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Colorado Springs

Audiology, Inc.

 

Phone  719.520.1155

LOCATION  & DIRECTIONS

Dr. Gene McHugh

Licensed Audiologist

In Colorado

 

 

OFFICE HOURS

Mountain Time USA

Mon-Thurs

9:00AM-5:00PM

Closed Fridays

 

 © 2017 

 

 

 

MEDICARE COVERAGE


For 30+ years, I have fielded the following two questions a lot:

1) "Does Medicare Cover Hearing aids?"  (The answer is an unequivocal "NO.")

2)  "Why not?"  That doesn't make sense. 

 

Medicare does not cover hearing aids. - Never has, and probably never will and this is regardless of who you see for your hearing aid services (including ear specialists). Audiologists may bill for, what is called "diagnostic tests" on Medicare, Part B as long as the purpose in no way involves testing to determine the need, selection or measurement for hearing aids.* 

 

 

DIAGNOSTIC SERVICES

     Diagnosis services refer to testing only - no hearing aids  Diagnostic services include hearing tests, special diagnostic tests such as middle ear assessment, brainstem audiometry or otoacoustic emissions to rule out medical disorders..  Medicare does allow these services to be billed as long as the testing is not for the purpose of selecting or fitting hearing aids.  Since Medicare is so strict regarding this point, if you are come to our office for the purpose of determining the need for, selecting or fitting hearing aids, the initial consultation is at no charge.  We do not bill Medicare.      

EARWAX REMOVAL

     Earwax removal is also not covered by Medicare. In our office, simple cases or earwax removal (i.e., minimal or no earwax) will not be charged.  However, more difficult (i.e., time consuming or difficult cases) are charged $25.00 per ear and normally paid at the time of service by the patient.  

HEARING AIDS

       Medicare is the government run insurance program for seniors that started in the 1960's.  At that time coverage for hearing aid benefits was not included.  Since that time, there have been several attempts to include hearing aids under Medicare, but they have all failed and there are no plans to include hearing aids in the foreseeable future.  Essentially, hearing aids are an out-of-pocket expense for most people in this country.  

Do any insurances cover hearing aids?  A few insurances do provide partial benefits for hearing aids such as the Federal Employees insurance plan.  However, most either do not cover hearing aids or offer very low quality hearing aids with no assistance on how to use them.  The best example of this is United Health's supplemental insurance to Medicare. .

How about coverage by the state of Colorado?   Colorado has no general coverage for hearing aids except in two cases: 

  • Children, under the age of 21 who are covered if the family receives Medicaid assistance, and;

  • Persons living in Nursing homes who are eligible for hearing aid assistance under the PETI (Post Eligibility Treatment of Income) program.  PETI is a program through Medicaid (state insurance for the indigent) that pays for low-cost hearing aids for persons who are:  1) in a nursing home and 2) who are eligible for Colorado Medicaid.  Testing must be completed by a certified audiologist and Dr. McHugh is ASHA certified.   

What about managed care or preferred provider plans for hearing aids?  Some plans are covering hearing aids for a "reduced price."  However, the reduced price is not always lower than our regularly low costs on hearing aids.  Be sure to check around before accepting what and where to buy your hearing aids.  As a general rule, we choose not to participate in most managed care programs since we provide the initial hearing test at no charge, and have hearing aid fees that are usually lower than others' discounted prices.   

What about the VA?   Prior to the Bush Administration, the Department of Defense and Veteran's Affairs (DOD/VA) only allowed veterans with carefully scrutinized direct military related hearing loss to receive hearing aid services.  The Bush administration changed this policy so anyone who ever served in the military (at any time, and no matter for how short a time) could receive hearing aid benefits.  Essentially free hearing aids for life if you ever served in the military.  Service-connected hearing loss does make sense to provide "limited and defined compensation." However in my opinion, many of the hearing and/or tinnitus problems for which many Vets are receiving compensation and benefits are primarily related to aging, (i.e., non-service connected noise induced hearing loss), recreationally-induced hearing loss and/or family history (genetics), and NOT military experience.  While these hearing aids may be "free" to vets, their hearing aids are not free to tax-payers.  Moreover, hearing aid manufacturers have found the VA a convenient way to "dump" their over-supply of hearing aids, including their most premium (i.e., most expensive) hearing aids.  The waste is so wide spread that if veterans have minor problem with their hearing aids or don't like their hearing aids, the VA/DOD simply issues them a new pair, again at significant tax-payer expense.  President Obama did not change this VA policy and unlikely President Trump will be more scupulous toward providing totally free hearing aids for aging Veterans .... again at the uncontrolled expense of us, the US tax payers.  On the positive side, many Vets who recognize this inappropriate use of VA benefits choose to pay for their hearing aids privately thereby allowing Vets who really deserve the care to receive it.      

   *Professionals charging Medicare for testing when the purpose IS associated with the selection of hearing aids are committing Medicare fraud.  For more information, Medicare.gov is your best source for information

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