Why Doesn’t Medicare Cover Hearing Aids?

Medicare does not cover hearing aids, hearing exams or exams for fitting hearing aids.

When Medicare was passed in 1965, it did not address the normal frustrations of aging; instead, it focused on, in the understanding of 53 years ago, actual diseases. Hearing loss was thought to be part of normal aging, and hearing aids produced by the technology of the time were big, ugly, and not terribly effective.

Even today, with much better technology, 70% of the population with hearing loss does not use hearing aids. One reason for this, of course, is their high cost, which is not covered by most private insurance plans. Even those that cover them generally pay no more than $2500, and a top-of-the-line hearing aid can easily cost triple that. Congress was, of course, worried about the expense.

So, What’s the Situation Now?

There has been some discussion in Congress of having Original Medicare cover hearing aids, but no bills have been reported out of committee. Medicare Advantage plans may, but are not required to, cover hearing aids. If you think you need a hearing aid, it is best to consult a licensed insurance agent who can tell you which plans cover them. Remember that Medicare Supplement plans (“Medigap”) rarely cover hearing aids also.

On the other hand, if your hearing loss is the result of a defined medical condition other than just age-related hearing loss, Medicare does cover the treatment of the underlying condition but does not pay for hearing aids even if they are medically necessary. If you have the sort of deafness that can be cured with a cochlear implant, Medicare will pay for that. It will also pay for surgery on the ear itself, if it is required to treat hearing loss. But diagnosis, treatment, and hearing aids for normal, age-related hearing loss are never covered unless if there is some other underlying condition that can be corrected.

What Does the Future Hold?

The Food and Drug Administration, which governs which medical devices can be sold in the U.S. and how they can be marketed, recently approved the first over-the-counter hearing aids that are actually hearing aids, as opposed to simple amplifiers, known as Personal Sound Amplifiers (PSAPs). The FDA has until September 2020 to write results covering OTC hearing aids, so don’t expect to find a lot of them before then. It is important to make sure that you are buying a hearing aid, not a PSAP. The FDA expects to approve some, but certainly not all, current PSAPs for marketing as hearing aids.

So, What Do I Do Now?

First, see your doctor to exclude any treatable, Medicare-covered cause for hearing loss. If it is not a treatable condition and is just age-related, your only option other than paying yourself is to enroll in a Medicare Advantage plan. In addition to covering hearing aids, Medicare Advantage plans have out-of-pocket limits, which Original Medicare does not. This means that after you have spent a certain amount per year, all further services are covered with no charge to you. You will need to make sure that the plan you choose covers hearing aids and if there is any additional cost to you.

The best advice on this, and Medicare in general, comes from a professional insurance agent. Contact MedicareHealthInsuranceFacts.com at (877) 829-1109 for assistance with choosing a plan.