Is Hearing Aid Coverage Included in Medicare Benefits?

03/26/2024 | Hearing Aids, Insurance, Patient Resources

2020 should be an interesting year for Audiologists and Medicare beneficiaries.  Two separate but important pieces of legislation are making headway through both the Senate and Congress and has bi-partisan support.

First up is the Medicare Audiologist Access and Services Act of 2019 (HR 4056/S.2446) introduced by U.S. Senators, Elizabeth Warren (D-Massachusetts) and Rand Paul (R-Kentucky).  According to the American Speech Language and Hearing Association (ASHA), it will remove “unnecessary barriers, allowing patients to receive appropriate, timely, and cost-effective audiologic care.” Currently, if you have Medicare and want to have your hearing tested, your insurance requires a physician order to see an audiologist.  Medicare only covers the hearing testing and no plan of treatment or follow up care.

This legislation is designed to improve outcomes for beneficiaries by allowing direct access to audiologic services and streamlining Medicare coverage policies so that audiologists can provide the full range of diagnostic and treatment services covered by Medicare that correspond to their scope of practice.

The legislation will also reclassify audiologists as practitioners, which is consistent with the way Medicare recognizes other non-physician providers, such as clinical psychologists, clinical social workers, and advanced-practice registered nurses.  This legislation has support from all three major Audiology organizations as well as hearing loss consumer advocate groups.

In October of 2019, the House Energy and Commerce Committee passed the Medicare Hearing Act of 2019 (H.R. 4618). Sponsored by Rep. Lucy McBath (D-Georgia) and Rep. Debbie Dingell (D-Michigan), it amends the Social Security Act to provide insurance coverage for hearing aids and hearing health services under Part B of the Medicare program. This is exciting as many consumers do not have existing insurance coverage for hearing aids and hearing aids can cost a few hundred to several thousands of dollars.

Now, before consumers get too excited, this bill as some serious limitations to it:

  • Medicare will only pay for one pair of hearing aids every five years (currently we do not know how much will be covered and if patients are able to upgrade)
  • Coverage will only be provided to those with severe-to-profound hearing loss (there are some questions on how this will be quantified)
  • Over-the-counter hearing aids are not covered
  • A written order from a doctor or qualified audiologist will be required

This particular piece of legislation has a long way to go.

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It still has to pass the House of Representatives, the Senate has to develop and pass similar legislation and then finally be signed into law by the President. However, with the way the political climate is right now, both sides are looking for items they can promote and believe will help sway voters.

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Dr. Person Au.D, CCC-A

Dr. Person has been a private practice owner since 2005. She currently specializes in hearing aids, tinnitus management and vestibular diagnostics, while operating in an unbundled service delivery model. Dr. Person is the host of The Unbundled Audiologist podcast. She serves as the incoming VP of Audiology for ISHA for a three year term. Her greatest accomplishment is creating a life where she can serve others while still spending quality time with her husband and two small children.