Does Medicare Cover Hearing Aids

Summary: As we age, it’s common to lose at least some hearing ability. Many beneficiaries wonder if Medicare covers hearing aids. Here, we will answer that question and more about what Medicare can offer you for hearing aid coverage. Estimated Read Time: 7 mins

Table of Contents:

1. Will Medicare Pay For Hearing Aids?
2. Do Medicare Advantage Plans Cover Hearing Aids?
3. Do Medicare Supplement Plans Cover Hearing Aids?
4. How Much Do Hearing Aids Cost?
5. Changes in Hearing Aid Coverage With Medicare
6. Will Medicare Cover Over-the-Counter Hearing Aids?
7. Why Doesn’t Medicare Cover Hearing Aids?
8. Does Medicare Pay for a Hearing Test?
9. Medicare Coverage for Cochlear Implants

As we age, many of us face hearing loss, and the need for hearing aids increases. Most hearing loss is irreversible, but it is also treatable, thanks to hearing aids. Hearing aids can help you follow conversations and socialize as you normally would. Hearing aid use also lowers the risk of developing dementia later in life.

One of the biggest questions beneficiaries ask when enrolling in Medicare is, “Does Medicare cover hearing aids?” If you are a Medicare beneficiary or will be soon, this question may be on your mind. Below, we provide the information you need about Medicare coverage for hearing aids and how to pay for them.

Will Medicare Pay For Hearing Aids?

Unfortunately, Original Medicare (Medicare Part A and Part B) does not provide coverage for hearing aids or exams for fitting hearing aids. Thus, beneficiaries are responsible for 100% of these costs as Original Medicare does not deem hearing aids medically necessary.

In some cases, Medicare may cover hearing exams if your practitioner orders them in conjunction with another medical issue. For example, if your provider requests a diagnostic hearing and balance exam because you have a history of falling regularly, Medicare Part B will provide coverage.

However, if you discover a hearing problem, Medicare will not pay for hearing aids. If you have Medicare and want to receive coverage for hearing aids, you must seek an additional policy.

Do Medicare Advantage Plans Cover Hearing Aids?

Medicare Advantage plans (Medicare Part C) may offer hearing benefits that include hearing aid coverage. However, not all plans have this benefit, and the coverage varies per plan. It’s also important to note that the availability of any Medicare Advantage plan is based on your state and ZIP code.

Before signing up for a Medicare Advantage plan, you must be sure it’s available in your area and that the network includes your preferred providers and the hearing coverage you require. Also, check to ensure that you have access to a local and reputable audiologist within your plan network for your hearing health needs.

When you enroll in a Medicare Advantage plan, you should budget for out-of-pocket costs such as copayments, coinsurance, and the plan’s deductible. If you purchase hearing aids, you will want to keep the plan’s maximum hearing benefit in mind.

Do Medicare Supplement Plans Cover Hearing Aids?

Medicare Supplement plans work as supplemental coverage to Original Medicare. Also known as Medigap, these policies only cover the out-of-pocket balance of what Medicare covers. Because Medicare does not cover hearing aids, Medicare Supplement plans don’t cover them either.

You can, however, enroll in a separate insurance policy that includes hearing services and hearing aids. Often, hearing coverage comes bundled with vision and dental coverage. Hence, Medicare beneficiaries receive coverage for the most significant gaps in Original Medicare from such ancillary policies. Policy coverage limits vary depending on the carrier.

How Much Do Hearing Aids Cost?

Prescription hearing aid costs typically range from around $1000 to $8000 per pair, with an average of $4600. This cost may include a consultation, hearing test, fitting, follow-up adjustments, battery replacements, future cleanings, and a warranty against loss or damage.

However, since late 2022, there are also less expensive over-the-counter options for hearing aids. The average cost of OTC hearing aids is around $1600 per pair, and the typical range is anywhere from $250-$3000 per pair.

Changes in Hearing Aid Coverage With Medicare

In recent years, the high cost of hearing aids has attracted the attention of Congress. Legislation is in the works to make hearing aids more affordable for Medicare beneficiaries. However, nothing has yet been passed to lower the cost of hearing aids for those on Medicare.

In early 2021, lawmakers introduced the Medicare Hearing Aid Coverage Act (H.R. 244) of 2021 in the House of Representatives. The bill would allow Medicare to cover hearing aids for beneficiaries with moderate to severe hearing loss.

If the bill passes, Medicare will pay for one pair of hearing aids every five years for each beneficiary. However, over-the-counter hearing aids would not receive coverage. Additionally, a qualified audiologist or physician would also need to deem the hearing aids necessary for the patient.

The Medicare Hearing Aid Coverage Act was reintroduced in January, 2023 but it still hasn’t passed.

It is difficult to say if and exactly when those on Medicare can take advantage of expanded hearing benefits in the future. The goal of the legislation is to make costly elements of healthcare more affordable for seniors and disabled individuals.

Will Medicare Cover Over-the-Counter Hearing Aids?

Although the Medicare Hearing Aid Coverage Act is currently in limbo, the federal government has passed some relief for those in need of hearing aids.

Congress has allowed the U.S. Food and Drug Administration (FDA) to approve over-the-counter hearing aids in a ruling passed in August of 2022. More affordable hearing aids have been available over-the-counter in stores across the country since October, 2022.

OTC hearing aids are designed for those with mild to moderate hearing loss. Though they are available in stores and online without a medical exam or prescription they still must meet strict regulatory standards as approved by the FDA.

At around $250-$3000 per pair, OTC hearing aids are still pretty expensive. However, that’s still a savings from the average cost of prescription hearing aids from an audiologist.

Original Medicare will not cover any over-the-counter hearing aids. Any supplemental Medicare options won’t cover any of the costs either. You can only pay out-of-pocket for OTC hearing aids.

FDA rules for OTC hearing aids include limits on noise levels, frequency, distortion, and insertion depth. They also require safety information on all labels.

It’s important to note that if you have more significant hearing loss, then you may still need stronger prescription hearing aids. If you have trouble hearing louder sounds, such as a horn honking, or if you have trouble hearing conversations in a quiet room, then your hearing loss could be considered more severe. In that case, it’s recommended to speak to an audiologist for a hearing tool that will work for you.

Why Doesn’t Medicare Cover Hearing Aids?

The federal health insurance program Medicare was established in 1965 and hearing aid technology wasn’t well known yet. When Medicare was passed, hearing aids were specifically excluded from benefits in the Social Security Act. The demand for hearing aid coverage has been rising ever since, and it’s not slowing down, as about one-third of adults 65+ have some form of hearing loss.

As of today, CMS still doesn’t deem hearing aids as medically necessary, so Medicare Part A or Part B does not cover them.

Does Medicare Pay for a Hearing Test?

Medicare Part B pays for hearing exams when a practitioner deems them medically necessary. However, it does not pay for tests to measure hearing loss and determine if you need hearing aids.

If your healthcare provider does recommend a medically necessary test, Medicare Part B will cover 80% of the costs. You would have to cover the remaining 20% out of pocket unless you also have a Medigap plan which could cover that 20%.

For example, if you have Medicare Supplement Plan G, your hearing exam costs could be fully covered if the procedure qualifies under Original Medicare. You would also have to meet your Part B deductible.

Medicare Coverage for Cochlear Implants

When a doctor deems it medically necessary and the beneficiary has met specific criteria, Medicare Part B will cover cochlear implants. Since Medigap pays after Original Medicare, those who have a Medicare Supplement plan will likely spend the least out-of-pocket for medically necessary cochlear implants.

Talk to your doctor about the cost of cochlear implants with your policy. Further, discuss the specific rules or criteria that may apply.

FAQs About Medicare Coverage for Hearing Aids

How to Get Help Paying for Hearing Aids with Medicare

Depending on your situation and where you live, federal, state, or local programs may help you pay for an audiologist visit and hearing aids. If you qualify, Medicaid pays for hearing aids in 29 states.

However, if your income is too high to qualify for Medicaid, you may be able to get assistance through your county Social Services department.

Another option for hearing aid coverage when you are on Medicare is to purchase an ancillary policy alongside your Original Medicare coverage – with or without Medigap. To explore policies, call the number above or fill out our online rate form to get started!

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