Does Medicare Cover Hearing Aids?

Hearing loss is one of the significant challenges of aging. In fact, according to the National Institutes of Health, hearing loss can affect the quality of life of one in four people between 65 and 74 — with that increasing to one in two for those over 75. The effects of hearing loss are far-reaching, affecting relationships both at home and in the community. It can also increase the chances of cognitive decline in later years. While hearing aids can be the solution, less than one in three adults who could benefit has ever used them.

The cost of hearing aids is the primary obstacle: with most conventional devices costing thousands of dollars, many seniors find them unaffordable. Fortunately, legislators are doing what they can to lower the cost of products that serve part — but not all — of the population. Historically, costs have remained high because hearing aids are considered medical devices controlled by the U.S. Federal Drug Administration (FDA). As such, the category is protected from competitive forces, which would typically bring pricing down.

Since most of the senior population with hearing problems also have Medicare coverage, the question becomes: Does Medicare cover hearing aids? If so, which hearing aids? And what about hearing exams?

The different parts of Medicare were created to cover different things. For example, Original Medicare’s Part A and Part B offer hospital and medical coverage, but don’t typically include prescription drug coverage. Part C (Medicare Advantage) provides everything Part A and Part B do, often bundled with prescription drug coverage and additional benefits such as vision, dental, and hearing plans. Part D covers prescription drugs through private, standalone policies. And Medicare Supplement Insurance (Medigap) plans complement Original Medicare and reduce the amount left to pay out of pocket. So, where do hearing aid solutions fit in?

As the demand for hearing aids increases, politicians have tried to pass legislation that adds new coverage or expands what already exists. However, the process is slow. So, does Medicare pay for hearing aids yet? At this article’s time of writing in 2023, this is the status of coverage of the two significant aspects of hearing solutions: hearing aids and hearing exams.

• Part A covers neither hearing aids nor hearing exams
• Part B covers some hearing exams but not hearing aids
• Part C (Medicare Advantage) usually covers hearing exams and hearing aids, but it depends on your particular plan
• Part D covers neither hearing aids nor hearing exams
• Medigap covers 20% of the hearing exam covered by Part B

It’s also important to note that there are a few Medigap policies that cover additional hearing aid benefits.

Original Medicare won’t cover the cost of hearing aids or the routine exams performed by audiologists to fit them. You will have to pay 100% of the cost out of pocket.

However, Medicare Part B will cover diagnostic exams related to hearing or balance if your doctor prescribes the exams for medical reasons, but not for hearing aid placement. Medicare also covers surgically implanted devices, such as cochlear implants, classified as prosthetic devices. In this instance, you’ll pay the 20% copayment of the Medicare-approved amount after Medicare pays its 80% — assuming you have met that year’s Part B deductible. If testing is done in an outpatient hospital setting, you could be required to pay a hospital copayment.

If you have a Medigap plan, that supplement will pick up the 20% balance on hearing exams. However, if someone asks, “Does Medicare Plan F pay for hearing aids?” the answer is no because Plan F only covers the coinsurance for Original Medicare, which doesn’t cover hearing aids.

The best option for having your whole hearing solution covered will typically come from a Medicare Advantage plan because Medicare Advantage plans cover hearing exams for medical reasons. Up to 97% of such plans cover routine hearing exams but don't necessarily pay for hearing aids. The coverage varies from plan to plan, some with maximum dollar caps or frequency limits on how often the benefit can be utilized. KFF clarifies that plans may specify the following:

• Which hearing aid brands are available
• Whether they can be analog or digital
• Whether the style can be for the inside or outside of the ear
• If earmolds, fitting exams, and batteries are included

Depending on what each plan pays for, getting hearing aids can mean high out-of-pocket costs even if you have hearing coverage.

There’s one other coverage possibility for any beneficiaries who are dual-enrolled in Medicare and Medicaid: depending on your state of residence, some level of hearing-aid coverage may be available.

So how much does a pair of hearing aids cost? Hearing aids vary considerably in price, based primarily on the type and technology of the hearing aid. Are they Bluetooth-capable? Are the batteries rechargeable? Are the hearing aids visible? Forbes quotes prices ranging from $2,000 to $8,000 or more for a set of two, as well as the following pricing for each hearing aid:

• In-the-Ear (ITE) for people with mild to severe hearing loss: $3,167
• Behind-the-Ear (BTE) for people with mild to profound hearing loss: $2,698 to $3,247
• Receiver-in-Canal (RIC) for mild to severe hearing loss: $2,466
• In-the-Canal (ITC) for mild to severe hearing loss: $2,500 to $4,900
• Completely-in-Canal (CIC) for mild to moderate hearing loss: $1,500 to $4,000
• Invisible-in-Canal (ITC), similar to CIC aids: $1,000 to $3,100

The pricing listed above generally includes:

• The retail price of the device plus
• The professional audiology services to fit and program the aids
• Repairs and maintenance, often for two to four years
• Diagnostic testing

Because the services can account for a large percentage of the cost, there is a trend toward unbundling the pricing so products and services can be purchased separately. This trend lowers upfront pricing with a pay-as-you-need model for follow-up audiologist visits.

Pricing also varies by distribution point, with audiologists, otolaryngologists, and hearing aid specialists charging the most and retailers such as Costco charging the least — as little as $700 per aid — although all models may not be available.

In addition to conventional hearing aids, personal sound amplification products (PSAPs) are available without a prescription between $100 to $500 each. The FDA or other regulatory agencies do not regulate PSAPs. As their name implies, they simply amplify the sound and remove some environmental noise — which may be enough for early, less complex hearing issues — although their capabilities are expected to improve with technological advances.

Over-the-counter (OTC) hearing aids are becoming available to adults over 18 following legislative efforts that were finalized in 2022. These government-regulated units are available through stores and online retailers, with more popular name-brand models running $700 to $3,000 per pair. Like conventional hearing aids, they’re designed for adults with moderate hearing loss, but do not require professional consultation for fitting and tuning. You fit, self-program, and adjust them to your needs. Assessments can rely on telehealth visits and online- or app-based hearing tests. When purchasing OTC hearing aids, you should consider the device’s adjustability, warranty, trial period, customer support, sound performance, and battery life.

Medicare Advantage plans themselves can vary in price by issuing company, specific plan, the state where you live, age, and specialized coverage. Be sure to read the fine print to see what’s covered in any hearing plans offered. Copayments for hearing aids can vary from $0 to thousands. Some plans may cover the cost of the devices but not the audiologists’ services, while others limit audiologist coverage to in-network only. Device coverage can range from your plan’s cap to 100%.

Hearing aid prices with Medicare will vary. For example, with some plans, hearing aids covered by Medicare can reach up to $2,000 per ear. Annual hearing exams may cost you $0. The annual copay for advanced hearing aids could cost $699 per ear, with premium versions being as high as $999. To avoid disappointment, take time to explore the premiums, deductibles, copays, and out-of-pocket maximums of your plan, in addition to how that plan’s hearing aid package meets your needs.

Hearing aid batteries can be an expensive ongoing cost for Medicare hearing aids. So, are hearing aid batteries covered by Medicare? Most devices come with batteries, but you may have to buy replacements separately. If your Medicare Advantage offers an over-the-counter allowance, you may be able to use that to purchase batteries.

Among all the Medicare plans, Medicare Advantage offers the best hearing benefits. For example, Original Medicare only pays for “medically necessary” hearing exams, and hearing aids, unfortunately, aren’t deemed medically necessary. But Medicare Advantage can pay for all aspects of the hearing aid solution, although in differing percentages. Coverage depends on the specific plan and may require prior authorization from your insurer.

When choosing a plan, you should seek out one of the 97% of Medicare Advantage plans that cover hearing exams and the 88% of plans that cover hearing aids. However, remember that “covering” is not the same as “covering completely,” so you could still be left with high out-of-pocket costs if you don’t do proper research.

The importance of caring for your hearing issues cannot be exaggerated. Today, given the new options available — including PSAPs and OTC devices — hearing aids have become more affordable. However, they still represent a significant expense.

To find the right insurance solution for you, it’s best to speak with a licensed insurance agent. Call us at 844-910-2061 for further assistance, or visit us at Open Medicare.

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