What You Need to Know About Medicare Hearing Aid Coverage
Hearing loss is common. Approximately 15% of Americans aged 18 and older report some trouble hearing, and the prevalence and severity of hearing loss only increases with age. Nearly 25% of those between ages 65-74 have disabling hearing loss. That number increases to 50% for adults aged 75 and above.
Although hearing loss is common, hearing aids are expensive, and not covered very well by Medicare. For most people, a typical pair of hearing aids can range from just under $2,000 to as much as $10,000 or more.
In this guide, we’ll walk through some facts on hearing loss and hearing aids, then dive into how Medicare coverage works for hearing aids. We’ll also share some of the questions you should ask if you or a loved one on Medicare needs hearing aids.
Key Takeaways
Original Medicare and Medicare Supplement plans do not pay for hearing aids.
Some Medicare Advantage plans will pay for some of the costs of hearing aids.
Different Medicare Advantage plans have different rules and coverage options for hearing aids, so it’s important to understand how your plan works.
Over-the-counter (OTC) hearing aids became available after approval from the FDA in 2022.
OTC hearing aids are best for those with mild-to-moderate hearing loss.
How do hearing aids work?
Hearing aids work to boost or amplify sound to help people with hearing loss hear more clearly and participate more fully in conversations and daily life. Hearing aids receive sound through a microphone, convert the sound into electrical signals, and send them through an amplifier, which acts like a speaker inside the wearer’s ear.
Hearing aids don’t replace or repair any damage, but rather increase the volume to help those who don’t hear as well. There are three different styles of hearing aids: behind-the-ear (BTE), in-the-ear (ITE), and canal. Hearing aids can also have two different types of electronics: analog and digital. Both have their advantages, which you can learn more about here.
Who needs hearing aids?
Many people can benefit from using hearing aids, but usage doesn’t match up with need. More than 1.5 billion people worldwide have hearing loss in at least one ear and about 13% of people ages 18 and older experience some difficulty hearing—even while using hearing aids. But people experiencing hearing loss tend to wait about seven years before getting help.
If you experience mild to severe hearing loss, you should consult an audiologist who can help you determine the best solution. With over-the-counter hearing aids available for mild to moderate hearing loss, there’s a good solution on the market for everyone who’s hearing impaired.
Perhaps one of the reasons hearing aid usage doesn’t match hearing aid needs is because most health insurance plans don’t pay for hearing aids.
How can hearing loss affect us?
Hearing loss affects more than just our hearing. Hearing and speech are important for communication, which is vital for our social needs. The prevalence of hearing loss increases with age, and so does loneliness. Both are believed to have impacts on both our mental and physical health. Hearing loss can affect our mental health and wearing hearing aids may even reduce the risk of dementia.
With hearing loss being common as we age, it’s only natural to wonder how Medicare covers hearing aids.
Will Medicare pay for hearing aids?
Original Medicare (Part A & Part B) covers hearing and balance examinations that are ordered by a doctor or healthcare provider, but it does not cover hearing aids. This means that for Medicare beneficiaries on Original Medicare (with or without a Medicare Supplement plan), Medicare does not pay for hearing aids, in part or in whole.
Some Medicare Advantage (also called Medicare Part C) plans offer hearing coverage, inclusive of hearing aids. Not every plan does, and those that do are not all the same. So, it's important to check with your Medicare advisor to ensure you're receiving the benefits you need. Also, be sure to understand exactly how hearing aids are covered before making your choice because your costs will be different depending on the type of hearing aids you want and coverage limits.
How much will hearing aids cost with Medicare Advantage?
The retail price of hearing aids can sometimes be more than $4,000 per hearing aid. Some Medicare Advantage plans have a hearing aid benefit that can significantly reduce the price you pay. Let’s explore how.
Negotiated rates with specific providers
Medicare Advantage plans negotiate pre-set rates with particular hearing providers where you purchase your hearing aids, passing a ton of savings on to you. Because Medicare Advantage plans have pre-negotiated rates with hearing aid providers, many plans require you to purchase from their partner providers. When you do, you receive the most affordable prices.
But this isn’t always a requirement. Some plans will help to pay for hearing aids that you purchase from another provider. These plans provide “out-of-network” hearing coverage, and typically require you to pay a co-insurance of 30-50% of the cost of the hearing aids.
Copayments and cost sharing
Some plans require that you pay a portion of the cost of hearing aids, called a co-pay. The co-pay can be as low as a few hundred dollars for a standard hearing aid or as much as ~$2,000 for newer, top-of-the line hearing aids.
Other plans will instead offer to pay a maximum amount for hearing aids. This amount can range widely from ~$500 to more than $2,500 so it’s important to choose your plan carefully if covering the cost of hearing aids is a priority for you.
For plans like this, if you choose a hearing aid under the maximum amount your Medicare plan will pay, you don’t pay anything. If you choose a more expensive hearing aid, you are responsible for the difference.
Because each Medicare Advantage plan is different, it’s important to understand exactly how the plan you enroll in works. If you’re unsure, you can reach out to one of our licensed Advisors or member Advocates to get help navigating your plan. And if you want or need to explore other plans and their benefits, you can do so during the Open Enrollment Period that occurs every fall from October 15 - December 7.
Is there non-Medicare financial assistance for hearing aids?
Hearing aids can be expensive, which may be one additional reason why usage doesn’t match up with needs. There are some nonprofit organizations that provide financial assistance or lower-cost options for hearing aids. If you’re seeking help, reach out to the National Institute on Deafness and Other Communication Disorders (NIDCD) Information Clearinghouse. They can point you in the right direction to get help paying for hearing aids.
Choosing the best Medicare plan to fit your health and hearing needs
If you or a loved one consider a Medicare Advantage plan to help cover hearing aids, it’s important to choose a plan based on all of its benefits, not just the hearing benefits.
For example, you will want to check that your preferred doctors are in-network, your prescriptions are covered, and that the plan provides other benefits that may also be important to you, like dental benefits, vision coverage, and gym memberships.
If you have any questions about the best Medicare plan for your needs, give us a call! Unlike other advisors, who only recommend plans from insurance companies that pay them. We look at all of your Medicare options to ensure we find the best one for your specific health and financial needs.
Our advice is always free, and requires no obligation from you!
If you would like a free personal consultation you can schedule a call with us by clicking here. Or you can call us directly at (855) 900-2427.