Does Medicare Cover Cochlear Implants?
Medicare Part B does cover cochlear implants if they are deemed medically necessary by a doctor.
Medicare Advantage (Part C) plans also cover cochlear implants when they are medically necessary. Medicare Advantage plans must at least cover the same services as Medicare Part A and Part B.
Medicare Advantage plans also include an annual out-of-pocket spending limit, which can help cap what you spend on out-of-pocket Medicare costs each year.
Original Medicare (Part A and Part B) doesn’t include an out-of-pocket spending limits.
Who is eligible for cochlear implants?
Cochlear implants are covered by Medicare for beneficiaries who have severe hearing loss in one or both ears, as long as a doctor who is enrolled in Medicare orders the implants.
Cochlear implants are surgically implanted electronic medical devices that replace the function of the damaged inner ear to provide sound signals to the brain.
Generally, those who need prosthetic cochlear implants don’t just struggle with the volume of sound, their brains are actually missing pieces of sound signals.
How much does it cost to get a cochlear implant?
If you are enrolled in Original Medicare, you typically pay 20 percent of the Medicare-approved amount for cochlear implants once you meet your Part B deductible (which is $185 per year in 2019).
This is called your Part B coinsurance or copayment.
If you have a Medicare Advantage plan, your coinsurance or copay costs may vary. Some, but not all, Medicare Advantage plans may feature $0 deductibles, and some may offer $0 monthly premiums.
Depending on the type of Medicare Advantage plan you have, you may be required to get your cochlear implants from a doctor in your plan network.
Speak with your doctor about specific pricing information regarding your specific cochlear implants, including whether or not they are covered by Original Medicare or your Medicare Advantage plan. There may be specific rules or selection criteria that apply.
Does Medicare cover hearing care?
Original Medicare does not cover most routine hearing services and supplies, including hearing aids and routine hearing care.
If you require routine hearing care in addition to your cochlear implant, a Medicare Advantage plan may help provide the hearing coverage you need.
In addition to the Part A and Part B benefits of Original Medicare, many Medicare Advantage plans provide additional benefits, such as hearing coverage and others like:
- Vision and dental coverage
- Prescription drug coverage
- Health and wellness program benefits, such as SilverSneakers membership
Find Medicare Advantage plans that cover cochlear implants
A licensed insurance agent can help you find Medicare Advantage plans in your area and discuss your options.
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