Medicare Advantage & Hearing Health
Delivered November 6, 2019. Contributor: Amy R.
Goals
To benchmark Medicare Advantage (MA) beneficiary hearing aid coverage and its growth potential in the MA market through to 2023 in an effort to draft a hypothetical market segmentation.
Early Findings
Please note that data specific to Medicare Advantage plan hearing aid coverage is fragmented based on each plan’s desire to promote hearing aid coverage. The research team attempted to locate relevant data to add value since triangulations will likely be required to complete the segmentation.
Hearing Loss
- Hearing loss affects 1/3 of all adults over the age of 65.
- Out-of-pocket costs for one hearing aid is ~$2,400 (most people need two which brings the total to almost $5,000). The article states "most people end up paying for hearing aids out-of-pocket."
- The OTC hearing aid market might experience a boom in 2021 if the Over-the-Counter Hearing Aid Act of 2017 continues without revision; this law allows OTC devices to be purchased without prior doctor approval (the devices will be available to the public in 2021).
- 25% ("only one-quarter of Medicare beneficiaries") who need a hearing aid actually receive one.
- 40% of people 60+ and 2/3 of people in their 70s have “clinically important hearing loss.”
- Only about 15%-20% of people who need hearing aids wear them.
Medicare Advantage Plans
- There are no circumstances where Medicare (Part A and Part B) will pay for hearing aids (even if a physician orders a diagnostic test and believes the Medicare beneficiary requires treatment.
- Only some Medicare Advantage programs pay for hearing aids.
- A representative from UnitedHealthcare Hearing noted that "only a small percentage of customers use their Medicare Advantage hearing-aid benefit. There’s a ‘lot of room to educate the market,’ he said. Demand is higher in plans with lower co-pays."
- A rep from Independence Blue Cross said its TruHearing program helps members with a flat copay of $499 to $999.
- 94% of Aetna’s Medicare Advantage plans offer some hearing loss coverage.
- Humana announced on October 1, 2019, that its 2020 Medicare Advantage plans would include dental, hearing, and vision coverage.
- One example showed that an insurance plan’s coverage for a 64 yo to get a set of hearing aids was $1,100.
In addition to this public search, we scanned our proprietary research database of over 1 million sources and were unable to find any specific research reports that address your goals.
Proposed next steps:
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