Does Medicare cover hearing aids in Georgia?

This is the most common question we get, and the answer has three parts because Medicare is really three different things.

Original Medicare, Parts A and B

Medicare states it plainly: Original Medicare does not cover hearing aids or exams for fitting hearing aids. That has been true since the program began and it has not changed.

What Part B does cover is diagnostic hearing and balance exams, when your doctor or another provider orders them to find out whether you need medical treatment. You pay 20 percent of the Medicare approved amount after your Part B deductible. You can also see an audiologist once every 12 months without an order from a physician, for non-acute hearing conditions and for diagnostic services related to surgically implanted hearing devices.

So the test can be covered. The hearing aids are not.

Medicare Advantage, Part C

This is where it gets worth checking. Medicare Advantage plans are sold by private insurers and are required to cover everything Original Medicare covers, but most of them add extras, and hearing is one of the most common additions. A plan might give you an allowance toward hearing aids, a fixed copay per device, or a network requirement that sends you to particular providers.

Three things to check on your specific plan.

• The amount and how often it renews. Allowances are often per ear, and often every two or three years rather than annually.
• Whether it is a network benefit. Some plans only pay through a specific hearing benefit administrator, which limits which devices you can get.
• Whether the fitting and follow up appointments are included or only the device itself.

The number on the back of your card is the fastest route. Ask them directly: does my plan include a hearing aid benefit, how much is it, how often does it renew, and do I have to use a specific provider.

Georgia Medicaid

Medicaid hearing aid coverage for adults varies enormously by state and changes from year to year. Coverage for children is far more consistent than coverage for adults. If you are on Georgia Medicaid, do not assume either way. Call the number on your card and ask specifically about hearing aid coverage for your age group, because a general answer about hearing services will not tell you what you need to know.

The Georgia program most people miss

Georgia runs a Hearing Aid Distribution Program administered through the Georgia Charitable Care Network. It provides hearing aids to eligible Georgia residents through state licensed hearing care providers.

The broad eligibility criteria are:

• Household income at or below 200 percent of the federal poverty guidelines for adults, or 400 percent for children.
• Georgia residency for at least one year.
• A recommendation from a state licensed hearing care provider.

You can reach the Georgia Charitable Care Network at 888-521-1231, or 678-389-3333 in metro Atlanta. It is worth a phone call before assuming hearing aids are out of reach.

Other routes people forget

• Veterans. The VA provides hearing aids to eligible veterans, and the eligibility is broader than most people expect. If you served, start there before anything else.
• Employer plans. If you are still working, check your health plan. Hearing benefits are increasingly common and rarely advertised.
• Flexible spending and health savings accounts. Hearing aids and batteries are qualified medical expenses.
• Medical expense deduction. Hearing aids count toward deductible medical expenses if you itemize. Worth mentioning to whoever does your taxes.

What to do next

Get the hearing test first. It takes about 45 minutes, and until you have an audiogram no coverage conversation means much, because you will not know what level of device you actually need. Bring your insurance card and Bella will help you work out what your plan covers before you commit to anything.

Schedule a consultation, or read about what drives the price of hearing aids.