Miracle Ear does not accept Medicare directly, but you may be able to use Medicare Advantage plans to help pay for hearing aids

Miracle Ear is a private hearing aid retailer, not a Medicare provider. Original Medicare (Parts A and B) does not cover hearing aids or hearing aid fittings at any retailer, including Miracle Ear. However, some Medicare Advantage plans (Part C) do cover hearing aids, and if your plan does, you can use that coverage at Miracle Ear locations.

The key difference is that you cannot walk into Miracle Ear and use your Medicare card to pay. Instead, if your Medicare Advantage plan includes hearing aid coverage, you would need to check whether Miracle Ear is in your plan's network. If it is, you can use your plan's hearing aid benefit there. If Miracle Ear is not in your plan's network, you would pay out of pocket or use a different provider that your plan covers.

Key Takeaways

  • Original Medicare does not cover hearing aids or hearing aid services from any provider, including Miracle Ear.
  • Some Medicare Advantage plans include hearing aid coverage, and coverage amounts vary widely by plan.
  • You must call your specific Medicare Advantage plan to find out whether they cover hearing aids and whether Miracle Ear is in their network.
  • If your plan does not cover hearing aids, you can still buy from Miracle Ear but will pay the full cost yourself.
  • Medicaid, not Medicare, covers hearing aids in many states, so check your state's Medicaid program if you have low income.

How to learn about your Medicare Advantage plan covers hearing aids at Miracle Ear

Start by finding your Medicare Advantage plan's member handbook or calling the plan's customer service number. This number is on your insurance card. When you call, ask three specific questions: Does your plan cover hearing aids? If yes, what is the annual dollar limit or number of hearing aids covered? Is Miracle Ear in your plan's network?

The answers matter because coverage varies dramatically. Some plans cover up to $2,000 per year for hearing aids. Others cover $500 or less. Some plans cover one hearing aid per ear every few years; others cover both ears annually. A few plans do not cover hearing aids at all. If Miracle Ear is not in your network, the plan may still pay a portion of the cost, but you would likely pay more out of pocket than if you used an in-network provider.

Write down the plan representative's name, the date you called, and exactly what they told you. If you later have a dispute about coverage, this record helps. Ask the representative to send you the hearing aid coverage details in writing if they are not already in your handbook.

What Original Medicare covers and does not cover for hearing

Original Medicare (the plan run directly by the federal government) does not cover hearing aids, hearing aid fittings, or hearing tests for the purpose of buying a hearing aid. This is true whether you go to Miracle Ear, a hospital audiology department, or any other provider. You pay 100 percent of the cost yourself.

Original Medicare does cover a hearing and balance exam if your doctor orders it to diagnose a medical condition — for example, if you have vertigo or sudden hearing loss that might signal a stroke. In that case, Medicare covers the test as part of your doctor visit. But if the test is done to fit you for a hearing aid, Medicare does not pay.

Medicare Advantage plans and hearing aid coverage

Medicare Advantage plans are run by private insurance companies under contract with Medicare. These plans must cover everything Original Medicare covers, but they can add extra benefits. Many plans add hearing aid coverage because hearing loss is common in older adults. However, not all plans do, and the ones that do vary widely in what they pay.

Some Medicare Advantage plans cover hearing aids as part of a broader "routine hearing care" benefit that also includes annual hearing tests and office visits. Others cover hearing aids only. A few plans cover hearing aids through a separate company — for example, your plan might contract with a specific hearing aid network and only cover providers in that network, even if Miracle Ear is not one of them.

When you are choosing a Medicare Advantage plan during open enrollment (October 15 to December 7 each year), you can compare hearing aid coverage across plans. The plan comparison tool on Medicare.gov lets you filter by whether plans cover hearing aids, though it does not show the dollar amounts. You have to read the plan documents or call to find out the actual limits.

What to do if your plan does not cover hearing aids

If your Medicare Advantage plan does not cover hearing aids, or if you have Original Medicare, you have several options. You can buy hearing aids out of pocket from Miracle Ear or another retailer. You can also look into whether you are covered by Medicaid, which covers hearing aids in many states. Income limits for Medicaid vary by state, so even if you think you earn too much, it is worth checking your state's program.

Some states have programs specifically for hearing aids for seniors with low income. Your state health department or your Area Agency on Aging can tell you what programs exist in your state. You can find your local Area Agency on Aging by calling the Eldercare Locator at 1-800-677-1116.

Miracle Ear and other hearing aid retailers sometimes offer payment plans or discounts for customers without insurance. Ask about these when you visit. Some also participate in manufacturer rebate programs that can lower the out-of-pocket cost.

How to use your Medicare Advantage hearing aid benefit at Miracle Ear

Once you have confirmed that your plan covers hearing aids and that Miracle Ear is in your network, call a Miracle Ear location near you and tell them you want to use your Medicare Advantage hearing aid benefit. They will ask for your plan name and member ID number. They should verify your coverage with your plan before you come in.

At your appointment, bring your insurance card and any paperwork your plan sent you about hearing aid coverage. Miracle Ear will handle the claim submission to your plan. You will typically pay any copay or coinsurance amount that your plan requires at the time of service. The plan then pays Miracle Ear directly for the rest, up to your plan's limit.

If Miracle Ear is out of network, you can still buy from them, but your plan may not pay anything, or may pay only a small amount. You would be responsible for the difference. Before you buy, ask Miracle Ear to give you a written estimate of the total cost and to tell you in writing what your plan will pay (if anything). This protects you from surprise bills.

Questions to ask Miracle Ear before you buy

Before you commit to buying hearing aids from Miracle Ear, ask these questions in writing and get written answers: What is the total cost of the hearing aids I need? Does this price include the fitting, adjustments, and follow-up visits? What is your return or trial period, and what is the cost if I return them? Do you accept my specific Medicare Advantage plan, and have you verified my coverage? What will I owe out of pocket after my plan pays?

Also ask whether the price includes a warranty and how long it lasts. Ask what happens if the hearing aids break or stop working. Some retailers include repairs and replacements in the price; others charge extra. Get all of this in writing before you buy, because hearing aids are expensive and you want to know exactly what you are paying for.

Frequently Asked Questions

Can I use my Original Medicare to pay for Miracle Ear hearing aids?

No. Original Medicare does not cover hearing aids or hearing aid fittings from any provider. You would pay the full cost yourself. If you have a Medicare Advantage plan that covers hearing aids, you may be able to use that coverage at Miracle Ear if they are in your plan's network.

What if Miracle Ear is not in my Medicare Advantage plan's network?

You can still buy from Miracle Ear, but your plan may not pay anything toward the cost. You would pay out of pocket. Some plans pay a portion of out-of-network costs, but usually less than they would pay in-network. Call your plan to ask what they will pay before you buy.

How much does Medicare Advantage hearing aid coverage usually pay?

Coverage varies widely by plan. Some plans cover up to $2,000 per year; others cover $500 or less. Some cover one hearing aid every few years; others cover both ears annually. You must call your specific plan to find out what they cover. The amount is not the same across all plans.

Does Medicaid cover Miracle Ear hearing aids?

Medicaid covers hearing aids in many states, but coverage rules vary by state. If you have low income, check whether you are covered by your state's Medicaid program. Your state health department can tell you the income limits and what hearing aids Medicaid covers in your state.

What should I do if Miracle Ear says my plan does not cover hearing aids?

Call your Medicare Advantage plan directly to verify. Use the customer service number on your insurance card. Ask whether they cover hearing aids and whether Miracle Ear is in their network. Get the plan's answer in writing. If your plan does cover hearing aids and Miracle Ear is in network, the retailer may have made an error in checking your coverage.