Medicare and Hearing Coverage

Hearing loss is a common problem for older Americans.

Roughly one third of Americans ages 65 to 74 experience hearing loss, while nearly half of people in the U.S. age 75 and older have difficulty hearing, according to the National Institute on Aging.

Scientists don’t know how to prevent age-related hearing loss and there is no way to reverse it.

Many devices and tools, such as hearing aids, are available to help people who suffer from hearing loss.

However, most older adults must pay out of pocket for some, if not all, costs related to these devices.

Original Medicare (Part A and Part B) does not cover hearing aids. It also does not cover exams to fit hearing aids.

Medicare supplemental insurance, also known as Medigap, doesn’t cover these expenses either.

Efforts are being made to include hearing aid coverage in Medicare.

H.R. 4618 — a Congressional bill introduced in October 2019 — would expand Medicare Part B coverage for hearing exams and hearing aids, with beneficiaries contributing 20 percent of costs.

However, the bill has failed to make any progress in Congress since January 2020.

Currently, Medicare Part C, also called Medicare Advantage, is the only type of Medicare plan that may cover hearing-related costs.

Medicare Advantage plans are administered by private companies that the government reimburses later.

These plans must provide the same basic level of care as Medicare Part A and Part B but may also bundle other benefits into a single plan, such as vision, dental and hearing.

All Part C plans are not created equal. If you’re considering Medicare Advantage, make sure to compare benefits of individual plans to ensure the services you need are covered.

Hearing aids are historically expensive. According to a 2022 Forbes article, the average cost for hearing aids can range between $4,000 to $6,000 for a pair.

Research published in the American Journal of Public Health found that these high costs prevent many older Americans from purchasing hearing aids. Only one in seven U.S. adults with hearing loss wears a hearing aid, according to researchers, and ownership is even more limited among minorities and people with low incomes.

But they are becoming both cheaper and more accessible. In 2022, the FDA passed a new rule allowing for the over-the-counter sale of hearing aids for those with mild or moderate hearing loss.

The change allowed for some Americans to get access to hearing aids without having to undergo an exam or get a prescription. It also set the stage for more manufacturers to enter the market, which could help to lower prices in the coming years.

While Medicare Advantage plans often advertise hearing coverage, out-of-pocket costs can vary.

For example, some plans may offer relatively low hearing aid copays of $200 or $300 per device but maintain high deductibles you must pay first.

Original Medicare doesn’t cover hearing aids, but it will help pay for diagnostic hearing and balance exams.

However, exams are only covered if your doctor or health care provider orders them in an emergency or to see if you need medical treatment.

For example, a doctor may run these tests to diagnose the cause of dizziness or vertigo.

You will pay 20 percent of the Medicare-approved costs for these services, and the deductible for Part B applies.

This Part B coverage is narrow and does not apply to exams that test for general hearing loss.