Does Medicare Cover BAHA Implants?

The BAHA, also known as Bone-Anchored Hearing Aid, system is a technology that is used to treat hearing loss. It provides sensitive hearing by way of bone conduction. Normally Original Medicare does not provide coverage for hearing aids.

But what about in this case? Does Medicare cover BAHA implants? In this article, we answer that question in clear, plain English. Also, you can find info on what BAHA implants cost as well as some other helpful info.

Does Medicare Cover BAHA Implants?

The short answer is yes. Medicare will cover the cost of BAHA implants. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your BAHA implants. Below we look at what these are so you know what to expect.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for BAHA implants. Parts A and B provide coverage for your BAHA implants if it is medically necessary. Your healthcare provider must first order the treatment for Original Medicare to provide coverage.

Coverage for BAHA implants is provided by Medicare Part B. Medicare considers BAHA implants as prosthetic devices, for which Medicare Part B provides coverage. Prosthetic devices are durable medical equipment, or DME, which Medicare Part B covers.

However, for Medicare Part B to provide coverage for your BAHA implants, your healthcare provider must order it. Your healthcare provider as well as your DME supplier must be enrolled in Medicare for Medicare Part B to provide coverage.

Once approved, Medicare Part B covers 80 percent of the costs of your BAHA implants. You will pay for the remaining 20 percent as a copayment or coinsurance.

Medicare Part B may also provide coverage for cochlear implants. Just like with BAHA implants, cochlear implants are considered as prosthetic devices DME. Medicare Part B provides coverage for cochlear implants under the same conditions as BAHA implants.

Once approved, Medicare Part B covers 80 percent of the costs of your cochlear implants. You will pay for the remaining 20 percent as a copayment or coinsurance

Even though Medicare Part B provides coverage for BAHA implants and cochlear implants, they do not provide coverage for hearing aids. Medicare Part B does not consider hearing aids as DME.

Part C Coverage for BAHA Implants

Medicare Advantage plans (Medicare Part C) also provide coverage for BAHA implants. Advantage plans have to cover all the same treatments, services, etc. that Original Medicare covers. These Advantage plans will also provide coverage for additional treatments and services that Part A & B do not cover. What each Advantage plan covers and how much your out-of-pocket costs are for the coverage depends on that plan you have.

How Much Do BAHA Implants Cost?

The cost of implanting BAHA can range around $10,000 to $17,000. The exact cost depends on the type of operation to implant the device. The sound processor can range from $5,000 to $8,000.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.