Coates Hearing Clinic, P.A.

Bill Proposal for Medicare to Cover Hearing Aids for Certain Patients

Note: We will do our best to keep this page updated with the latest information regarding the possibility of Medicare covering hearing aids for certain patients.

On Friday, November 19, 2021, the US House of Representatives passed President Biden’s “Build Back Better” (BBB) Act. This bill includes wide-ranging legislation with provisions for various programs from childcare subsidies to prescription drug pricing rules to taxes. Also included is a provision that would cover hearing aids for certain Medicare recipients. Patient education is one of our focus points at Coates Hearing Clinic. As such, we are publishing information about this bill as it becomes available. We want to keep our patients up-to-date to make better decisions about their hearing healthcare future. If you have questions that do not appear here, please email Jordan Coates at jordan@coateshearing.com, and he will respond as soon as possible.

When would this Medicare provision for hearing aids go into effect?

If the bill is passed, the best estimates say that the earliest patients will have access to these hearing aids on January 1, 2024. The wording of the bill is very generic when it comes to explaining how these hearing aids will be dispensed. There are incredible logistical hurdles for the Department of Health and Human Services to overcome. While we hope for a quick turnaround, more realistic estimates are mid-to-late 2024.

How likely will this Medicare provision for hearing aids get approved?

The House of Representatives narrowly approved the budget measure and passed it to the Senate for consideration on November 10, 2021. If the Senate makes any changes to the bill, it must go back to the House to be passed again. There will be changes made in the Senate, as two separate senators have indicated that they will not pass the BBB in its current form. Senate Democrats will need each of its 50 members’ votes to pass the bill. 

It seems as if some version of the bill will pass and go into effect, even if it is a watered-down version of what the House sent to the Senate for consideration.  The provision to require Medicare to pay for hearing aids (for specific patients) is one part of the bill that enjoys bipartisan support. It is expected that hearing aid coverage will be a part of any version of the BBB bill that makes it back to the House for final approval IF it makes it back for approval. That leaves us hopeful that some form of this coverage will be passed. 

There are VERY slim margins at play, with the democrats needing each of its Senate votes and the House able to lose only 3 of its democratic members’ votes.  Even so, we think that some version of the bill will be passed, and Senate Democrats say that they would like the bill passed by the Christmas holiday.

Which patients would be eligible for free hearing aids from Medicare?

At this point, the latest language in the bill says that patients with “severe or profound” hearing loss would be eligible. These classifications are based on audiological test results that give numerical results, NOT based on the provider’s opinion of the degree of hearing loss. Currently, only about 30% of our hearing loss patients qualify for hearing aids under the BBB Act.

Unfortunately, as written, the BBB Act will not pay for hearing aids for a majority of our patients who are hearing aid candidates. For the 70% of our patients who need hearing aids but do not meet Medicare guidelines, we will continue to offer competitive prices and second-to-none follow-up care.  Many of these patients already have an insurance benefit that pays for hearing aids anyway.

Should I wait to see if this Medicare coverage for hearing aids goes into effect before seeking care?

Unfortunately, hearing loss is a widespread problem that will not improve with time. Research shows that hearing loss patients who get treatment early have a decreased risk for many comorbidities, most notably cognitive decline. As a medical practice, we recommend coming in for treatment as soon as possible.

We also understand that purchasing hearing aids can be a significant investment. We do not want our patients paying for something they could get for free in the near future. We plan to evaluate each patient as we usually do, using state-of-the-art equipment and protocols based on industry best practices. If your hearing loss would put you in the category eligible for these devices (if the bill is passed), we can have an honest conversation about your best path forward and help you plan.  

Many patients, however, already have hearing aid coverage through their insurance! These insurance policies pay for part or all of a hearing aid purchase for many of our patients. We always check our patients’ insurance benefits before they come in, and we are glad to do the same for any patient who calls us.

Please do not wait to come in if you notice hearing loss or are experiencing tinnitus in one or both of your ears. We will work with all of our patients seeking treatment to ensure that they get exactly what they need for the best price possible.

Conclusion

We are cautiously optimistic that those who suffer from the highest degree of hearing loss will have access to hearing aids through Medicare by the end of 2024. While we are disappointed that a larger majority of our patients will not qualify for hearing aids from Medicare due to strict eligibility criteria, we see this as a first (small) step in the right direction.

Meanwhile, we will continue to push our professional organizations’ legislative advocacy groups to work with Congress to expand this coverage. We encourage you to reach out to your senators and representatives, urging them to expand this coverage to all Medicare recipients with hearing loss. Until hearing aid coverage is mandated (and paid for) for all types and degrees of hearing loss, we will continue our efforts to ensure that our patients have access to the highest levels of technology at the most affordable prices with second-to-none follow-up care. In addition, we are committed to helping our patients navigate the incredibly confusing world of insurance coverage to make sure they receive all the benefits to which they are entitled.

The first step is setting up an appointment to get your hearing tested.  From there, our audiologists can discuss treatment recommendations that will get you on the road to better hearing!

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