How to Find an Audiologist Who Takes Medicare

Hearing loss affects about one in three people between the ages of 65 and 74, and almost half of people over 75, but Medicare's coverage of hearing care is one of the most confusing parts of the program. Original Medicare, which is Part A and Part B, will pay for a hearing test if your doctor orders it to find out why you are having trouble, but Original Medicare does not pay for the hearing aids themselves. That gap costs many seniors thousands of dollars out of pocket. Knowing where to look, what questions to ask, and which Medicare plan you are on makes the difference between a fair price and a four-thousand-dollar surprise.

The first step is to know which kind of Medicare you have. If you only have Original Medicare with a red, white, and blue card, you are responsible for the cost of hearing aids unless you also have a Medigap supplement that includes hearing benefits, which most do not. If you have a Medicare Advantage plan, also called Part C, your plan probably includes a hearing aid benefit through a partner like NationsHearing, TruHearing, or UnitedHealthcare Hearing. The benefit usually covers one set of hearing aids every two to three years, often with a copay of five hundred to fifteen hundred dollars per ear. To find out, look on the back of your insurance card for a member services phone number, call it, and ask: "What is my hearing aid benefit?"

Once you know your coverage, the next step is to find an audiologist who accepts your plan. Audiologists are not all in network with every insurance company, and going out of network can cost you the entire benefit. The Medicare website at Medicare.gov has a tool called "Find Care Providers" that lets you search by zip code and service. Type in your zip code, choose Audiology, and the site shows local audiologists with their addresses and phone numbers. For Medicare Advantage plans, your plan website has its own provider finder under a tab labeled "Find a Doctor" or "Find a Provider." Always confirm by phone before the visit, because directories can be out of date.

When you call the audiologist's office, ask three questions. First, do they accept your plan as in network. Second, do they bill the plan directly or do you pay up front and submit for reimbursement. Third, what is the total out-of-pocket cost for a basic hearing aid through your plan, including the fitting, the follow-up visits, and the warranty. A good audiologist gives you straight answers to all three. If the office is vague or pushy, call the next one on your list. Costco Hearing Aid Centers are often the best value for people without strong insurance coverage, with full pairs of digital hearing aids starting around fifteen hundred dollars and free lifetime cleanings. Membership is required, but the savings can pay for the membership in one visit.