Medicare and Hearing Aids

When people find out that Medicare pays nothing for hearing aids, the reaction I get is often one of incredulous disbelief. What’s more, it was no accident. Hearing aids were specifically excluded! Why doesn’t Medicare pay for something that the vast majority of seniors are likely to need?

You have to remember that health insurance today, where even routine visits are covered, is not what it was back in 1965. Medicare was designed to address acute conditions with high associated costs, not ‘routine’ health care. In the government’s defense, back then we didn’t know how important treating hearing loss is to overall health, earning capacity, quality of life, and healthy aging. As a field of study, Audiology was less than two decades old at the time, begun in response to the large number of our returning veterans with noise-induced hearing loss (NIHL). At that time audiologists were only studying hearing and hearing loss, not dispensing hearing aids, which were seen as ‘elective’ and (at that time) relatively affordable items. Also, life expectancy in 1965 was considerably shorter (66.8 years vs. approx. 78.4 years), meaning fewer people with hearing loss.

Before going on, for complete accuracy, I do want to add a small caveat to my first sentence. While Medicare Parts A and B do not, some Medicare Part C (aka Medicare Advantage) plans offer a hearing aid “benefit.” However, I do not think very highly of these “benefits” (or Medicare Advantage itself, though that’s a whole different article). Good, proper hearing healthcare requires expertise and good tools (hearing aid/assistive technology) coupled with good and accessible resources and care. One alone isn’t enough, and these Part C “benefits” typically offer poor versions of more than one of them.

While there are some private (non-Medicare) insurance plans that offer “hearing aid benefits,” they are few and far between. And even then, there is often still a sizable (by most peoples’ standards/means) out-of-pocket cost.

As I’ve written many times in this space, when you’re buying hearing aids, you’re really buying hearing healthcare. This is true for OTC (over-the-counter), big box stores, and hospital clinics, as well as private practices. We emphasize to patients that we don’t sell hearing aids, we sell treatment (with the devices being a part of that treatment/care).

When buying hearing aids, the Hearing Industries Association (HIA) estimates that actual device costs represent about one-third of the total cost. The other two-thirds is therefore going towards the actual healthcare provided. Hence the cost differences between OTC (no actual healthcare provided), big box stores (sub-standard care), and hospital clinics/private practice (actual healthcare). Especially regarding hearing healthcare, like many things in this world, you get what you pay for.

So will Medicare ever cover hearing aids? To some extent, the answer to that question depends on what “cover” means—the devices themselves, provider care and services, or both? There is actually widespread bipartisan support for adding hearing, as well as dental and vision, coverage to Medicare. As recently as 2021, the “Build Back Better Act” included major provisions for Medicare hearing aid coverage, attempting to add hearing aids and audiology services under Part B for the first time. It passed in the House, but didn’t in the Senate. The bipartisan “Medicare Hearing Aid Coverage Act” (H.R. 500; introduced in 2023 and reintroduced in January of 2025) aims to make hearing care more accessible for seniors. Unfortunately, it has languished in committee with little chance of becoming law any time soon.

I do believe that Medicare will someday provide some coverage towards treatment of sensorineural (nerve) hearing loss (i.e. hearing aids). It will not be a panacea, but I believe that it will help drive down costs, making better hearing more affordable and accessible.

Please continue to show you love your community by supporting our local businesses and remembering the humanity of those around you. Wishing everyone a new year full of health, peace and prosperity.