According to the official Medicare & You Handbook published by the Department of Health and Human Services (DHHS) and the Centers for Medicare & Medicaid Services (CMS), Medicare does not cover hearing aids or exams for fitting hearing aids.
Hearing Services Medicare Covers
Original Medicare is composed of Part A (hospital insurance) and Part B (medical insurance). Medicare Part B covers some diagnostic hearing and balance exams but only if your doctor or another health care provider orders them to see if you need medical treatment. Medicare beneficiaries are responsible for paying 20 percent of the Medicare-approved amount for these exams, and the Part B deductible applies. A hospital copayment is also required in hospital outpatient settings.
Unfortunately, Original Medicare does not cover routine hearing exams, hearing aids themselves or exams for fitting hearing aids. Medicare Supplement Insurance (Medigap) usually does not provide coverage for routine hearing care either. The cost of these services and devices must be paid for out of pocket. That is, unless a senior has a Medicare Advantage Plan (Part C) that offers additional benefits.
Some Medicare Advantage Plans Cover Hearing Aids
Medicare Advantage Plans are health plans offered by private companies that contract with CMS. These plans provide the same benefits and coverage as Original Medicare and most include prescription drug coverage as well.
Added benefits like vision, dental and hearing are included in some Part C Plans. Medicare Advantage Plans that cover routine hearing tests and hearing aids may charge higher premiums. It’s important to carefully compare all health insurance options to ensure you get the coverage that meets your needs and budget. Medicare provides an online tool that beneficiaries can use to find and compare different plans.
Changes to Medicare elections can be made during certain times called enrollment periods. Aside from the initial Medicare enrollment period, the annual Open Enrollment Period for Medicare Advantage and Prescription Drug Coverage (October 15–December 7) is the most well known.
To determine if your Medicare Advantage Plan or other health insurance covers audiology services like hearing aids or cochlear implants, check with your individual plan. Most plans list a toll-free number for member services on their insurance cards.
Does Medicaid Cover Hearing Aids?
Seniors who require long-term care services but cannot yet qualify for Medicaid due to excess assets or income must reduce their own funds to meet Medicaid’s financial limits. If necessary, hearing aids can be part of an asset spend-down strategy. Some states even allow seniors to spend down their excess income to meet Medicaid income limits. Hearing aids are considered a qualifying medical expense that reduces one’s income.
A senior in a nursing home who already has long-term care coverage under Medicaid may be able to request that part of their income be used to purchase a hearing aid rather than be paid directly to the nursing home under the post-eligibility treatment of income (PETI) or share of cost provisions. In a roundabout way, Medicaid is essentially paying for the hearing aid by allowing the patient to divert some of their income for the purchase. Meanwhile, Medicaid pays the nursing home the cost of the hearing aid to make up for the diverted income.
Other Sources of Financial Assistance
Veterans may be able to receive help paying for their hearing aids through the Veterans Health Administration. For more information on financial assistance available to help pay for hearing services and hearing aids for seniors, consult the Hearing Loss Association of America website.