Medicare Advantage Plan Members with Hearing Aid
It is estimated that by 2023, 8.9 million Medicare Advantage members will experience hearing loss. Of these members, between 6.5 million and 8.9 million will have hearing aid coverage.
Medicare Advantage Enrollment
- In 2019, there were 22 million people enrolled in Medicare Advantage Plans. Since enrollment is expected to grow at a rate of between 4% and 6% per year until 2023, we assumed growth of 5% and were able to estimate the total number of enrollees in 2023 at 26.7 million (calculation provided in the research strategy).
Medicare Advantage Enrollees with Hearing Loss
- It is estimated that in 2023 at least 8.9 million Medicare Advantage enrollees will experience hearing loss (calculation provided in the research strategy).
Medicare Advantage Enrollees with Hearing Aid Coverage
- In 2015, only 47% of Medicare Advantage enrollees had a plan that covered hearing aids, while this increased to 73% in 2018. This shows that even without laws mandating coverage, insurers are making the move to provide more coverage.
- If the percentage of enrollees choosing coverage that included hearing aids stayed consistent in 2019, that would mean 5.4 million (calculation provided in the research strategy) enrollees with hearing loss would have a plan that covers hearing aids.
- The two largest players in Medicare Advantage are United Healthcare and Humana. Both announced changes and improvements to hearing aid coverage in 2019. This continues a trend that has been happening over the last five years.
- Since there is no definitive way to determine whether more private insurers will decide to cover hearing aids, or which plans enrollees will ultimately choose, a range of possible numbers is being provided, assuming somewhere between 73% and 100% of enrollees will have coverage. We assumed that the coverage would not decrease since the trend over the last five years has been to increase coverage.
- It is estimated that between 6.5 million and 8.9 million enrollees with hearing loss will have a Medicare Advantage plan with hearing aid coverage in 2023.
States That Mandate Hearing Aid Coverage
- "Colorado, Delaware, Georgia, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Missouri, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Tennessee, and Texas require that health benefits plans in their state pay for hearing aids for children. Arkansas, Connecticut, Illinois, New Hampshire, and Rhode Island require coverage for both children and adults. Wisconsin requires coverage for both hearing aids and cochlear implants for children."
- Based on the above, only four states, Arkansas, Connecticut, Illinois, New Hampshire, and Rhode Island, require hearing aid coverage for adults. That means in all other states, coverage would be at the discretion of the insurers.
To estimate the total number of Medicare Advantage enrollees in 2023, we did the following calculation:
22 million (2019 enrollees) * 1.05*1.05*1.05*1.05 (5% growth for 4 years) = 26.7 million enrollees in 2023 It is estimated that 1 in 3 people aged 65 or over has hearing loss. We made the assumption that the people who are members of Medicare Advantage have hearing loss at the same rate as the general population. Based on that statistic, and using the estimated number of Medicare Advantage enrollees in 2023, we were able to estimate the number of Medicare Advantage members with hearing loss in 2023 as follows:
26.7 million (2023 enrollees) *1/3 (1 in 3 people with hearing loss) = 8.9 million enrollees with hearing loss in 2023.
It should be noted that the number of people with hearing loss increases as people age. It is reported that two out of three people over 70 have difficulty hearing. Therefore, if a significant number of Medicare Advantage members are over 70, compared to those between 65 and 70, the estimate provided above would be on the low side. Unfortunately, statistics on the number of enrollees that were between 65 and 70 was not publicly available. Our estimate would be the minimum number of enrollees with hearing loss in 2023.
To estimate the number of enrollees with hearing loss that were covered by hearing aid insurance in 2019 we used the following calculation:
22 million (2019 enrollees) * 1/3 (1 in 3 people with hearing loss) * 0.73 (people who chose a plan with hearing aid coverage in 2018/2019) = 5.4 million
To estimate the number of enrollees with hearing loss that were covered by hearing aid insurance in 2023 we used the following calculations:
8.9 million (2023 enrollees with hearing loss) * 0.73 (people who chose a plan with hearing aid coverage in 2018/2019) = 6.5 million
8.9 million (2023 enrollees with hearing loss) * 1.0 (assuming by 2023 all insurers offering Medicare Advantage will cover hearing aids) = 8.9 million
Because Medicare Advantage coverage is provided by private insurers, a definitive answer on how many enrollees will have hearing aid coverage in 2023 could not be determined because it is dependent on what each private insurer decides to provide. Since there is currently no federal law that mandates hearing aid coverage, each provider is instead guided by any state laws. Information on the states that require hearing aid coverage is provided above.