Geetika Gupta, MD, is a board-certified internist working in primary care. She's been focusing on the outpatient care of COVID-19 since 2020.

Hearing loss affects a large number of people as they get older. People enrolling in Medicare may want to consider factoring in coverage for hearing aids when choosing a plan.

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), nearly one in four people between 65 and 74 years old has hearing loss severe enough to need hearing aids. The number increases to one in two for people 75 years and older.

When someone loses their hearing, they may have difficulties communicating effectively. They may have to speak more loudly or have people repeat themselves. This can impact their relationships with others. Their safety could also be put at risk. Not hearing a car horn, a smoke detector, or another alarm could literally put them in harm’s way.

Their long-term health is also impacted by hearing loss. Studies have found a link between hearing loss and dementia, including Alzheimer’s disease. Managing and treating hearing problems early on may help to decrease the risk for dementia in later years.

Understanding how important hearing is to your overall health, this article will address what hearing services are covered by each part of Medicare and will discuss what new hearing coverage options may be coming in the near future.

Hearing loss can sneak up on you. You may want to consider a hearing test if you experience any of the following:

Medicare is healthcare funded by the federal government and tax dollars. There are four parts of Medicare and they cover different parts of your care, as follows:

Medicare Part A and Part B are what is known as Original Medicare, “original” because they were the first parts of Medicare created in 1965.

Original Medicare covers a wide range of services. Unfortunately, some often-needed services get left behind—including routine hearing tests and hearing aids.

This does not mean that no hearing services are covered at all. If you have symptoms such as hearing loss or ringing in the ears (also known as tinnitus), Medicare may cover a hearing test with an audiologist, a trained hearing specialist.

Unfortunately, even when a hearing problem is identified, Original Medicare will not cover the hearing aids to correct it.

Interestingly, if you meet certain criteria, cochlear implants are covered by Original Medicare. One of the criteria to getting cochlear transplants is that hearing aids do not provide adequate relief.

Hearing aids work by amplifying sounds in the inner ear, making it easier to detect and interpret them. When hearing aids are not effective, cochlear implants may be considered.

The cochlea is the part of the inner ear that transmits sounds to the auditory nerve (the hearing nerve) and then sends those signals to the brain. Cochlear implants bypass the cochlea and stimulate the auditory nerve directly. This can be effective when the cochlea is damaged.

Hearing benefits are covered by Medicare Part B. You will need to pay a 20% coinsurance for each service.

Screening tests are performed on people who may be at risk for a medical condition but who do not currently have symptoms. Diagnostic tests, on the other hand, are performed when someone already has symptoms. They are not simply at risk for a condition, they already have one.

Original Medicare does not cover routine screening tests for hearing but does cover diagnostic tests for hearing-related conditions.

Medicare Advantage can help with hearing problems. Hearing coverage is one of the most popular supplemental benefits offered by Medicare Advantage plans. In 2021, as many as 97% of Medicare Advantage plans offered some sort of hearing coverage, although they did not all cover hearing aids.

It is important to look closely at each plan’s benefits. They are not the same. Depending on the plan you choose, you may have limits set on how often you can get certain services, how much a plan will pay in any given year, and what types of hearing aids are covered.

Specifically, you should look to see what hearing aid brands are covered and what types of hearing aids are covered, such as analog vs. digital nad inside the ear vs. outside the ear. You will also want to check if earmolds, fitting exams, and hearing aid batteries are paid for.

Medicare Advantage plans that put a cap on hearing coverage set an average limit of $960 per year but this amount ranges from $66 to $4,000 depending on the plan. For plans with limited coverage, you could pay similar out-of-pocket costs as you would without insurance.

Of those plans that had frequency limits, 58% allowed you to get hearing aids once per year, 28% once every two years, and 14% once every three years. You have to consider what you would do if your hearing aids get lost or broken.

There has been a big push to expand hearing coverage for people on Medicare. Congress proposed the Build Back Better Act in September 2021. If approved, the law would require that Original Medicare cover routine hearing tests starting in October 2023. It would also require hearing aid coverage once every five years for people with severe hearing loss.

The cost of hearing aids varies based on the kind of hearing aid you get and whether you need them in one or both ears. According to The Hearing Industries Association, the average hearing aid costs $1,000 to $4,000 per ear.

Depending on where you get your hearing aids, costs may be bundled together. This means that the cost of the hearing aid includes not only the hearing aids themselves but also the cost of services related to the hearing aids, services like hearing tests, proper fitting of the hearing aid to your ear, hearing aid batteries, and routine maintenance of the hearing aid.

For example, a hearing aid could get clogged with wax or stop working for other reasons. You may need an audiologist to evaluate it, or you may need to send your hearing aid for repairs.

At other times, your hearing services will be itemized, and you will pay for each service separately. It is important to understand what parts of hearing care your insurance covers to avoid getting an unexpected bill.

You can sign up for a Medicare Advantage plan when you first become eligible for Medicare. That may be when you turn 65 or if you qualify based on a disability. You can also pick a Medicare Advantage during the Open Enrollment Period from October 15 to December 7 each year. There are also special enrollment periods you could qualify for. 

If you are choosing a Medicare Advantage plan specifically for hearing coverage, you will want to do some research first. Consider plans that include:

Most importantly, make sure that a Medicare Advantage plan is the best plan for you before signing up. Saving on hearing aids does not mean that you definitely will save on the rest of your health care. It is important to weigh the pros and cons.

A Kaiser Family Foundation study found that many people spend less on health care when they have Original Medicare and a Medicare Supplement plan, known as Medigap. That is the case even when you consider the cost of monthly premiums.

Their out-of-pocket healthcare costs are often less than the spending cap for many Medicare Advantage plans. Also, people on Original Medicare can get care from any healthcare provider in the U.S. who takes Medicare. Medicare Advantage plans limit coverage to a network of healthcare providers and do not always cover care out of network.

Hearing aids can be expensive. If you have insurance, you will want to look to see what hearing care is covered by your plan. You should also know that several states have mandates that require private health plans, including employer-sponsored plans, to cover hearing aids.

You may wish to explore or see if you qualify for these sources of coverage:

If you don’t have insurance, and even if you do, you may also want to consider charitable organizations and discount programs to keep your costs down. The Hearing Industries Association provides an extensive list of financial assistance programs for children and adults alike. A partial list is included below:

People who have lesser hearing loss may be able to get hearing aids over the counter in the near future. In October 2021, the Food and Drug Administration (FDA) proposed that people with mild to moderate hearing loss be allowed to purchase hearing aids over the counter without the need for a medical exam. The goal is to decrease costs for people who need care and to make buying them more convenient.

Although millions of people on Medicare have hearing loss, Original Medicare does not cover routine hearing tests or hearing aids. Medicare Advantage plans may offer additional hearing coverage, but it is important to look closely at your plan’s benefits to make sure that the specific services you need are included.

Be sure to check on how often you are allowed to have hearing exams, how often you can get hearing aids, and how much you would pay for each service.

Good hearing allows you to interact with others and to engage in the world around you. Simply put, it can affect your quality of life. Although some Medicare Advantage plans offer hearing coverage, Original Medicare may offer hearing tests and hearing aids in the near future.

Even with insurance, the cost of hearing aids will vary. Original Medicare does not cover hearing aids at all but some Medicare Advantage plans may cover some or all costs relating to hearing aids. Depending on the type of hearing aid, they may cost anywhere from $1,000 to $4,000 per ear.

Hearing aid coverage differs from plan to plan. Some Medicare Advantage plans only cover the hearing aids themselves, while others will include the proper fitting of those hearing aids, hearing aid batteries, and even repairs when they are not working properly. Be sure to pick a plan that covers what you need.

Medicare Part B does not cover screening hearing tests or hearing aids. It will, however, cover a hearing exam for someone who has symptoms like ringing in the ears or hearing loss that affects their daily life. It also covers cochlear transplants for people who did not get good results from a hearing aid.

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National Institute on Deafness and Other Communication Disorders. Quick statistics about hearing.

Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet. 2020;396(10248):413-446. doi:10.1016/S0140-6736(20)30367-6

Centers for Medicare and Medicaid Services. Cochlear implantation.

Kaiser Family Foundation. Dental, hearing, and vision costs and coverage among Medicare beneficiaries in traditional Medicare and Medicare Advantage.

H.R.5376 - Build Back Better Act, 117th Congress (2021-2022). Introduced September 27, 2021.

BetterHealth.org. The price of hearing aids.

Kaiser Family Foundation. How much do Medicare beneficiaries spend out of pocket on health care?

Q1 Medicare. 2021 Medicare Advantage maximum out-of-pocket (MOOP) limits are changing and can now reach $7,550.

Food and Drug Administration. FDA issues landmark proposal to improve access to hearing aid technology for millions of Americans: proposed rule would establish new category of over-the-counter hearing aids.

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