Does Medicare cover cochlear implants?
Medicare Part B will cover 80% of the cost of your cochlear implants if a doctor recommends it, but other conditions may apply.
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Leslie Kasperowicz
Farmers CSR for 4 Years
Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...
Farmers CSR for 4 Years
UPDATED: Jul 18, 2022
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UPDATED: Jul 18, 2022
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident insurance decisions. Comparison shopping should be easy. We are not affiliated with any one insurance provider and cannot guarantee quotes from any single provider.
Our insurance industry partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different insurance companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- Cochlear implants are covered by Medicare if a doctor recommends that you should have cochlear implant surgery
- Medicare Part B covers devices like cochlear implants and will pay up to 80% of the approved cost
- You may be able to cover some costs associated with accessories or ongoing support through Medicare
If you’ve been suffering from hearing issues for some time, the doctor may have recommended that you consider cochlear implants. However, this procedure involves surgery, so you may be worried about the cost. That may leave you wondering if Medicare covers cochlear implants.
Read on to learn how Medicare handles these claims so you can be confident about your coverage.
Are cochlear implants covered by Medicare?
Medicare will cover some of the costs associated with cochlear implants. Coverage falls under Medicare Part B, which is dedicated to doctor services, outpatient care, preventive services, and medical supplies.
When it comes to a cochlear implant, Medicare coverage considers it a prosthetic device that you may need to replace a bodily function. Therefore, it’s a covered claim when considered “medically necessary.” However, you will need to get a Medicare-enrolled doctor or health provider to recommend it first.
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How much of the costs of cochlear implants are covered by Medicare?
Cochlear implants may cost anywhere between $30,000 and $50,000 on average. As there is Medicare coverage for cochlear implants, you may be able to get 80% of the amount approved by Medicare after you have met your Part B deductible.
You may need to talk with an agent to determine exactly how much Medicare will cover. The amount may vary from one individual to the next based on various factors, including the extent of your hearing problem and the kind of solutions you’ve looked at before considering this type of surgery. Also, you can only work with a provider recognized by Medicare and able to receive payments through the Medicare system.
Remember that when it comes to cochlear implants and Medicare coverage, Medicare will not necessarily meet the cost that an individual doctor or supplier intends to charge you.
In addition, Medicare administrators may have notional rates for this type of work and thus may only approve a portion of your doctor’s bill. In this case, you may be responsible for the difference.
Will Medicare cover additional costs and accessories?
You may need ongoing support after your surgery, and Medicare might pay for clinical care or accessories that keep your implants functioning correctly. However, you may want to consider whether you can meet your ongoing costs out of your own pocket, as submitting a Medicare claim every time you need ongoing care may be challenging.
Before having surgery, check with your provider about these ongoing costs and how your Medicare coverage will apply.
Will Medicare cover hearing aids instead of cochlear implants?
Some states insist that health insurance providers cover hearing aids for children and younger people, but often these aids are considered to be elective devices. Medicare does not currently offer coverage for hearing aids.
What are cochlear implants?
These implants are small electronic devices consisting of two separate portions. You have to place one behind the ear and need to get the other one surgically implanted underneath the skin.
The design should improve your quality of life and enable you to experience sensations or sounds you would not otherwise have been able to. In this way, they are significantly more advanced than a standard hearing aid.
What are the pros and cons of cochlear implants?
As you can claim part of the cost for your cochlear implant through Medicare, you may want to weigh the pros and cons associated with this procedure, as reported by the U.S. Food and Drug Administration (FDA).
Some patients say they can hear completely different sounds and recognize distinct voices following the surgery. They may be able to watch TV without captions and enjoy music again. Others report post-surgery side effects such as infection, dizziness, bleeding, swelling, or ringing in the ear.
The Bottom Line on Medicare Insurance and Cochlear Implants
If a doctor or recognized healthcare provider recommends that you need cochlear implant surgery, you can file a claim through Medicare Part B. Once you have paid the deductible, Medicare will pay up to 80% of the cost of the procedure.
Remember that the maximum Medicare will pay may be lower than the amount requested by the provider. Always examine your costs and coverage before committing to a procedure.
Are you looking for free insurance quotes?
Your one-stop online insurance guide. Get free quotes now!
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Leslie Kasperowicz
Farmers CSR for 4 Years
Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...
Farmers CSR for 4 Years
Editorial Guidelines: We are a free online resource for anyone interested in learning more about insurance. Our goal is to be an objective, third-party resource for everything insurance related. We update our site regularly, and all content is reviewed by insurance experts.