Licensed Audiologist in Colorado
Mountain Time USA
9:00 AM - 5:00 PM
Medicare does not cover hearing aids. They never have and probably never will, regardless of who you see for your hearing aid services, including ear specialists. Audiologists may bill for 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 refer to testing only, not 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 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 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.
Medicare is the government operated 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. Most, however, 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:
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 determining 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. However, during the Iraq war, the Bush administration changed this policy so basically anyone who had ever served in the military at any time (even for one day) could receive hearing aid benefits - FREE for life. Really? Direct service-connection for hearing loss is clearly justified allowing for "limited and defined compensation." However, many of the hearing and/or tinnitus problems for which many veterans are receiving compensation and benefits for are related to aging, non-service related noise exposure, recreationally-induced hearing loss (such as hunting), and/or family history of hearing loss, rather than direct military exposures. While these hearing aids may be free to vets, they are not free to us tax-payers and they're expensive. Naturally, the hearing aid manufacturers have found the VA a convenient way to "dump" their over-supply of hearing aids. The waste is so widespread that if veterans have even minor problems with their hearing aids or don't like their hearing aids, the VA/DOD simply issues them a new pair, again, at taxpayer expense. Presidents Obama and Trump did not change this VA policy and it's unlikely to change under President Biden.
*Professionals charging Medicare for testing when the purpose is associated with the selection of hearing aids are committing Medicare fraud. Medicare.gov is your best source for information.