Medicare covers cochlear implantation "for the treatment of bilateral pre-or post-linguistic, sensorineural, moderate-to-profound hearing loss in people who exhibit minimal improvement with amplification," according to the most recent National Coverage Determination. This includes adults over age 55 or younger individuals with acquired deafness.
There are two types of cochlear implants: one that uses an electrode placed directly into the cochlea to transmit electrical signals to the remaining hair cells which then stimulate the brain's auditory nerve fibers, and one that uses a microphone attached to a speaker unit worn by the patient that receives audio signals from the implant transmitter wirelessly. Both types of implants can provide some relief for patients suffering from severe to profound hearing losses in both ears. However, cochlear implants do not restore hearing to those who are deaf. They replace the damaged nerve fibers that would have transmitted sound information to the brain.
Cochlear implants are expensive ($100,000 per device), require frequent maintenance, and cannot be used during sleep. However, they do allow many people who were previously unable to communicate effectively to hear again. Hearing aids alone can't do this. The only alternative for these patients is a cochlear implant. Cochlear implants are generally recommended for patients who understand the need for continuous access to adequate medical care and support systems for life after surgery.
Medicare, Medicaid, the Veteran's Administration, and other public health care insurance cover cochlear implants. Because cochlear implants are deemed medically essential for the treatment of severe to profound hearing loss, the majority of US health insurers fund the procedure. It is important to understand that although most insurers cover cochlear implants, they may have different requirements in terms of who can receive them and where they can be performed.
In section 50.3 of the Medicare National Coverage Determinations Manual, there is now an NCD for cochlear implants. Medicare now covers these devices if the speech recognition scores are 30% or below. This coverage includes both unilateral and bilateral cochlear implants.
This coverage was initiated under PDSP 5.0. It became effective on January 1, 2005.
Prior to this new policy, hearing aids were the only device available for people who were not able to hear with their ears but did have some sound perception with their eyes. Cochlear implants were not considered affordable by most health insurance companies at the time they were developed. But through private fundraising efforts, several thousand people worldwide have been fitted with these life-changing devices since the 1980s.
People who receive cochlear implants can understand speech better than before they were implanted. This allows them to communicate more easily with others. And because they no longer have to listen to everything they say, they can focus their attention on conversations with others.
Cochlear implants are medical devices used to treat sensorineural hearing loss. This condition occurs when there is damage to the hair cells in the ear that transduce acoustic signals into nerve impulses. Hair cells are the sensory receptors of the ear; they are located inside the cochlea.
Medicare, TRICARE, the Veteran's Administration, and other federal health programs cover cochlear implants (CI). State Medicaid programs also cover CIs. Most companies that sell hearing devices include cochlear implants in their product line.
How do you get cochlear implants? Your doctor will first try to fit you with hearing aids. If this isn't successful, you may be referred to a center that performs cochlear implant surgery. The surgeon will take an image of your inner ear using magnetic resonance imaging (MRI) or computerized tomography (CT) scans. This image is used to create a three-dimensional model of your inner ear. Using this model, the surgeon can design a custom-made device for your specific case.
Cochlear implants work by transmitting sound signals directly to the part of the brain that processes hearing information. You will receive an internal microphone along with the implant. This microphone is connected to the external part of the implant. You wear it like a necklace or headband. It fits under your clothes and is removed when you want to swim or take a shower.
Cochlear implants are very effective at restoring hearing to people who are deaf or who have severe hearing losses.
"Medicare does not fund hearing aids or hearing aid fitting tests." Hearing aids and tests are completely paid for by you. Some Medicare Advantage Plans (Part C) provide additional benefits that Original Medicare does not, such as vision, hearing, and dentistry. These plans can also be called managed care programs because they often include services such as primary care visits with a doctor, specialty visits with a specialist, hospitalization, and more.
However, it is important to understand that Medicare pays only for actual expenses incurred by patients. This means that although hearing aids and hearing aid fittings are not covered by Medicare, their cost may have been covered by another source. For example, if you receive financial assistance from your employer to pay for your hearing aids, then your employer would be the responsible party for any remaining balance after Medicare has paid its portion.
What this means for you is that even though hearing aids are not covered by Medicare, there is no reason for you to worry about paying for them. The only thing you need to know is that your employer will be responsible for paying any remaining balance after Medicare has paid its portion of your hearing aid bill.
If you have any questions about whether Medicare covers hearing aid costs or not, feel free to contact us at any time! We're here to help.