No. Medicare covers only ear-related medical conditions, not routine hearing care, hearing aids or exams for fitting hearing aids. But with the FDA’s approval of over-the-counter hearing aids for mild to moderate hearing loss, you can now find lower-cost options.
Considered one of Medicare’s main coverage gaps, its lack of coverage for hearing aids means you may have to pay significant bills for hearing care services on your own.
A need unfilled. More than a quarter of adults 65 and older have difficulty hearing, and much of the hearing loss is treatable. About 4 percent of those older adults claimed they had “a lot of difficulty” or “couldn’t hear at all,” according to the Centers for Disease Control and Prevention’s 2019 National Health Interview Survey.
Treating hearing loss is important because of its link to an increased likelihood of memory loss and social isolation. A recent study found that hearing aids may reduce dementia risk by nearly half. This reinforces the idea that hearing well is vital to keeping you safe in your own home.
You foot the bill. The average Medicare beneficiary who used hearing care services paid $914 out of pocket in 2018, the most recent information available, and 10 percent of those who used hearing services spent $3,600 or more of their own money, according to a Kaiser Family Foundation (KFF) study. Traditional hearing aids ordered through an audiologist can often cost $1,000 to $6,000 a pair.
You can get hearing coverage other ways, including Medicare Advantage plans that offer benefits for hearing aids and hearing exams. Also, if you qualify, you may get coverage from Medicaid in some states or through the U.S. Department of Veterans Affairs health benefits. If you have retiree health insurance, that plan may help with the cost.
What hearing coverage does Medicare Advantage offer?
While most Medicare Advantage plans cover hearing aids and exams, that coverage is limited and varies significantly by plan.
Coverage capped. Most Medicare Advantage plans regulate the dollar amount or frequency of hearing aid purchases. In 2021, the average annual limit was $960, ranging from $66 to $4,000, according to the KFF study.
Typically, Medicare Advantage plans limit enrollees to one set of hearing aids a year, but more than a quarter of plans restrict hearing aid coverage to one pair every two years. The KFF study reported that 14 percent cover one set every three years.
Expect different copayments based on the level of digital technology — typically basic, standard, advanced and premium levels. Copays may start around $699 for an advanced-level hearing aid and $999 for a premium-level hearing aid. Because Medicare Advantage plans have such a wide range of hearing coverage, it’s important to compare all plan options in your area.
How to check out plans. To find out what hearing aid coverage Medicare Advantage plans offer, type your zip code into the Medicare Plan Finder and click Medicare Advantage Plan under Plan Type for plans in your area. A green check mark notes plans that include hearing benefits. Then click Plan Details and scroll down to Extra Benefits. You’ll see copayment details for hearing aids, exams, hearing aid fitting/evaluation services and other hearing benefits.
You can visit the plan’s website or contact the plan directly. You may be required to use an in-network provider and have prior authorization for some hearing services.
How else can I save money on hearing aids?
Other options for help with hearing aid costs:
- Hearing discount programs. You may be able to save money on hearing aids by shopping around, joining a discount program or getting help from a charitable foundation. Some Medigap plans also offer membership in hearing care discount programs.
- Leases. You’ll pay more overall for hearing aid subscription plans, just like you might for a car lease, but the idea of a monthly fee rather than paying thousands of dollars at once can help with budgeting.
- Local hearing aid programs. Ask your hearing specialist about local sources of financial help for hearing aids. Many Kiwanis Clubs and Lions Clubs have hearing aid programs. You can also contact your Area Agency on Aging for additional resources.
- Medicaid. Some Medicaid programs cover hearing aids and exams for people who qualify based on income. Contact your state Medicaid program to find out more about coverage and eligibility.
- Retiree coverage. Depending on the plan, retiree health insurance may provide some coverage for hearing tests and discounts on hearing aids or contribute a fixed dollar amount toward them, such as $1,500 every three years.
- Veterans health care. Because hearing injury is one of the top service-related medical issues for military veterans, the U.S. Department of Veterans Affairs provides hearing services and hearing aids for eligible veterans.
Keep in mind
Over-the-counter hearing aids are now available for people with mild to moderate hearing loss, thanks to the U.S. Food and Drug Administration–approved ruling in August 2022. Over-the-counter hearing aids are available without a medical exam, prescription or special fitting from an audiologist.
The FDA estimates OTC aids will save customers on average about $2,800 a pair. While you can purchase them in pharmacies, stores and online, similar to a pair of reading glasses, all OTC hearing aids must meet federal quality standards.
Some Medicare Advantage plans may include OTC hearing aids as part of their OTC supplemental benefits, which cover drugs and other drugstore items. A separate Kaiser Family Foundation study found that 84 percent of Medicare Advantage enrollees have some coverage for OTC benefits.
And Advantage plan members often are able to use a Medicare Advantage flex card to buy OTC hearing aids at approved locations and through some mail-order pharmacy programs.
https://www.aarp.org/health/medicare-qa-tool/does-medicare-cover-hearing-aids/
