En español No. Medicare covers only ear-related medical conditions, not routine hearing care, hearing aids or exams for fitting hearing aids.
This is one of Medicare’s main coverage gaps. If you experience hearing loss and need hearing care services, you may have to pay significant bills 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 said they had a lot of difficulty or could not hear at all, according to the Centers for Disease Control and Prevention’s 2019 National Health Interview Survey .
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 for the services, according to a Kaiser Family Foundation 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, as well as Medicaid in some states and the U.S. Department of Veterans Affairs health benefits if you qualify for either. If you have retiree health insurance, that plan also may help with the cost.
Now that the FDA has approved over-the-counter hearing aids for mild to moderate hearing loss, you may soon find lower cost options.
While most Medicare Advantage plans cover hearing aids and exams, that coverage can be limited and can vary 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 Kaiser Family Foundation study.
Typically, Medicare Advantage plans limit enrollees to one set of hearing aids a year, but more than a quarter of the plans restrict hearing aid coverage to one pair every two years. And 14 percent cover one set every three years, according to the Kaiser study.
Expect different copayments based on the level of digital technology — often basic, standard, advanced and premium. Copays may start around $699 for an advanced level hearing aid and $999 for a premium level hearing aid. Because Medicare Advantage plans can 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 more about a Medicare Advantage plan’s hearing aid coverage, 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.
For more information about the plan’s hearing coverage, click Plan Details and scroll down to Extra Benefits. You’ll see copayments for hearing aids, exams, hearing aid fitting/evaluation services and other hearing benefits.
You also 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.
Other options for help with hearing aid costs:
Over-the-counter hearing aids will be available as soon as mid-October. People with mild to moderate hearing loss will be able to buy them without a medical exam, prescription or special fitting from an audiologist, according to a rule the U.S. Food and Drug Administration approved Aug. 16, 2022.
The FDA estimates the over-the-counter aids will save customers on average about $2,800 a pair. They will be available in pharmacies, stores and online, similar to a pair of reading glasses. The new hearing aids will need to meet federal quality standards.
What’s unknown, as of early September, is whether Medicare Advantage plans will pay at least part of the cost. Some plans may include OTC hearing aids as part of their OTC supplemental benefits, which cover drugs and other drugstore items. A recent study by the Kaiser Family Foundation found that 84 percent of Medicare Advantage enrollees have coverage for OTC benefits of some kind. Individual plans may determine their 2023 coverage before open enrollment begins on Oct. 15.
Updated September 8, 2022
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