It’s frustrating when you can’t communicate well with friends and family. Hearing loss can even be dangerous if it means you don’t understand your doctor’s advice or you can’t hear sounds like fire or carbon monoxide alarms. Recent studies have also made a connection between hearing loss and Alzheimer’s disease.2
For many seniors — and especially men, who tend to be more affected by hearing loss3 — hearing tests and hearing aids are crucial. One of the easiest solutions is to get a hearing aid. But are hearing aids, which can be costly, covered by Medicare? Will Medicare pay for them? The answer: It depends.
Does Medicare Cover Hearing Exams?
So if you opt for only Original Medicare and you need a hearing aid, you’ll be paying 100% out-of-pocket for your device and any exams related to getting it. The same holds true for a Medigap policy (which is sold by a private insurance company to fill the “gaps” of Original Medicare), which typically has no hearing coverage.
Your primary care doctor, however, will check you for hearing issues during your annual wellness visit, which is covered by Original Medicare.
Medicare Part B applies when you see your doctor for preventive or outpatient care. Under Part B, you don’t have to choose just one primary care physician. You can generally see a specialist like an ear, nose and throat doctor without a referral as long as the specialist participates in Medicare. However, patients who need to see an audiologist do need a doctor’s order.
Medicare Part B (Medical Insurance) covers diagnostic hearing and balance exams if your doctor or other health care provider orders them to see if you need medical treatment. (A hearing aid is not medical treatment.).4 For example, Medicare Part B might cover diagnostic hearing and balance exams if your doctor orders the tests to help diagnose a condition like vertigo or dizziness.
In that situation, your cost with your Original Medicare plan will be 20% of the Medicare-approved amount for your doctor’s services for covered exams, and the Part B deductible applies. If you’re getting the hearing-related tests in a hospital outpatient setting, you will also pay a copayment to the hospital.5
Medicare doesn’t cover hearing exams, hearing aids, or exams for fitting hearing aids.
Does Medicare Advantage Cover Hearing Aids?
If you have a Medicare Advantage plan from a private insurance company (also known as Medicare Part C), your plan may cover a portion of the cost of a hearing aid. You’ll need to check with your plan provider and the plan’s Summary of Benefits for your specific hearing-related benefit since plans can vary widely in their coverage.
Medicare Advantage is an alternative to Original Medicare that operates a lot like a traditional health insurance plan. It offers services above and beyond Part A and Part B such as vision, dental and hearing.
Medicare Advantage is sold and administered by private insurance companies. While it replaces Part A and B coverage, it still offers all services included in Medicare Part A and Part B.
Many private insurers offer Part C plans, which come with their own premiums, deductibles, copays, and physician networks. For hearing benefits, while one Medicare Advantage plan might cover a little over $1,000 per ear, for example, another may cover less and another substantially more.
If you think you’ll need a hearing aid and benefits to cover exams and fittings, you may want to shop around and evaluate a variety of Medicare Part C plans to see how their hearing coverage varies.
When Do You Know You Need a Hearing Aid?
Obvious signs that you might need a hearing aid include:
- Trouble understanding group conversations.
- Feeling like people are always mumbling when they aren’t.6
- Frequently asking people to repeat themselves, especially in noisy environments.
- Nnot being able to hear well on the phone.
- Needing the television or radio volume set especially loud in order to understand.
- A ringing or hissing sound in your ears.
Normal hearing means you can hear sounds less than 25 decibels (whisper). If the softest sound you can hear is 30 decibels or louder, it may be time to consider getting a hearing aid.7
It’s important to know that hearing aids don’t make your hearing revert to normal. Instead, they help amplify sounds in certain pitch ranges, specifically the ranges in which you’ve experienced hearing loss. It’s not uncommon to find that you need a hearing aid in both ears.
Wearing a hearing aid in both ears often comes with benefits, including better understanding of speech when there’s background noise and you may find that you’re not as worn out at the end of the day.8
How Much Are Hearing Aids?
Hearing aids can range widely in cost depending on the type and the features involved, and, unfortunately, out-of-pocket costs can be high.
One hearing aid option is a behind-the-ear variety; another is one that sits completely in the ear canal and is molded to fit the inside of your ear. Special hearing aid features, which can add to the cost, might include rechargeable batteries, wireless connectivity, wind noise reduction and even remote controls.
The price of just one hearing aid could be as much as $2,400, according to a 2015 report from the President’s Council of Advisors on Science and Technology.9 Most people end up needing a hearing aid for each ear, which would bring your out-of-pocket cost to nearly $5,000.
Where Can You Get Help to Pay for Hearing Aids?
There are a variety of options when it comes to getting help paying for hearing aids. If you’re a veteran and you qualify for VA health benefits, your hearing tests and hearing aids may be fully covered.10
Hearing aids can also be paid for with money in a Health Savings Account or Flexible Spending Account, if you have one, while people with Medicaid may be able to qualify to get a hearing aid through their state Medicaid benefit.
Many civic and nonprofit organizations can help seniors find help to cover the cost. For example, Sertoma connects people who need hearing assistance with help. The organization has a thorough listing of national and state charitable programs and also runs a hearing aid recycling program through its 420 clubs.
Hear Now, sponsored by the Starkey Hearing Foundation, provides hearing aids to low-income individuals and some local Lions Clubs run projects that give affordable hearing aids to people in need. Reach out to your local Lions Club chapter to learn more.
Another option is to purchase a hearing aid at a warehouse club. Respondents to a Consumer Reports survey found that CR members spent around $1,926 for a pair of hearing aids at wholesale clubs versus $4,107 at name-brand hearing aid stores, $3,909 at audiology offices and $3,517 at hospitals and clinics.11 The survey also found that many survey respondents who asked for a discount got one. Yet, some patients still prefer the service they receive at a professional audiology clinic.
For many Americans, a hearing aid will become a necessity in older age. Not only does improving hearing enhance your interactions with friends and family, it can also be crucial in keeping you safe.
As you’re mulling over your Medicare options, keep in mind that Original Medicare does not cover hearing aids, nor does a Medigap policy. Many Medicare Advantage plans, however, do include a hearing benefit and they will cover hearing aids to some extent. Many nonprofit organizations also offer seniors in need help in paying for hearing aids.
Ultimately, what works best for you for a Medicare plan when it comes to hearing aids and exams will depend on your financial and medical situation.