Medicare Advantage hearing aid coverage varies by plan and is usually limited
Most Medicare Advantage plans do cover some hearing aid costs, but the coverage is typically much narrower than Original Medicare combined with a Medigap plan. Many plans cover hearing exams but not the aids themselves, while others cover both but with high out-of-pocket costs. The specific coverage depends entirely on which plan you choose, so you need to check your plan's details before you assume you are covered.
Unlike Original Medicare, which does not cover hearing aids at all, Medicare Advantage plans are required by federal law to cover at least a hearing exam. However, that requirement does not mean they cover the cost of the actual hearing aids. Some plans offer hearing aid coverage as a supplemental benefit, meaning it is extra coverage beyond what Medicare requires. Other plans offer it only through a discount program with specific hearing aid retailers, not as true coverage.
Key Takeaways
- Medicare Advantage plans must cover hearing exams, but coverage for the hearing aids themselves is optional and varies widely between plans.
- Some plans cover hearing aids through a discount program with particular retailers rather than paying a percentage of the cost like they do for other services.
- You need to read your specific plan's Summary of Benefits and Coverage document to learn what hearing aids cost you out of pocket.
- If your current plan does not cover hearing aids well, you can switch to a different Medicare Advantage plan during the annual enrollment period (October 15 to December 7).
- Original Medicare plus a Medigap plan may offer better hearing aid coverage than your Medicare Advantage plan, though you should compare costs before switching.
How to find your plan's hearing aid coverage
Your Medicare Advantage plan's coverage details are in a document called the Summary of Benefits and Coverage, which your plan mails to you each year and posts on its website. Search that document for "hearing" or "audiology" to find the section that describes what you pay for a hearing exam and whether hearing aids are covered at all.
If the document says hearing aids are covered, look for the copay amount (a flat fee per visit or per aid) or coinsurance percentage (your share of the cost). Also check whether there is an annual limit on hearing aid coverage — many plans cover only one or two aids per year, or cap the total dollar amount they will pay. If the document mentions a "discount program" or "network provider," that means you must use a specific retailer or audiologist to get the discount; going elsewhere will cost you more.
If you cannot find the information in the document or it is unclear, call your plan's customer service number (on your insurance card) and ask directly: "Does my plan cover hearing aids, and if so, what is my out-of-pocket cost per aid?" Write down the answer and the date you called, in case you need to refer back to it.
Hearing aid coverage through Medicare Advantage discount programs
Many Medicare Advantage plans do not pay a percentage of hearing aid costs the way they do for other medical services. Instead, they offer a discount program with retailers like Costco, Miracle-Ear, Signia, or Starkey. When you use a network provider, you get a reduced price on hearing aids — typically 10 to 50 percent off the retail price — but the plan itself does not pay the retailer. You pay the discounted price directly.
This is different from coverage. If your plan covers 80 percent of a hearing aid that costs $2,000, you pay $400. If your plan offers a discount program instead, you might pay $1,200 for the same aid (a 40 percent discount), and the plan pays nothing. The discount can be substantial, but you are still paying out of pocket.
Before you buy hearing aids through your plan's discount program, ask the retailer for the full price and the discounted price. Then compare that to what you would pay at other retailers or through other plans. Sometimes the discount is genuinely good; sometimes you can find a better price elsewhere.
What happens if your plan does not cover hearing aids
If your Medicare Advantage plan does not cover hearing aids or only offers a small discount, you have several options. The first is to switch to a different Medicare Advantage plan during the annual enrollment period (October 15 to December 7 each year). You can compare plans on Medicare.gov and filter by hearing aid coverage to find plans that offer better benefits for your needs.
A second option is to switch from Medicare Advantage to Original Medicare and add a Medigap plan. Original Medicare itself does not cover hearing aids, but some Medigap plans (Plan C and Plan F, if you are may be able to access for them) include hearing aid coverage. This route usually makes sense only if you need significant hearing aid coverage and your current Medicare Advantage plan offers little or none, because Medigap premiums can be high.
A third option is to pay for hearing aids out of pocket. Hearing aids range from about $500 to $6,000 per aid depending on the technology and features. Some audiologists and retailers offer payment plans or discounts for cash purchases. You can also look into nonprofit organizations like the Hearing Loss Association of America, which sometimes has information about low-cost hearing aid programs in your area.
Comparing Medicare Advantage plans for hearing aid coverage
If hearing aids are important to your decision about which Medicare Advantage plan to choose, use the plan comparison tool on Medicare.gov. Enter your zip code and the tool will show you all available plans. Click on each plan and look at the "Prescription Drug Coverage" or "Additional Benefits" section — hearing aid coverage is usually listed there, though the detail level varies.
You can also call 1-800-MEDICARE and ask a representative to compare hearing aid coverage across plans in your area. They cannot recommend a specific plan, but they can tell you which plans cover hearing aids and what the costs are. Write down the plan names and coverage details so you can compare them side by side.
When you compare, look at the total cost to you, not just whether coverage exists. A plan that covers 50 percent of hearing aids might cost you more out of pocket than a plan with a good discount program, depending on the hearing aid prices and your plan premiums. Factor in the plan's monthly premium, deductible, and copays for other services you use regularly, not just hearing aids.
When to switch plans for better hearing aid coverage
You can change Medicare Advantage plans only during specific times. The main opportunity is the Annual Enrollment Period, which runs from October 15 to December 7 each year. Any plan change you make during this period takes effect on January 1 of the following year. You can also switch plans if you move to a new state, lose your current coverage, or experience certain life changes like retirement or loss of employer coverage.
If you realize mid-year that your plan's hearing aid coverage is worse than you expected, you cannot switch until the next Annual Enrollment Period unless you may have access to for a special circumstance. Plan ahead: if you know you will need hearing aids soon, check your plan's coverage before the enrollment period ends so you have time to switch if needed.
Frequently Asked Questions
Does Original Medicare cover hearing aids?
No. Original Medicare does not cover hearing aids or hearing exams. However, if you add a Medigap plan (supplemental insurance), some plans include hearing aid coverage. You would need to check the specific Medigap plan's benefits.
Can I use any audiologist or hearing aid retailer with my Medicare Advantage plan?
It depends on your plan. Some plans cover hearing aids from any provider, while others only cover them if you use a network provider (a specific retailer or audiologist). Check your plan's Summary of Benefits and Coverage or call customer service to find out whether you are restricted to certain providers.
What if I need hearing aids but my plan's coverage runs out mid-year?
If your plan has an annual limit on hearing aid coverage and you reach it before the end of the year, you would pay the full cost for any additional aids until January 1. You cannot switch plans until the next Annual Enrollment Period unless you have a may have access to life event. Plan your purchases with the annual limit in mind.
Are there programs that help pay for hearing aids if my insurance does not cover them?
Some states have programs for low-income seniors, and nonprofit organizations like the Hearing Loss Association of America maintain lists of low-cost hearing aid programs. Your audiologist may also know about manufacturer information programs or payment plans. Contact your local Area Agency on Aging to ask about programs in your state.
If I switch to a different Medicare Advantage plan, will it cover hearing aids I already bought?
No. Insurance covers services and equipment going forward, not things you already paid for. If you switch plans, the new plan's coverage applies to hearing aids you purchase after your coverage starts on January 1.