hearing. Hearing loss is a common and sometimes frightening development that takes place as you age. Does Medicare Cover Hearing Aids?

Causes of Hearing Loss

A variety of circumstances can cause hearing loss. External causes, like long-term exposure to noise pollution, are common. Internal causes, such as genetics or illness, can also play a major role in hearing loss.

Do You Need Your Hearing Tested?

If you have noticed that you are having trouble hearing, you may need a hearing test. Sometimes, symptoms can come on very gradually, so it’s difficult to be sure. If you notice that you are asking people to repeat themselves, or that people seem frustrated that you can’t hear them, this can be an indicator before you even notice yourself. Also look for symptoms such as ringing or feeling like your ears are plugged. Keep in mind that, even if you show no symptoms now, as you age you will likely need a hearing exam at some point in your life.

Where to Buy Hearing Aids

Typically, hearing aids need to be prescribed by a doctor and can be very expensive. Thanks to the Over the Counter Hearing Aid Act of 2017, hearing aids will soon be able to be bought over the counter at a more affordable price. These hearing aids are for people with mild to moderate hearing loss. The goal is to make the market more competitive so that costs for hearing aids everywhere reduce.
Until this happens, and as hearing issues progress, you will still unfortunately be paying a high cost for hearing aids if you don’t have the right coverage.

Understanding Medicare Coverage for Hearing

It is important to understand fully what you are covered for when it comes to hearing as you age. As with most Medicare coverage, Medicare covers services that they find medically necessary.

Diagnostic Hearing Exams

Routine hearing exams are not covered under Medicare. Under Medicare Part B, diagnostic hearing and balance exams can be covered if ordered by your health care provider to determine whether you need medical treatment. One example of this would be testing for the cause of vertigo or dizziness. Under these circumstances, you are still partially financially responsible. If the test is done in a hospital, the hospital copayment will be due. If the test is done outside of a hospital, the Medicare 20% coinsurance applies. Medicare supplement plans are available which will pick up these costs.

Medicare Coverage for Hearing Aids

One of the most common things people wonder about as they start to approach age 65 is Medicare coverage for hearing aids. This is because hearing aids can be very pricey. Not only are the actual hearing aids themselves costly, but the tests and exams required to determine need of the hearing aids!
Medicare does not cover hearing aids, routine hearing exams, or the exams for fitting hearing aids. This leaves a big hole in your health coverage should you just accept this fact. Fortunately, there are alternatives and supplements to Medicare insurance. However, not all of these will provide you with the coverage you need, either. Here is a breakdown of different plans you may have heard of and what hearing services they do – and don’t- cover.

Medigap

You may have heard of Medigap before. It is also commonly known as Medicare Supplement insurance. This is private insurance that supplements Medicare A and B. Many people use these plans to assist with medical out-of-pocket costs. It is important to remember that Medigap doesn’t pay for services not covered by Medicare. Instead, it pays for remaining costs that would typically be out-of-pocket for the patient.
There are ten different types of Medigap plans, and each has different benefits. None of them cover hearing aids.
These plans can still help you with hearing service costs. For Medicare Part B covered diagnostic hearing tests, Medigap will pay the 20% coinsurance. Some plans, such as Plan C and Plan F, will pay the deductible as well.

Medicare Advantage

Medicare Advantage is another option you may have heard of, and is also privately issued. It is also referred to as Medicare Part C. It provides the same benefits as Medicare Parts A and B, and in some cases additional benefits. With certain plans, hearing exams may be covered, but hearing aids are typically not covered by Medicare Advantage.

Help with Costs and Expanding Your Coverage

If you are looking to reduce your costs when it comes to hearing services, there are a few things you can do. Enrolling in a Medigap plan will help you cover out of pocket costs when it comes to doctor-ordered diagnostic hearing tests.

You can also expand your Medicare coverage by adding specialized Dental, Vision, and Hearing plans to your Medicare plan. These plans are affordable and can cover your routine hearing tests. They even sometimes cover hearing aids.

To find out what type of coverage is best for you, compare rates and plans here. You will find an easy-to-follow system and help from qualified individuals who can help guide you to the right plan.

Does Medicare Cover Hearing Aids?

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Insurance is ending coverage for some key drugs that affect the health of patients. It’s a David-vs.-Goliath dispute, and millions of patients are caught in the middle — perhaps even unaware they’re about to lose coverage for compounded medications they need for their conditions. Insurers End Coverage for Key Drugs
At issue are the customized medications pharmacists prepare for patients who can’t metabolize or tolerate commercial drugs. Compounded medicines often are the only option for doctors treating certain children and seniors, patients coping with the pain of cancer and diabetes, and those with liver or kidney diseases.
In one corner: powerful insurance companies and pharmacy benefit managers (PBMs) hell-bent on saving money by eliminating or cutting coverage of those medications.
In the other corner, fighting to reverse their moves: a coalition of patients, physicians, pharmacists and pro-patient groups like the Veterans Advocacy Group of America, the Kidney Cancer Association and the Arthritis Foundation.
“This is about shifting costs to patients,” says Jay McEniry, executive director of Patients and Physicians for Rx Access (saverxaccess.org). “Physicians are being placed in the impossible position of either prescribing a compounded medication the patient needs but can’t afford, or prescribing a less effective treatment because it may be covered by the patient’s insurance.”
The list of “Goliaths” who’ve announced or already implemented such cutbacks now includes United Healthcare/Optum Rx, Catamaran, CVS/Caremark, Harvard Pilgrim and Blue Cross Blue Shield plans in several states.
But the coalition’s immediate wrath is directed at the nation’s largest PBM: Express Scripts, which in September is slated to stop covering 1,000 drug ingredients commonly found in compounded medications — effectively “eliminating an entire class of medications,” says McEniry.
Express Scripts and others argue that commercial drugs can do the job just as well for less money. But try telling that to patients like Linda Sauer.
The Dwight, Illinois, woman relies on her doctor-prescribed compounded medications for relief from several painful and debilitating conditions, and is outraged that Express Scripts’ decision leaves her no choice but to pay for them out of pocket.
“They’re denying me access to medicines that work better than the mass-produced drugs I’ve tried,” she says. “It will cost me and others hundreds of dollars per month.”
Sauer at least has read the advisory notice from Express Scripts, which the coalition claims gives “misleading reasons” for targeting what it calls “essential medicines” whose ingredients are purchased from FDA-regulated suppliers. But what of patients who didn’t?
Sadly, they’re in for a shock the next time they try to fill a prescription.