Aetna Medicare Advantage hearing aid coverage varies by plan and location
Aetna Medicare Advantage plans do cover hearing aids, but the amount they pay depends on which specific plan you have and where you live. Some Aetna plans cover hearing exams and a set dollar amount toward hearing aids each year — often between $500 and $2,000 per ear annually. Other plans may cover hearing aids through a network of preferred providers, meaning you pay less if you use someone on Aetna's list. A few plans cover nothing for hearing aids at all.
The only way to know what your plan pays is to check your plan documents or call Aetna directly. Your plan's coverage details are in the Summary of Benefits and Coverage document you received when you enrolled, or you can request it from Aetna. The coverage year runs January through December, so any unused benefit amount does not roll over to the next year.
Key Takeaways
- Aetna Medicare Advantage hearing aid coverage ranges from $500 to $2,000 per ear per year, but some plans cover nothing — you must check your specific plan documents.
- Plans that use a preferred provider network require you to see an audiologist or hearing aid dispenser on Aetna's list to receive the full benefit.
- Your plan's Summary of Benefits and Coverage document lists hearing aid coverage details, copays, and any deductibles that explore.
- If your plan does not cover hearing aids, you may be able to switch to a different Aetna plan during the annual enrollment period in October and November.
How to find your plan's hearing aid benefit
Start by locating your plan's Summary of Benefits and Coverage, which lists all covered services and what you pay. You received this document when you enrolled, and it is also available on Aetna's website under your account. Search the document for "hearing" or "audiology" to find the section that describes your coverage.
If you cannot find the document or need clarification, call the customer service number on the back of your Aetna Medicare Advantage card. Have your member ID ready. Ask specifically: Does my plan cover hearing aids? How much does it pay per ear per year? Do I have to use a specific provider, or can I go to any audiologist? Is there a copay or deductible? Customer service can also tell you whether you have used any of your benefit this year.
Plans with preferred provider networks for hearing aids
Many Aetna Medicare Advantage plans partner with hearing aid networks like TruHearing, Amplifon, or Miracle-Ear. If your plan uses one of these networks, you will pay less — sometimes nothing out of pocket — if you see a provider on that network. If you see someone outside the network, you may pay the full cost and receive a smaller reimbursement, or no reimbursement at all.
When you call Aetna customer service, ask which network your plan uses and request a list of providers near you. You can also visit the network's website directly and search for locations. Before you schedule an appointment, confirm with both the provider and Aetna that the provider is in-network for your specific plan, because network status can change.
What happens if your plan does not cover hearing aids
If your current Aetna Medicare Advantage plan does not cover hearing aids, you have options. During the annual enrollment period — October 15 through December 7 each year — you can switch to a different Aetna Medicare Advantage plan that does cover hearing aids. You can also switch to Original Medicare and enroll in a standalone hearing aid discount plan, though Original Medicare itself does not cover hearing aids.
If you need hearing aids before the next enrollment period, you can pay out of pocket and keep receipts. Some hearing aid providers offer payment plans or discounts for uninsured or underinsured customers. You can also contact your local Area Agency on Aging to ask about state or local programs that help pay for hearing aids — some states fund these through Medicaid or aging services.
Copays, deductibles, and what you pay out of pocket
Your out-of-pocket cost for hearing aids depends on your plan's structure. Some plans charge a copay per visit (for the hearing exam) and then cover a percentage of the hearing aid cost. Others cover a flat dollar amount per ear per year, and you pay anything above that amount. A few plans have an annual deductible you must meet before hearing aid coverage begins.
Your Summary of Benefits and Coverage will show these details in a table format. If the document is unclear, ask Aetna customer service to walk you through an example: "If I buy two hearing aids at $3,000 each, what will I pay out of pocket?" Getting a specific number helps you budget and compare plans if you are thinking about switching.
Hearing exams and follow-up care
Most Aetna Medicare Advantage plans cover the hearing exam itself — the test that determines whether you need hearing aids and what settings they should have. This is usually covered at little or no cost. However, follow-up visits to adjust your hearing aids, clean them, or replace batteries may have a copay or may not be covered at all, depending on your plan.
Ask Aetna whether follow-up appointments with your audiologist or hearing aid provider are covered, and whether there is a limit on how many visits per year you can have. Some plans cover unlimited adjustments; others limit you to a certain number. If adjustments are not covered, ask the hearing aid provider whether they offer free adjustments as part of the purchase price, which many do.
Frequently Asked Questions
Do I have to buy hearing aids from Aetna's preferred provider to get coverage?
It depends on your plan. If your plan uses a preferred provider network, you will receive the full benefit only if you buy from someone on that network. If you buy from an out-of-network provider, your plan may reimburse you a smaller amount or nothing at all. Check your plan documents or call Aetna to confirm whether your plan requires you to use a network provider.
Can I use my hearing aid benefit if I already bought hearing aids this year?
No. Your benefit covers hearing aids purchased after your plan's coverage year begins on January 1. If you bought hearing aids before that date, you cannot use your benefit to reimburse yourself. However, if you bought them in December and your plan covers them, you may be able to use your new-year benefit to purchase a second pair or replacements.
What if I need new hearing aids next year — do I get another benefit?
Yes. Your hearing aid benefit resets every January 1. If your plan covers $1,000 per ear per year and you used that benefit in March, you will have another $1,000 per ear available starting January 1 of the next year. Some plans limit how often you can receive a new pair — for example, once every three years — so check your plan documents.
Can I switch to a plan with better hearing aid coverage mid-year?
No, not unless you have a may have access to life event like losing other health coverage, moving to a new service area, or becoming may be able to access for Medicaid. You can switch plans during the annual enrollment period in October and November, which takes effect January 1. If you need hearing aids urgently before then, you may want to pay out of pocket and keep your receipts in case you switch plans later.
Does Aetna cover hearing aid batteries and repairs?
Coverage for batteries and repairs varies by plan. Some plans cover them as part of the hearing aid benefit; others do not. Check your Summary of Benefits and Coverage or call Aetna customer service. Many hearing aid providers include batteries and repairs for a set period after purchase, so ask what is included when you buy.