Why Doesn’t Medicare Cover Hearing Aids

 In Health Insurance for Hearing Aids, Hearing Aid Insurance

Why Doesn’t Medicare Cover Hearing Aids

Why doesn’t Medicare cover hearing aids.  Many patients in my office ask this question.  They express frustration because they  have paid into Medicare system that provides coverage for other medical procedures and services.  While it is understandable that a costly medical device such as hearing aids may not be fully covered, it is a reasonable question to ask why Medicare doesn’t cover ANYTHING for them?

 

medicare cover hearing aids

Medicare Health Insurance

Other Covered Hearing Services

I am unaware of publicly stated policy why Medicare doesn’t cover hearing aids.  However, a recent article titled “Why does Medicare cover cochlear implants but not hearing aid?” by hearing industry expert Dr. Fan-Gang PhD offers 3 reasons as to why they might not covered.  The article was published in the September 2016 edition of The Hearing Journal. 

  1. A device must provide a health benefit and “be determined to be reasonable and necessary to be covered by Medicare.  Furthermore, it must be for the diagnosis or treatment of an illness or injury.  Also, it must be to improve the functioning of a malformed body member. Cochlear implants, which are a surgically implanted hearing device, have been shown through scientific and clinical evidence to improve hearing.  Those are a covered benefit by Medicare.  Zeng states that “apparently, Medicare has determined that the published evidence on the health benefits of hearing aids is inadequate.   Accordingly, hearing aids do not merit any coverage”.
  1. Regulatory differences contribute to coverage disparities. Almost all pharmaceuticals and medically invasive Class-III medical devices have to be “proven” both safe and effective through comprehensive and expensive clinical trials required to obtain FDA approval.  Hearing aids are regulated as lesser invasive medical devices and are exempted from rigorous controlled clinical trials to demonstrate health benefits.  His opinion is that “achieving Medicare coverage will depend on the willingness and ability of hearing aid manufacturers to quantify the health benefits of hearing aids, which would be directly compared to other covered medical devices”.
  1. Medicare regulatory members are primarily composed of physicians who decide on what to cover as well as how much to cover. Hearing aids do not require surgery and are dispensed by non-physicians (audiologists and hearing aid dispensers), seldom engaging physicians.  In Dr. Zeng’s opinion, this lack of inter-relationship between the two professions has contributed to the present coverage disparity between cochlear implants and hearing aids.

To learn more about why doesn’t Medicare cover hearing aids, read Dr. Zen’s article or contact your local congress person.

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