Most insurance plans cover hearing aids only partially, and many cover them not at all

Whether your insurance covers hearing aids depends on the type of insurance you have, what your plan says, and sometimes your age. Medicare covers a hearing test but not the hearing aids themselves. Most private insurance plans either exclude hearing aids entirely or cover them at a low percentage — typically 50 percent of the cost, up to a yearly maximum of $500 to $2,000. Some employer plans are more generous. Medicaid varies by state: some states cover them, others do not. The only way to know what your plan covers is to call your insurance company directly and ask for the specific dollar amount and percentage they will pay.

Even when insurance does cover hearing aids, the coverage often comes with limits. You might be allowed one pair every three to five years, or the plan might cap what it will pay per ear. Some plans require you to use a hearing aid provider in their network. Before you buy, get a written statement from your insurance company showing exactly what they will pay, what you will owe, and whether there are network restrictions.

Key Takeaways

  • Medicare does not cover hearing aids, though it does cover the hearing test that leads to a prescription.
  • Private insurance plans vary widely — some cover 50 percent up to a yearly cap, others cover nothing, and a few cover more.
  • Medicaid coverage depends on your state; you must check with your state's Medicaid office to learn what they cover.
  • Always call your insurance company before buying and ask for a written statement of what they will pay and what you will owe out of pocket.
  • Some employers offer hearing aid coverage through supplemental plans or wellness programs separate from your main health insurance.

How to find out what your specific plan covers

Start by finding your insurance card or logging into your online account. Call the customer service number on the back of your card. Tell them you want to know about hearing aid coverage. Ask these specific questions: Does the plan cover hearing aids? If yes, what percentage do they pay? Is there a yearly maximum dollar amount? How often can you get new hearing aids? Do you have to use a network provider?

Write down the answers and ask the representative to send you a written summary by email or mail. This protects you if there is a dispute later about what was promised. If the representative is unclear or gives you conflicting information, ask to speak with someone in the benefits department who specializes in durable medical equipment — that is the category hearing aids fall under.

If you have coverage through your employer, also check whether your company offers a separate hearing aid benefit or discount program. Some employers partner with hearing aid retailers to offer discounts even when the main insurance plan does not cover hearing aids. Your HR or benefits department can tell you whether this applies to you.

Medicare and hearing aid coverage

Original Medicare (Parts A and B) does not cover hearing aids or the fitting and adjustment of hearing aids. This is a long-standing exclusion that has not changed. Medicare does cover a hearing test if your doctor orders it as part of diagnosing a medical condition, but the hearing aids themselves are not covered.

Medicare Advantage plans (Part C) are run by private insurance companies and can choose to cover hearing aids if they want to. Some do; most do not. If you have a Medicare Advantage plan, call the plan directly to ask whether they cover hearing aids. Do not assume they do just because you have Medicare Advantage.

Some people use their Medicare Savings Account (if they have one) or other out-of-pocket funds to pay for hearing aids. Others look into whether they may have access to for Medicaid in their state, which may cover hearing aids in addition to Medicare. You can contact your state Medicaid office or call 1-800-MEDICARE to ask about coverage options in your situation.

Medicaid coverage by state

Medicaid is run by each state, so coverage rules are different everywhere. Some states cover hearing aids for children but not adults. Some cover them for all ages. Some cover them only if you meet income limits or have a specific medical condition. A few states do not cover hearing aids at all.

To find out what your state covers, contact your state Medicaid office directly. You can find the phone number by searching "[your state] Medicaid" online or by calling 1-800-MEDICARE and asking for a referral. When you call, ask whether Medicaid in your state covers hearing aids, whether there are age limits, and whether you need a referral from a doctor. Also ask whether the state has a list of approved hearing aid providers — many states do.

If you are not currently on Medicaid but think you might may have access to based on income, you can explore through your state Medicaid office or through Healthcare.gov. The process and income limits vary by state.

Private insurance plans and typical coverage limits

Private insurance companies handle hearing aid coverage differently. Some exclude it entirely from their plans. Others cover it as a durable medical equipment benefit, which means they pay a percentage of the cost up to a maximum amount per year or per hearing aid.

A common structure is 50 percent coverage up to $1,000 per year. This means if you buy a pair of hearing aids that costs $4,000, the insurance pays $1,000 (50 percent of $2,000, which is half the cost) and you pay $3,000. Another plan might cover 80 percent up to $2,000 per ear every three years. Plans also differ on whether they cover both ears or just one, and whether they cover the fitting, adjustment, and follow-up visits.

Some plans require you to use a hearing aid provider in their network. If you go to an out-of-network provider, the insurance may pay nothing or a much smaller percentage. Before you schedule a hearing test or buy hearing aids, ask your insurance company for a list of in-network providers in your area.

Employer plans and supplemental coverage

If you get health insurance through your job, your employer may offer hearing aid coverage as part of the main plan, or they may offer it separately through a supplemental plan or wellness program. Some employers partner with hearing aid retailers like Costco, TruHearing, or regional chains to offer discounts to employees.

Check your benefits handbook or ask your HR department whether your employer offers any hearing aid benefit or discount. If your main health plan does not cover hearing aids, a supplemental plan or discount program might still help you save money. Some employer programs offer 20 to 30 percent discounts on hearing aids, or they may cover a set dollar amount per year.

What to do if your insurance does not cover hearing aids

If your insurance does not cover hearing aids, you have several options. Some people pay out of pocket and look for ways to reduce the cost. Costco, Sam's Club, and Walmart all sell hearing aids at lower prices than many independent audiologists — typically $1,000 to $3,000 per pair instead of $4,000 to $6,000. You do not have to be a member of Costco or Sam's Club to buy hearing aids there, though membership can give you access to their in-store audiologists.

Online hearing aid companies like Lively, MDHearing, and Eargo sell direct to consumers and cost less than traditional routes, though they may not offer the same level of in-person support. Some nonprofits and community health centers offer hearing aids at reduced cost or on a sliding fee scale based on income. You can search for these through your state health department or by calling 211 (a helpline that connects you to local resources).

If you are over 65 and on Medicare, some states have programs that help seniors pay for hearing aids. Contact your state's aging office or your Area Agency on Aging to ask whether such a program exists in your state.

Frequently Asked Questions

Does Medicare cover hearing aids?

No. Original Medicare (Parts A and B) does not cover hearing aids or the fitting of hearing aids. Medicare Advantage plans (Part C) can choose to cover them, but most do not. Call your specific plan to ask.

Will my insurance cover hearing aids if I have diabetes or another medical condition?

Hearing loss caused by a medical condition does not automatically change insurance coverage. Most plans exclude hearing aids regardless of the cause of hearing loss. However, some Medicaid programs cover hearing aids for people with specific conditions. Check with your state Medicaid office or your private insurance company to ask whether your condition changes the coverage rules.

Can I use my Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for hearing aids?

Yes. Both HSAs and FSAs allow you to use pre-tax money to pay for hearing aids and related services like fittings and adjustments. You will need a prescription from a doctor or audiologist. Check your account rules to confirm, as some FSAs have different rules than others.

What if my insurance says they cover hearing aids but the audiologist tells me they do not?

Call your insurance company back and ask them to contact the audiologist's office directly to confirm coverage. Sometimes there is confusion between what the insurance company covers and what the provider is in-network for. Get everything in writing before you proceed with the purchase.

Do I need a referral from my doctor to get hearing aids covered?

Most insurance plans do not require a referral, but some do. Call your insurance company to ask. You will need a hearing test and a prescription from an audiologist or doctor, but that is different from a referral. The audiologist can usually order the hearing test themselves.