Hearing Aid Benefits

Hearing Aid Benefits

Wed, 11/24/2021 - 09:45
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Everyone can now buy hearing aids over-the-counter (OTC). Seniors may get expanded Medicare coverage to help pay for hearing aids.

Hearing Aid

Medicare to cover hearing aids?

Maybe but not soon. The recently passed House bill called the Build Back Better Act would add coverage for hearing services to Medicare Part B, beginning in 2023.

• It is important to remember that this has not yet been finalized. The House bill must now pass the Senate where no Republican senators are expected to vote for the bill and two Democrat senators continue to try to be puppeteers.

♦ The new benefits cover devices furnished after a written order from a physician, audiologist, hearing aid professional or other clinician.

Hearing aids would be available once per ear, every 5 years, to individuals diagnosed with moderately severe, severe, or profound hearing loss. Hearing services would be subject to the Medicare Part B deductible and 20% coinsurance.

Hearing aids would be covered similar to other Medicare prosthetic devices and would also be subject to the Part B deductible and 20% coinsurance. For people in traditional Medicare who have other sources of coverage such as Medigap or Medicaid, their cost sharing for these services might be covered.

• Payment for hearing aids would only be on an assignment-related basis.

Assignment-related basis means that the claim submitted by a physician, supplier or other person who agrees to accept the Medicare payment in full and prohibits them from charging the beneficiary more than the deductible or any coinsurance that is approved by Medicare.

The final rules have yet to be written but it is easy to guess that physicians or other suppliers will try to offer upgraded models at an additional cost over the Medicare approved models.

• If you are an educated consumer before you walk in the door you are more likely to walk out with more of your money still in your wallet.

As with other Medicare-covered benefits, Medicare Advantage plans would be required to cover these hearing benefits.

♦ The Food and Drug Administration separately has moved to make hearing aids available over the counter, in a bid to make them cheaper. Audiologists have been fighting this for years but it is now finally going to happen.

Over-the-counter

Over-the-counter (OTC) hearing aids are intended for people with mild to moderate hearing loss. Consumers would be able to buy directly, without visiting a hearing health professional.

In 2017, Congress passed a bipartisan proposal to allow hearing aids to be sold over the counter. However, the Trump administration and the Food and Drug Administration (FDA) failed to issue the necessary rules that would actually allow hearing aids to be sold over the counter, leaving millions of Americans without low-cost options.

On July 9th, President Biden directed the department of Health and Human Services (HHS) to get the rules finished within 120 days so OTC hearing aids could be marketed and sold.

• OTC hearing aids will be regulated as medical devices by the FDA.

On October 20th, the FDA finally issued a proposed rule to establish a new category of over-the-counter (OTC) hearing aids.

The rule is not yet finalized. It is open for comment until January 18, 2022. When finalized, the rule would allow hearing aids within this category to be sold directly to consumers in stores or online without a medical exam or a fitting by an audiologist. It is expected that physicians and audiologist groups will try to narrow the scope of OTC hearing aids.

The FDA says it’s unclear exactly when the new products will be in stores, but finalizing the ruling is a top priority.

♦ Actually, the gate has opened and the horses are running.

A quick search on Google finds many sites already offering hearing aids. Some being the more famous and more expensive brands sold by audiologists. There are even Black Friday sales.

Walgreens have partnered with Connect Hearing to sell hearing aids in a small number of Walgreens stores.

Per FDA rule, OTC hearing aids are intended only for adults who believe they have mild to moderate hearing loss. People with more severe hearing loss are advised to see a hearing specialist.

What is mild and moderate hearing loss?

You may be told that you have a mild hearing loss if you can only hear sounds when they are at 30 db. You have a moderate hearing loss if sounds are closer to 50 dB before you hear them.

For the average person, it is tough to know if they have mild or moderate hearing loss without seeing a specialist and taking a hearing test.

• People with mild hearing loss often report that they can hear but can't understand conversations clearly. People with mild hearing loss often say they hear well in quiet environments when talking one-on-one with someone; however, not so well when they are in noisy environments, nor when a person is facing away or is standing some distance away from them.

• A person with a moderate hearing loss may hear almost no speech when another person is talking at a normal level. It would be common to ask people to speaker louder or repeat themselves. A person with moderate hearing loss may have difficulty hearing sounds such as a refrigerator humming.

If you have trouble hearing conversations even in quiet settings or miss loud sounds like cars honking when you drive or announcements in public buildings, your hearing loss may be more severe than moderate and OTC hearing aids are NOT intended to address this level of hearing loss.

An audiologist will diagnose your level of hearing loss with an audiogram, a test used to identify the quietest sounds you can hear, measured in decibels. You may be tested to assess how easily you hear words against background noise, like in a crowd or restaurant.

What to do first

Before you go shopping for a hearing aid get a checkup. See your doctor to rule out any causes of hearing loss, such as earwax or an infection. And have your hearing tested by a hearing specialist (audiologist) to at least establish a baseline for your hearing loss.

An audiologist will suggest a type of hearing aid based upon your degree of hearing loss.

Do not be rushed into making a purchase. There are many styles and prices to consider. This is a major purchase and one you will have to live with for at least a few years.

As you start looking for a hearing aid, explore your options to understand what type of hearing aid might best suit you and your lifestyle.

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