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Does Medicare cover cochlear implants​?

Does Medicare cover cochlear implants​?

Medicare can cover cochlear implants for those who meet the eligibility requirements.The costs may vary depending on whether the procedure is inpatient or outpatient.Medicare eligibility for cochlear implantsFor Medicare to pay for cochlear implants, a person must have:a diagnosis of bilateral moderate-to-profound sensorineural hearing impairment with limited benefit from standard hearing aidsthe ability to understand and participate in training and rehab after surgeryan accessible cochlear lumen, which is the fluid-filled area in the inner ear, that's suitable for implantationAlso, a person must not have:a middle ear infectiondamaged areas in the auditory nerve and sound areas of the central nervous systemother conditions that could prevent a safe surgeryWhat is the cochlear implant 60-60 rule?The 60-60 rule refers to specific standards a person must meet to qualify for cochlear implants.The first 60 refers to the pure-tone average (PTA). A healthcare professional can check whether someone's ear with less hearing loss has a PTA of 60 decibels of hearing level or greater.The second 60 refers to word recognition. On a hearing test, a person must have a word recognition score of 60% or less.If someone meets these standards, they can qualify for cochlear implants.Cochlear implant costs with MedicareAccording to Medicare's 2025 national average data, the average cost of cochlear implantation surgery in a hospital outpatient department is $939. This cost includes doctors' fees and facility costs.Cochlear implantation procedures occur in ambulatory surgical centers, which are outpatient facilities. They have an average cost of $569.In both instances, Medicare Part B may typically cover the costs.Out-of-pocket costs can include premiums, deductibles, copayments, and coinsurance. The standard 2025 monthly Part B premium is $185, and the deductible is $257. Once a person pays their deductible, they must typically pay a 20% coinsurance.If a person experiences a hospital admittance, Medicare Part A may cover the costs of cochlear implants. Part A costs include a 2025 deductible of $1,676. After paying this, the first 60 days in the hospital are not subject to any other out-of-pocket expenses.
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