Medicare Advantage checklist.

Get the Insurance Facts to Hear and Live Your Best

With hearing loss affecting millions of Americans — including nearly a third of adults aged 65 and older — access to quality health care is critical. Intervention with hearing aids not only can help improve communication and connection to loved ones but may help reduce risk of other problems such as social isolation, depression, dementia, and even early mortality.

So how do you choose the right hearing health care? Some of our patients wonder whether hearing aid coverage under Medicare Advantage plans can help. The insurance benefit, however, may not be all that it seems, given potential restrictions on the type and extent of hearing aid coverage. We’re breaking down some key facts to help you make informed decisions about your hearing wellness.


What Is Medicare Advantage?

Medicare Advantage, also called “Part C,” is a form of Medicare provided by a private agency that contracts with the federal government. Unlike Original Medicare, which includes Part A (hospital insurance) and Part B (medical insurance) for hospital stays and outpatient care, Medicare Advantage bundles those two parts and may also offer other benefits, such as:

  • Vision Care
  • Dental services
  • Hearing care and hearing aids

In addition, Medicare Advantage plans may include Part D prescription drug coverage — an optional election with Original Medicare — and might have lower premiums than Original Medicare. On the other hand, they might require co-payments and coinsurance for most health care services, all of which can add up to more out-of-pocket expenses.


What About the Medicare Advantage Hearing Aid Benefit?

Unlike Original Medicare, most Medicare Part C Advantage plans include a hearing care benefit, but the details — such as scope of coverage — can differ significantly across various plans. Does the plan cover hearing technology in addition to hearing exams and other visits? What about other hearing-related services? These are factors to consider in evaluating whether Part C can meet your hearing needs.

Plus, enrolling in a Medicare Advantage plan with hearing benefits doesn’t necessarily mean the devices are provided free. Typically the insurance company has negotiated with selected hearing aid manufacturers for certain types or classes of devices. You’ll still pay out-of-pocket — but likely with less choice in the range of hearing aids you can select.

It’s also important to note that Medicare Advantage is regional, which can have implications for access to care. Even if the plan provides some hearing care benefits, you may be limited to providers within the plan’s network, restricting your choice for hearing care services and practitioners. This could be a concern if, for example, you spend winters elsewhere. Opting to go outside the network could result in increased costs and further limits on covered services.


How Might Medicare Advantage Impact Your Hearing Care?

In addition to limitations on providers or services, Medicare Advantage plans may impede your hearing care in other ways:

  •  Referral requirement — You may have to secure permission or a referral before seeing a hearing specialist, an additional step that could add costs or delay needed care.
  • Out-of-network expenses — Your preferred provider may be out of the network, which could mean higher expenses to see the professional of your choice, reduced coverage, or no coverage at all.
  •  Prior authorizations — You may have to obtain prior authorization from plan administrators, which could result in delay or denial of necessary hearing care.
  • Yearly limits — Annual maximums on what your plan will cover for certain hearing care expenses could drive up out-of-pocket costs or get in the way of ongoing care.
  • Service exclusions — Some plans may exclude services, such as hearing evaluations, in order to comply with state and federal requirements or may restrict the types of hearing aids you can receive, which can potentially limit care, increase your expenses, or change your hearing experiences.

Whether considering a Medicare Advantage plan or already participating in one, it’s important to carefully review the scope of coverage, requirements, annual limits, restrictions, and other details to be clear on what you’re getting and how to best use the plan. It may fall short of the coverage you need for optimal hearing health.


How Can the Hearing Connection Help?

When you need hearing help, you shouldn’t have to compromise. Access to complete diagnostic evaluations, a range of treatment options, comprehensive follow-up care, and advanced hearing technology is a must. That’s why at the Hearing Connection, we focus more on delivering complete care rather than trying to fit within the constraints of a Medicare Advantage plan.

Our services include:

  • Full hearing evaluations
  • Hearing aid evaluations
  • Hearing aid fittings
  • Ear cleanings
  • Audiometric testing
  • Service and repair for the life of your hearing aids

Because of our commitment to delivering the highest level of care to all patients, our acceptance of Medicare Advantage plans is limited. To help ensure access to quality care and service, we work closely with you to find solutions that fit your listening lifestyle, your hearing levels, and your budget. We also offer payment plans and work with a variety of other insurances.

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