Understanding and knowing the details of Medicare and what it covers can be downright confusing. The federal health insurance program covers people who are 65 or older, as well as some younger individuals with disabilities or severe diseases. However, Medicare does not cover all costs of medical services, which is where the rules can get tricky. There are a number of factors that affect coverage, so it is imperative that all individuals take the different kinds of coverage available into consideration. Before we get into answering the question, "Does Medicare cover hearing aids?" we need to understand what it does and does not cover. If you want to skip to the answer, click down to the section below Items Not Covered by Medicare.
When you are choosing a type of insurance, you should consider your medical needs and make sure that the option you take will cover you.
Ask your doctor or healthcare provider if they will accept Medicare. Not all practitioners will accept this form of insurance, and you don't want to have to switch doctors.
What type of healthcare is most pertinent to your wellbeing? If you are living with hearing loss, you may want to consider a plan that will cover at least a portion of your costs. Medicare Part B will sometimes cover part of a hearing loss treatment. Generally, Medicare will not cover a routine hearing exam, but if you are approved for a diagnostic hearing exam, you may only have to pay 20 percent of the charges.
Medicare will cover services that are considered to be necessary to treat a disease or condition, such as surgeries, lab tests and doctor visits as well as supplies like wheelchairs and walkers. While there are different rules for people with a Medicare Advantage Plan, you will be under the general coverage of the Original Medicare plan.
Part B covers two types of services: Medically necessary and preventative services. Preventative services include healthcare to detect an illness at an early stage, like the flu. Most of these services are provided at no cost for people with Part B coverage.
This plan is a healthcare option that is run by a private insurance company that is under contract with Medicare. The Advantage Plan usually includes coverage of all parts of Medicare.
Medicare Prescription Drug Plans each have a specific list of available mediations. The drugs are separated into different tiers based on your out-of-pocket costs for each. Drugs that are listed in the lower tiers will cost you less than a drug in a higher tier. The drug plans have specific coverage rules laid out that need to be considered as well.
Hospital outpatient drugs: Prescription drugs given in a hospital outpatient setting, which are considered self-administered drugs, are generally not covered by Part B. However, there are certain circumstances when your Medicare drug plan will cover them.
Vaccine coverage: Medicare drug plans must cover all vaccines that are commercially available to prevent illness.
Automatic refill services: By January 2014, the automatic refill services offered by Medicare will change in order to reduce the waste caused by the program. When you need a prescription refilled, prescription drug plans will need approval before sending the medication. However, if you specifically request the prescription, it will be sent out.
Before getting Medicare, it is also important to note what is not covered by either plan. If you need any of the services not covered by Medicare, you will have to use other insurance or pay for them in full.
The long and the short of it, hearing aids are not covered by Medicare. This does not mean that you should not consider using Medicare as part of your overal healthcare plan. Also, if you are seeking hearing aid coverage as Medicare id not providing that benefit, there are other avenues to get financial assistance for hearing aids. View our Hearing Help article on Insurance Coverage and Financial Support for Hearing Aids for additional informaiton and options.
You can apply for Medicare on the Social Security website without having to wait in line or go into an office. The application takes about 10 minutes to be filled out, and can be submitted electronically so an envelope and stamp isn't even required. You can use the online form to apply for Medicare if you want to sign up for Medicare and currently have no Medicare coverage, do not want to start receiving Social Security benefits or are at least 64 years and 9 months old.
Medicare covers a number of screening services and preventative tests under the Medicare Part B plan. These include general shots for the flu, hepatitis B and pheumococcal. In addition, it will cover a yearly wellness visit to keep up with overall health. Here is a list of other services offered by Medicare:
Since Medicare does not cover everything, many people will use Medicare with other health insurance coverage. If you have both Medicare and health insurance, each of these is considered a "payer." Individuals with both forms of coverage will need to decide which one will pay first. The first or primary payer will receive the bills first, and send the rest to the secondary payer. The first will pay up to the limits of its coverage and then the second will pay if the primary payer reached its limits.
This content was last reviewed on: October 10th, 2013