Original Medicare (Parts A & B)

Original Medicare does not cover hearing aids. This is one of the most significant gaps in Medicare coverage. Medicare Part B does cover:

• Diagnostic hearing and balance exams when ordered by a physician to determine a medical diagnosis (not routine hearing tests)
• Cochlear implants (as a surgical procedure)

Routine hearing tests and hearing aids — both OTC and prescription — are explicitly excluded from original Medicare coverage.

Medicare Advantage (Part C)

Medicare Advantage plans are required to cover everything original Medicare covers, but many offer additional benefits — including hearing aids. Coverage varies significantly by plan:

• Some plans cover OTC hearing aids only (typically $200–$500 benefit per year)
• Some plans cover prescription hearing aids with a fixed benefit ($500–$2,500 per pair every 1–3 years)
• Some plans cover hearing exams and aids through a network provider (e.g., TruHearing, HearUSA)
• Some plans offer no hearing aid benefit at all

Check your specific plan's Evidence of Coverage document for hearing aid benefits. Benefits change annually — review during open enrollment each fall.

Medicaid

Medicaid coverage for hearing aids varies by state. Federal law requires states to cover hearing aids for children under 21 through the EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) program. For adults, coverage is optional and varies widely:

• Some states cover hearing aids for adults with no restrictions
• Some states cover one hearing aid per ear every 3–5 years
• Some states cover hearing aids only for specific diagnoses
• Some states provide no adult hearing aid coverage

Contact your state Medicaid office or a local audiologist for current coverage in your state.

Private insurance

Private insurance coverage for hearing aids is inconsistent. Approximately 60% of employer-sponsored health plans offer some hearing aid benefit. Common structures:

• Fixed dollar benefit ($500–$3,000 per pair every 1–3 years)
• Percentage coverage after deductible (e.g., 50% up to a maximum)
• Network-based coverage through hearing benefit managers (TruHearing, HearUSA, Amplifon)

Check your Summary of Benefits and Coverage (SBC) document or call your insurer's member services line to understand your specific benefit.

Veterans Administration (VA)

The VA provides hearing aids to eligible veterans at no cost — including premium prescription devices. This is one of the most comprehensive hearing aid benefits available. Eligibility is based on service-connected hearing loss, disability rating, or other qualifying criteria. Veterans should contact their VA audiologist or the VA's Audiology and Speech Pathology service before purchasing hearing aids elsewhere.

FSA and HSA

Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) can be used to purchase hearing aids — both OTC and prescription — with pre-tax dollars. This effectively reduces the cost by your marginal tax rate (typically 22–32% for most working adults). Key points:

• Both OTC and prescription hearing aids qualify as eligible medical expenses
• Hearing tests, batteries, and accessories also qualify
• FSA funds typically expire at year-end (check your plan's grace period)
• HSA funds roll over indefinitely

Other assistance programs

• State vocational rehabilitation programs: May cover hearing aids for working-age adults whose hearing loss affects employment
• Lions Club International: Provides hearing aids to low-income individuals through local chapters
• Starkey Hearing Foundation: Provides hearing aids to those in need
• Hear Now (Starkey): Assistance program for low-income adults
• Manufacturer financing: Most major hearing aid manufacturers offer 0% financing through CareCredit or similar programs