Learn About Medicare Coverage for Hearing Aids

Understanding Medicare's Current Hearing Aid Coverage Policy

Medicare's coverage of hearing aids has changed significantly in recent years. As of 2023, Original Medicare (Parts A and B) began covering hearing aids for people with hearing loss. This represents a major shift from the previous policy, where hearing aids were not covered under Original Medicare at all. To understand what this means for you, it's helpful to know that Medicare Part B now covers up to two hearing aids per ear (four hearing aids total) every three years for people with a documented hearing loss diagnosis.

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The coverage includes the hearing aid devices themselves, as well as related services such as hearing tests (called audiologic function tests), fitting visits, adjustments, repairs, and replacement of hearing aids. Medicare will pay 80 percent of the approved amount for these services after you meet your Part B deductible. This means you would be responsible for paying the remaining 20 percent as coinsurance.

It's important to note that while Medicare now covers hearing aids, it does not cover hearing aid batteries or maintenance kits. You'll need to budget separately for these ongoing supplies. Additionally, the hearing aid benefit works differently than some other medical services—your doctor cannot simply prescribe hearing aids. Instead, you'll need to have a specific type of test performed by an audiologist to document your hearing loss before coverage can apply.

Medicare Advantage plans (Part C) also must cover hearing aids under the same rules as Original Medicare, though individual plans may have slightly different details about copayments or preferred providers. If you're enrolled in a Medicare Advantage plan, you should contact your specific plan to understand exactly how your hearing aid benefits work.

Practical Takeaway: Review your current Medicare coverage type (Original Medicare or Medicare Advantage) and contact Medicare directly at 1-800-MEDICARE or your plan if you have Medicare Advantage to confirm the specific hearing aid coverage details that apply to you.

How to Access the Hearing Aid Benefit

To access Medicare's hearing aid coverage, you'll need to follow several steps. The process begins with getting a hearing test, but not just any hearing test. The test must be an "audiologic function test" performed by a licensed audiologist or qualified physician. This specific type of test documents your hearing loss and allows your healthcare provider to submit the information to Medicare for coverage purposes.

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Once you have this test completed, the results create a record of your hearing loss. Your audiologist or physician will use these results to recommend whether hearing aids would be beneficial for you. If they determine that hearing aids are medically necessary based on your test results, they can then work with you on obtaining them.

The next step involves working with an audiologist to select appropriate hearing aids. When choosing hearing aids, you can work with any licensed audiologist who participates with Medicare. You don't have to use a particular brand or provider—Medicare covers hearing aids from various manufacturers. The audiologist will help fit the hearing aids to your specific hearing loss pattern and explain how to use and care for them.

After receiving your hearing aids, you may need follow-up visits for adjustments. Medicare covers these adjustment appointments as part of the hearing aid benefit. These visits are important because hearing aids often require fine-tuning in the weeks after you first start using them to ensure they work as effectively as possible for your individual needs.

One key detail: you must be enrolled in Medicare Part B for this coverage to apply. If you've chosen to decline Part B coverage, you would not have access to the hearing aid benefit through Medicare. Additionally, you need to be living in the United States to use this benefit.

Practical Takeaway: Start by scheduling an audiologic function test with a licensed audiologist in your area. Make sure to mention that you have Medicare, as this will help the audiologist ensure the test is performed in the way Medicare requires and that they handle the billing correctly.

Understanding Medicare Part B Deductibles and Coinsurance

Medicare Part B uses a deductible and coinsurance structure that affects how much you pay for hearing aids. The Part B deductible is the amount you must pay out of your own pocket before Medicare begins sharing the cost of covered services. Once you've met your deductible in a calendar year, Medicare pays 80 percent of the approved amount for most Part B services, including hearing aids, and you pay the remaining 20 percent as coinsurance.

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The Part B deductible changes each year. In 2024, the Part B deductible is $240. This means you would need to pay up to $240 for Part B covered services before Medicare starts paying its share. It's important to note that your Part B deductible applies across all Part B services—not just hearing aids. So if you've already used Part B services earlier in the year (such as doctor visits or lab tests), you may have already paid toward or met your deductible.

Once your deductible is met, the 20 percent coinsurance for hearing aids means you pay one-fifth of the approved amount. Here's a practical example: if the approved amount for two hearing aids is $6,000, Medicare would pay $4,800 (80 percent) and you would pay $1,200 (20 percent), assuming your deductible has been met. If your deductible hasn't been met, you'd first pay toward that deductible amount.

The approved amount that Medicare uses is different from what some hearing aid providers might charge as their regular price. Medicare has established specific approved amounts for hearing aids based on current pricing data. This approved amount is what Medicare and your coinsurance are calculated from, not necessarily the full retail price a provider might quote you. This is one reason why it's valuable to work with Medicare-participating audiologists—they understand these approved amounts.

If you have a Medigap (supplemental insurance) policy, it may help cover your Part B coinsurance, which could reduce your out-of-pocket costs. If you have a Medicare Advantage plan, your costs may work differently—you'd need to check your specific plan's cost structure.

Practical Takeaway: Before getting hearing aids, ask your audiologist what the approved amount is for the specific hearing aids you're considering, so you can calculate what your 20 percent coinsurance would be after meeting your deductible. Keep track of other Part B services you've used earlier in the year to understand whether you've already met your deductible.

Differences Between Original Medicare and Medicare Advantage Plans

While both Original Medicare and Medicare Advantage must cover hearing aids under the same basic rules, there are important differences in how these two types of coverage work. Understanding these differences can help you make decisions about your Medicare coverage that work best for your situation.

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With Original Medicare (Part A and B), you have more flexibility in choosing your healthcare providers. You can visit any audiologist or physician who accepts Medicare, regardless of where you live or whether they're on a preferred provider list. The hearing aid benefit works as described above—you pay your Part B deductible, then 20 percent coinsurance for approved amounts. Original Medicare has no network restrictions, so you're not limited to seeing certain providers to receive coverage.

Medicare Advantage plans, also called Part C, are an alternative way to receive your Medicare benefits. These plans are offered by private insurance companies that contract with Medicare. Medicare Advantage plans must cover hearing aids, but they have the flexibility to structure their hearing aid benefits differently than Original Medicare. For example, a Medicare Advantage plan might require you to use audiologists within their network, or they might have different copayment amounts instead of coinsurance percentages.

Some Medicare Advantage plans may offer benefits that Original Medicare doesn't, which could include more generous hearing aid coverage. For instance, some plans might cover hearing aid batteries or maintenance kits, or they might have lower out-of-pocket costs for hearing aids. However, other plans might have more restrictions or higher copayments. The specifics vary significantly by plan and location.

If you're currently enrolled in Original Medicare and want to learn what a Medicare Advantage plan in your area offers for hearing aids, you can review plan information during the annual enrollment period (October 15 through December 7). Similarly, if you're in a Medicare Advantage plan and want to understand Original Medicare's hearing aid coverage, you can switch back during the annual enrollment period.

One additional consideration: if you have Original Medicare and want additional coverage for hearing aids or other services, you can purchase a Medigap policy, which may help cover your coinsurance costs. Medicare Advantage plans and Medigap policies cannot be held at the