When Will Medicare Cover Hearing Aids? Here’s What to Look For
As you might not know, original Medicare Parts A and B do NOT currently cover hearing aids.
Also, they do not cover hearing exams needed for fitting hearing aids.
In essence, you have to pay out of pocket.
There is no set date for when this might change.
But there is hope. There are some Medicare options that provide immediate access to hearing benefits that original Medicare excludes completely.
Surprise, some of these plans may cover up to $2,500 of your hearing aid costs and offer free annual exams that would otherwise come out-of-pocket. Let us get into finding out how you can benefit from these Medicare options.
Key Takeaways:
Medicare’s blind spots could drain your savings
The coverage clock is ticking – waiting costs you
Smart alternatives exist, but stay hidden
One decision saves thousands each year
Your current plan might be silently overcharging
“My wife and I are retiring at end of 2024, and trying to understand Medicare plans is not for the weak of heart, it is absolutely mind boggling. Kayla at Senior Benefit Services came to the rescue, she understands and is able to navigate you through this myriad of confusion. She is very understanding and knowledgeable of the Medicare system and its providers. She listens, and finds you your best options, making the process less daunting… Thank you Kayla, and Senior Benefits for being there. If your retiring in the near future, go see Kayla at Senior Benefit… you’ll be glad you did.” B. Ridgley
Understanding Medicare Coverage for Hearing Aids
Many seniors face unexpected gaps in essential health benefits. Let’s explore how different plans address auditory support for our Senior Benefit Service locations in Maryland, Virginia, West Virginia, and Pennsylvania.
Overview of Parts A, B, and Advantage
Original Medicare combines Part A (hospital stays) and Part B (doctor visits). These government plans exclude routine auditory care. Private insurers offer Advantage plans (Part C) as alternatives. Many include annual checkups or discounts on devices.
Coverage Type
Original Medicare
MedicareAdvantage
Routine Exams
Not covered
Often included
Devices
Excluded
Discounts available
Specialist Visits
Partial coverage
Lower costs
Always review plan details, and benefits differ between providers. Some Advantage options partner with clinics for bundled pricing.
Medicare Advantage: Expanding Hearing Care Benefits
Private insurers are rewriting the rules for senior auditory care. Unlike traditional plans, many Medicare Advantage options now deliver essential support through innovative benefit packages.
Extra Perks You Won’t Find Elsewhere
These plans frequently include annual hearing exams at no extra cost, which is a stark contrast to Original Medicare’s diagnostic-only approach. Advantage plans now bundle auditory services like:
Discounted devices from partner clinics
Reduced copays for balance tests
Specialist networks for ongoing care
Understanding the Fine Print
While benefits shine, coverage caps exist. Most plans limit device replacements to one set every 3 years.
Consider this comparison:
Service
Original Medicare
Advantage Plan
Annual Exams
Not covered
Free
Device Allowance
$0
Up to $2,500
Follow-up Visits
80% after deductible
$25 copay
Savings add up quickly. A senior needing $4,000 devices could pay half through smart plan selection. But always verify renewal terms; some benefits reset annually.
Pro tip: Local availability varies. Compare plans during enrollment periods to maximize your health budget while addressing hearing loss concerns.
Costs Considerations for Hearing Aid Coverage
Hearing health expenses can catch many seniors off guard, especially when basic devices cost more than some monthly mortgages. Let’s unpack what you’ll likely pay and where to find relief.
When it comes to hearing aids, they can be quite expensive. Original Medicare doesn’t cover these devices, leaving beneficiaries to pay the full cost themselves.
Many Medicare Advantage plans offer some hearing aid coverage through annual allowances, which can help reduce out-of-pocket expenses.
While Original Medicare might cover diagnostic hearing exams if ordered by a doctor, routine hearing care generally falls outside its coverage.
Medicare Advantage plans typically include some hearing benefits with more reasonable copays for exams and may include follow-up care that Original Medicare doesn’t cover.
Smart Budgeting Strategies
Diagnostic hearing balance tests often serve as gatekeepers for treatment. Part B might cover these if ordered for medical reasons, like vertigo concerns. For ongoing needs:
Explore Medicaid programs offering auditory support
Check employer retiree benefits for device subsidies
Ask audiologists about payment plans
Remember: Medicare advantage plan benefits reset annually. Review renewal terms to avoid surprise costs.
Alternative Solutions for Hearing Care Coverage
Nearly 1 in 4 adults with auditory challenges now use non-traditional solutions, according to Johns Hopkins research. While Original Medicare remains limited, fresh approaches help bridge the gap between medical needs and budget realities.
Revolution at the Drugstore Counter
The FDA’s approval of over-the-counter devices changed the game. These self-fitting options cost less than prescription models and can be perfect for mild to moderate issues. Brands like Jabra and Sony now offer tech-packed models for a much less price.
Though not right for severe loss, these devices provide extra benefits like Bluetooth connectivity. Always pair them with professional hearing balance assessments. Some Advantage plans cover these checkups even if you buy OTC aids.
Beyond Standard Insurance Options
VA benefits cover devices for qualified veterans
Many states offer Medicaid programs for auditory support
Supplemental plans like AARP Medicare Supplement Insurance often include hearing exam allowances
Some advantage plans now blend traditional coverage with other discounts. Florida’s Humana Gold Plus members, for example, get money every year towards any FDA-cleared device. This flexibility helps seniors mix-and-match solutions without breaking the bank.
Remember: Annual balance exams remain crucial, and they can uncover issues beyond simple auditory decline. Pairing these checkups with smart device choices creates a complete care strategy that Original Medicare alone can’t match.
FAQ
Does Part B cover hearing exams?
Here’s the deal: Medicare Part B only pays for diagnostic hearing tests when your doctor says they’re medically necessary.
Think symptoms like sudden hearing loss or severe dizziness that need investigation.
Your doctor must document WHY you need the test – not just “hearing seems worse.”
Regular hearing checks for fitting aids? Medicare won’t pay a penny for those.
Can Medicare Advantage help with hearing aid costs?
Short answer: Absolutely, but read the fine print.
While Original Medicare ignores hearing aids completely, many Advantage plans jump in with annual allowances between $500-$2,500.
The catch? Most plans restrict you to:
Specific provider networks
Limited hearing aid brands
Coverage for devices only every 2-3 years
Use Medicare.gov’s Plan Finder tool to filter specifically for hearing benefits when comparing plans.
Are there upcoming changes to Medicare hearing aid coverage?
The truth: Don’t hold your breath for Original Medicare coverage anytime soon.
Despite ongoing discussion in Congress, Medicare.gov shows no confirmed changes to hearing aid coverage coming down the pipeline.
Legislative proposals continue to surface, but none have become law yet.
Want the latest updates?
Give us a call (800) 924-4727. We can walk you through this process. We are here to help!
What costs should I expect with Medicare Advantage plans?
Let’s break down the typical costs:
Hearing exams: Usually $0-$50 copay Hearing aids: Either copays or coinsurance plus annual benefit caps Coverage limits: Most plans cover devices every 2-3 years, not annually
The hidden detail many miss: Some plans cover both ears, while others limit coverage to one ear per benefit period.
Are over-the-counter hearing aids a good alternative?
Quick take: Great for mild hearing loss, terrible for severe cases.
After the FDA’s 2022 regulations, OTC hearing aids hit the market at much lower prices than prescription devices.
Perfect if you:
Have mild to moderate hearing loss
Feel comfortable with self-fitting
Want to save thousands of dollars
Not right if you:
Have severe hearing loss
Struggle with tech
Need professional adjustments
Medicare doesn’t cover either type, but the price difference makes OTC options worth considering.
How can I determine if my hearing loss qualifies for Medicare-covered testing?
The key distinction: Medicare covers diagnostic tests, not routine screenings.
Your hearing test gets covered when:
Your doctor orders it to investigate a medical condition
You have symptoms beyond gradual hearing loss (dizziness, tinnitus, sudden changes)
The focus is diagnosis and treatment, not hearing aid fitting
Your doctor must document medical necessity in your record, or Medicare won’t pay.
