Medicare is the federal health insurance program primarily covering individuals aged 65 or older. The most direct answer to whether Medicare paid for hearing aids in 2022 was largely no, except through specific private plan options. Original Medicare (Parts A and B) has a long-standing exclusion for coverage of hearing aids and related fitting examinations. The financial burden for these devices falls entirely to the beneficiary unless they have alternative coverage.
Status of Original Medicare Coverage
Original Medicare, specifically Part B, contains a statutory exclusion preventing payment for hearing aids or examinations for their fitting or routine purchase. This exclusion remains a significant gap in coverage for the approximately one-third of Americans aged 65 to 74 who experience hearing loss. Federal regulation states that items or services “not reasonable and necessary” for diagnosis or treatment are not covered, which has long included hearing aids.
While the devices are excluded, Original Medicare Part B does provide coverage for certain diagnostic hearing and balance exams. These exams are covered only when ordered by a physician to determine if medical treatment is required for a specific illness or injury, such as vertigo or a balance disorder. This is distinct from a routine hearing check or an exam performed solely for fitting a hearing aid, which is not covered.
If a diagnostic hearing test meets Medicare’s “reasonable and necessary” criteria, the beneficiary is responsible for the Part B deductible and 20% of the Medicare-approved amount for the service. The distinction between a covered diagnostic exam and an uncovered routine exam determines whether the beneficiary pays all or a portion of the cost. This coverage framework for Original Medicare has remained consistent for those enrolled in Parts A and B.
Understanding Medicare Advantage Benefits
The primary way Medicare beneficiaries access coverage for hearing aids is through Medicare Advantage (MA) plans, also known as Part C. These plans are offered by private insurance companies approved by Medicare and must cover all services included in Original Medicare. MA plans often provide supplemental benefits not covered by Original Medicare, with hearing care being one of the most common additions.
In 2022, nearly all Medicare Advantage plans offered some form of hearing benefit, though the specifics varied significantly. Coverage typically takes the form of a fixed dollar allowance toward the purchase price or a set copayment for a hearing aid within a specific network. Some plans might offer a $1,250 annual allowance per ear, while others might require a copayment ranging from a few hundred to over a thousand dollars.
MA plans frequently impose limitations on the frequency of coverage, often allowing for new hearing aids every one to three years. Beneficiaries must carefully review their Annual Notice of Change (ANOC) or Evidence of Coverage document to understand the exact allowance, copayment structure, approved vendors, and frequency limitations. Due to this variability, beneficiaries may still face significant out-of-pocket costs, particularly if they select a high-end device or one outside the plan’s network.
Non-Medicare Financial Assistance Options
Several non-Medicare options exist to help manage the expense of hearing aids for those without Medicare Advantage or who face high out-of-pocket costs. A significant development in late 2022 was the establishment of a new category for Over-the-Counter (OTC) hearing aids. This FDA ruling, finalized in August 2022, allowed adults with perceived mild-to-moderate hearing loss to purchase devices directly from retailers without a medical exam or prescription.
OTC hearing aids are generally far less expensive than prescription devices, often costing between $200 and $1,500 per pair, making them a more accessible alternative for many individuals. While not a Medicare benefit, this change provides a viable, lower-cost solution for the most common types of age-related hearing loss. Government assistance programs like Medicaid may cover hearing aids for dual-eligible beneficiaries, though this coverage varies by state.
Veterans enrolled in the Veterans Health Administration (VA) healthcare system who meet specific eligibility criteria, such as having a service-connected disability, can receive hearing aids and related services at no cost. Various non-profit organizations offer assistance programs that provide free or discounted hearing aids to low-income individuals. Taxpayers can also potentially deduct hearing aids and related maintenance costs as itemized medical expenses on their federal income tax return, subject to certain income thresholds.