Hearing Aid Reimbursement

Medicare does not pay for most hearing care and reimbursements are extremely rare.

Advantage Plan Recipients: Hearing Aid Reimbursement

Each Advantage Plan has different rules and regulations regarding hearing aid reimbursement. Reimbursement is only likely if you follow the insurance company's rules very carefully. For example, you get a referral from your doctor and you use plan providers for testing and equipment. Even then you may not get reimbursed for the amount of money you have spent on either a hearing test or a hearing aid. If you follow the rules related to hearing care you shouldn't need to be reimbursed because the providers will bill the company directly and only present you with a bill after their portion is paid.

Original Medicare Recipients: Hearing Aid Reimbursement

Most hearing care isn't covered under Original Medicare so hoping for Medicare reimbursement is just that, wishful thinking. In fact, Medicare has become quite automated and reimbursements even for regularly covered services are extremely rare. The only way you might be able to get a Medicare reimbursement for hearing care would be under extremely special circumstances. For example, if you were in an accident and you needed diagnostic testing immediately from a doctor who didn't take Medicare assignment you would likely be reimbursed for a portion of the diagnostic testing and treatment by Medicare.

Avoiding reimbursements is the best approach when it comes to hearing aids and hearing care. If a provider is pressuring you for a sale it is often wise to wait. If they want payment now and are telling you that Medicare will reimburse you for the hearing aid in all likelihood you will not be reimbursed and you will end up paying 100% of the costs out-of-pocket. In addition, if you have an Advantage Plan, a pension plan or Medicaid in most cases they will have preferred providers and you will need to order from those providers to have insurance pay a portion of the costs. Direct payment arrangements are usually already set up.

Reimbursements can occur for hearing aid coverage if you have secondary insurance that pays for a portion of the cost of a hearing care. For example if you have a diagnostic hearing test emergency and your federal employee insurance pays for most of the cost of care you may need to send in an additional reimbursement to Medicare.

In summary, reimbursements of any kind from Medicare are uncommon. Hearing aid reimbursement from Medicare almost never happens. Don't count on reimbursements of any kind even if you have hearing care coverage through a pension plan or Medicare Advantage Plan. Generally, reimbursements are insurance lingo for "you haven't followed the rules," and this means that the company and/or Medicare doesn't have to pay.

Avoiding reimbursements is also a way Medicare, Medicaid and insurance companies avoid fraud. A plan's refusal to reimburse plan members isn't just to save money and avoid paying; it is a way to protect the entire system from expensive abuse.