Medigap Plans and Their Impact on Hearing Health
Navigating Medicare can often feel like trying to learn a new language. Between the different "Parts" and all of the supplemental options, it’s easy to get lost, especially when trying to figure out how your plan affects your hearing health.
If you’re approaching age 65 or are already enrolled in Medicare, you may have heard of Medigap plans. While these policies can help manage certain healthcare costs, there can be confusion about what they do and don’t cover.
We’ll cut right to the chase: Medigap covers copays and deductibles; it does not cover the cost of hearing aids. In this article, we’ll look at why that is.
What Is Medigap?
Medigap, also known as Medicare Supplement Insurance, is a type of extra insurance. You can buy a Medigap policy from a private health insurance company to help you cover out-of-pocket costs that Original Medicare (Part A and Part B) doesn't cover.
These out-of-pocket costs are often referred to as "gaps" in coverage, which can include:
- Copayments
- Coinsurance
- Deductibles
To buy a Medigap policy, you’ll need Original Medicare (Part A and Part B). [1]
As you look at plans, you’ll see they are standardized and identified by letters (e.g., Plan G or Plan N). Their primary goal is to protect you from unexpected out-of-pocket costs for medically necessary services that Original Medicare already covers, such as hospital stays and doctor visits.
Does Medigap Cover Hearing Aids?
Important Note: Medigap is strictly a policy designed to cover copays and deductibles for Medicare-approved services. If Medicare doesn't approve the service (like a hearing aid purchase), the Medigap plan generally won't pay the remaining balance.
Medigap vs Medicare Advantage
It can be easy to confuse Medigap with Medicare Advantage, but there are distinct differences between the two. When comparing Medigap vs Medicare Advantage, you’ll want to understand the differences in hearing coverage:
● Medigap. Working alongside Original Medicare, it allows you to see doctors who accept Medicare. Standard Medigap plans generally do not include dental, vision, or hearing coverage, although some carriers may offer separate “new” or "innovative" benefits. [3] Medicare Advantage (Part C). These are "bundled" plans offered by private companies. They replace Original Medicare and often include extra benefits, such as prescription drug coverage and, crucially, routine hearing exams and hearing aid coverage.
People may assume that because they have Original Medicare and Medigap, they don’t need any other hearing care coverage. But hearing aid benefits are more commonly available in Medicare Advantage plans.
Clearing Up the Confusion
Because Amplifon partners with many insurance providers to offer discounted hearing aids and services, beneficiaries sometimes assume that any Medicare-connected insurance plan will unlock these benefits. It is important to verify your specific coverage:
- If you have a Medigap plan, you likely do not have a funded hearing-aid benefit under that policy.
- However, you may still have access to Amplifon’s savings programs. Want to know for sure? Call our team at (877) 934-0743 and verify your benefits.
A Note of Advice: Always check your plan's details. If you have Medigap and are facing high costs for hearing care, there are options out there. While your Medicare coverage may not foot the bill, organizations like Amplifon can often help you access high-quality hearing technology at significantly lower negotiated rates.
Avoid an Unwanted Surprise at the Audiology Clinic
Medigap can be a powerful tool for financial protection against hospital and medical copays, but it’s not a solution for hearing loss costs. Understanding Medigap’s limitations helps you better manage your budget and prevent surprises at the audiology clinic.
If you’re unsure about your coverage, review your policy. Not sure if you even have hearing health insurance? You can also use our insurance benefits checker to understand what coverage you have and where there may be gaps!
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We appreciate you reaching out to us.
Our hearing care advocates will call you shortly and help answer all your questions.Sources:
1. Medicare. What's Medicare Supplement Insurance (Medigap)?
2. Medicare. Learn What Medigap Covers.
3. Kaiser Family Foundation. (2024.) Key Facts About Medigap Enrollment and Premiums for Medicare Beneficiaries.
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