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does Medicare cover cochlear implants

Does Medicare Cover Cochlear Implants?

As we get older, our bodies don’t quite work the way they used to. It’s just the way it is. 

And one common thing that many experience as we age is hearing loss. Many people over the age of 65 experience hearing loss. It affects the way they communicate and interact with the world.  

Hearing aids can be a big help for those going through experience loss. However, they aren’t the right fit for everyone. For people with severe hearing loss, hearing aids may provide little, if any, improvement in their hearing. 

Which brings us to cochlear implants. These can help restore hearing to those who have severe hearing loss or who have already lost their hearing.  

So a common question many people have is, “Does Medicare cover Cochlear Implants?” In this article, we answer this question in clear, plain English. You will also find the average costs of cochlear implants and other helpful info. 

Does Medicare Cover Cochlear Implants? 

The short answer is yes; Medicare will cover the cost of cochlear 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 cochlear implants. Below we look at what these are so you know what to expect. 

Original Medicare (Medicare Part A and Part B) provides coverage for cochlear implant costs.  

More specifically, Medicare Part B will cover the costs of cochlear implants. Part B generally is the part of Medicare that covers prosthetics. Medicare Part B provides coverage for prosthetic devices that a patient needs to replace a body part or function.  

And cochlear implants fall under this category of medical device. As an approved surgically implanted device, cochlear implants are eligible for coverage.  

However, for Medicare Part B to cover your cochlear implants, you will need a prescription from your healthcare provider. Also, both your healthcare provider and implant supplier must be enrolled in Medicare. Your prosthetic supplier may also accept Medicare assignments.  

Once Medicare Part B approves, they will pay for 80% of the cost of your cochlear implants. You will pay for the remaining 20%.  

Medicare Advantage plans (Medicare Part C) also provide coverage for cochlear implants. They cover everything Original Medicare covers as well as offer some additional benefits. However, exactly what they cover and how much the out-of-pocket costs are will vary depending on the specifics of your plan.  

How Much Does Cochlear Implants Cost? 

The costs of cochlear implants include the implants themselves as well as the surgery. The average cost of the implants and surgery is around $40,000. It varies depending on where you live, the type of implants you get and the experience level of the doctor that performs the surgery.  

Procedures And Tests Before Having A Cochlear Implant 

Before getting a cochlear implant, your healthcare provider will first evaluate your condition and assess your specific needs. You may be eligible for a cochlear implant if you are struggling with normal hearing activities such as:  

  • Difficulty understanding spoken words on TV 
  • Having trouble listening when there is a lot of background noise 
  • Having trouble picking out environmental noises 

Your healthcare provider will conduct tests to determine the nature of your hearing loss. If you have severe hearing loss, then your doctor may recommend cochlear implants to help partially restore your hearing.

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.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover mammograms?

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