Sep 11, 2023
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Lori Lovato MA, FAAA, Audiologist
Understanding Medicare and Medicaid Coverage for Hearing Care
We understand that navigating the world of hearing care insurance can be daunting, which is why we're proud to network with Medicare and Medicaid insurance providers to assist you in getting the help you need.
In this article, we'll explore the coverage provided by these programs for individuals experiencing hearing problems and requiring hearing aids.
Our goal is to help you understand your coverage so you can make informed decisions about your hearing healthcare.
Medicare and Hearing Care
Medicare is a federal health insurance program designed for individuals aged 65 and older, as well as certain younger individuals with disabilities. There are four parts to Medicare:
When it comes to hearing care, Medicare Part B provides coverage for diagnostic hearing tests when ordered by a physician to assess hearing loss and determine the most appropriate treatment. However, traditional Medicare does not typically cover routine hearing exams or hearing aids.
Some Medicare Advantage (Part C) plans may offer additional benefits, such as coverage for hearing aids and related services. It's essential to review the specifics of your Medicare Advantage plan to understand the extent of your hearing aid coverage.
Medicaid and Hearing Care
Medicaid is a state and federal program that provides health coverage for eligible low-income individuals, families, and people with disabilities. In Washington State, the Medicaid program is known as Apple Health.
Medicaid coverage varies by state, but Washington's Apple Health program offers a comprehensive set of benefits for individuals requiring hearing care services.
Apple Health provides coverage for medically necessary hearing evaluations, hearing aids, and related services for eligible adults and children. To qualify for these services, a licensed audiologist, like us at Highline Hearing, must perform a comprehensive hearing evaluation and recommend the most appropriate hearing aids based on your specific needs.
Hearing Aid Coverage for Adults
Under Apple Health, eligible adults can receive coverage for one hearing aid per ear every five years.
The program covers a range of hearing aid styles, including behind-the-ear, in-the-ear, and in-the-canal devices. Additionally, Apple Health covers necessary repairs and adjustments to ensure your hearing aids are functioning optimally. Please note that some restrictions and limitations may apply, so it's essential to discuss your coverage options with us.
Hearing Aid Coverage for Children
Children under the age of 21 with hearing loss may be eligible for more extensive hearing aid coverage through Apple Health's Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program.
This program ensures that children receive appropriate screenings, diagnoses, and treatments for hearing loss, including necessary hearing aids and related services.
Working With Highline Hearing to Understand Your Insurance
At Highline Hearing, we are committed to helping you navigate the complexities of insurance coverage for your hearing care needs.
Our experienced team will work closely with you to determine your eligibility, obtain necessary authorizations, and submit claims on your behalf.
We are proud to network with Medicare and Medicaid insurance providers to ensure that our patients receive the highest quality of care.
Getting the Hearing Help You Need
Understanding the coverage provided by Medicare and Medicaid for hearing care is crucial for individuals seeking assistance with hearing loss. At Highline Hearing, we are dedicated to helping you navigate your insurance options and obtain the best possible care for your hearing needs.
Don't let uncertainty about insurance coverage stand in the way of improving your quality of life. Take the first step toward better hearing by contacting us today.
Our team of experienced professionals is ready to answer your questions, guide you through the process, and provide exceptional hearing care tailored to your unique needs.
Call us at 206-246-8677 or visit our appointments page to schedule an appointment. Together, we'll help you hear life's moments more clearly and confidently.
Lori Lovato MA, FAAA, Audiologist
Lori is a lifelong resident of the Tri-Cities. She and her husband Anthony are proud to be raising their family here. She attended Washington State University where she received a bachelor’s degree in speech and hearing sciences and her master’s degree in audiology. Lori began practicing audiology in the Tri-Cities in 1993. During this time, she has worked in a variety of clinical settings, including private practice and ear, nose, and throat physicians’ offices. She has spent her career focused on assisting those with hearing difficulties through the use of hearing aids, listening strategies, assistive devices, and counseling. She is experienced in working with both adult and pediatric patients. It is important to Lori to develop close relationships with each and every patient, as she helps them develop better communication strategies to live a fuller life.
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