Medicare hearing aid coverage

Medicare hearing aid coverage is defined as Medicare’s specific policy on covering hearing aids for beneficiaries, where Original Medicare (Parts A and B) excludes hearing aids from coverage per Section 1862(a)(7) of the Social Security Act. Medicare Part B only covers diagnostic hearing exams when ordered by a physician to diagnose or treat a medical condition, not routine hearing exams for fitting hearing aids.

Medicare Advantage plans, such as UnitedHealthcare and Humana offerings, may include partial hearing aid benefits, often capping annual benefits between $500 and $2,000 depending on plan and location. Enrollment in a Medicare Advantage plan with hearing aid benefits reached 29.5 million people in 2023 (KFF).

Out-of-pocket costs for hearing aids average $2,000–$7,000 per pair due to lack of Original Medicare coverage (Hearing Loss Association of America). Audiologists participate in the Medicare program by providing covered diagnostic services but cannot bill Medicare for hearing aid fittings.

Coverage for follow-up services related to hearing aids remains excluded under both Original Medicare and most Medigap policies, based on findings by Your Insurance Info. The Centers for Medicare & Medicaid Services (CMS) confirm that prescription hearing aids require full payment by the beneficiary unless supplemental insurance is purchased.

Cochlear implants, classified as prosthetic devices, receive Medicare coverage if deemed medically necessary by a provider. Medicaid programs in some states cover hearing aids with variable eligibility and limits; for example, California covers one hearing aid per ear every four years for adults enrolled in Medi-Cal.

The Bipartisan Budget Act of 2018 authorized expanded access to over-the-counter (OTC) hearing aids without insurance requirement starting in October 2022, but these are not covered by Medicare either.