Aetna's hearing aid coverage depends on your specific plan

Aetna covers hearing aids under some plans but not others, and the amount they pay varies widely. Whether you have coverage comes down to three things: which Aetna plan you're enrolled in, whether it's a Medicare Advantage plan or a commercial plan, and whether your plan includes hearing benefits at all. Many Aetna plans cover zero dollars toward hearing aids, while others cover a percentage of the cost or a fixed dollar amount per ear every few years.

The only way to know what your plan covers is to check your plan documents or call Aetna directly with your member ID. Generic information about "Aetna coverage" won't tell you what you personally owe.

Key Takeaways

  • Aetna hearing aid coverage is plan-specific — some plans cover nothing, while others cover 50% of the cost or a set amount per ear.
  • Medicare Advantage plans through Aetna often include hearing benefits, but commercial plans frequently do not.
  • You need your member ID and plan name to find out your actual coverage limits and whether you need a referral.
  • Even with Aetna coverage, you will likely pay out of pocket because hearing aids cost $2,000 to $6,000 per pair and most plans cap their payment.

How to find out what your Aetna plan covers

Call the customer service number on the back of your Aetna card and ask specifically: "Does my plan cover hearing aids, and if so, how much?" Have your member ID ready. The representative will tell you whether hearing aids are covered, what percentage or dollar amount the plan pays, how often you can get a new pair, and whether you need a referral from your primary care doctor.

You can also log into your Aetna account online and search the plan documents for "hearing" or "audiology." Look for a section called "Durable Medical Equipment" or "Hearing Services" — that's where hearing aid coverage usually appears. If you can't find it after searching, the plan likely doesn't cover hearing aids.

Keep the coverage details in writing. Take notes during the call or screenshot the plan document. You'll need this information when you contact an audiologist or hearing aid provider, because they will ask what your insurance covers before fitting you.

Medicare Advantage plans versus commercial plans

Aetna Medicare Advantage plans are more likely to include hearing benefits than commercial plans sold to working-age people. Many Aetna Medicare Advantage plans cover a hearing aid benefit — often $0 to $500 per ear every two or three years, or a percentage of the cost. However, not all Medicare Advantage plans include it, and the amount varies by plan.

Commercial Aetna plans (the kind you get through an employer or buy on your own) rarely cover hearing aids. Most exclude them entirely or list them as not covered. If you have a commercial plan and want hearing aid coverage, you may need to explore other options like standalone hearing aid discount programs or manufacturer programs that offer reduced prices.

What happens after Aetna approves coverage

If your plan covers hearing aids, you will typically need to see an audiologist or hearing aid provider who is in Aetna's network. Using an in-network provider means Aetna's negotiated rate applies, which is usually lower than the provider's standard price. If you see an out-of-network provider, you may pay more out of pocket.

The audiologist will perform a hearing test, recommend hearing aids, and submit a claim to Aetna. Aetna will then pay their portion directly to the provider, and you'll pay the difference. If your plan covers $500 per ear and the hearing aids cost $3,000 per pair, you owe $2,500 (plus any fitting fees or adjustments not covered by insurance).

Some providers offer payment plans for the amount you owe out of pocket. Ask about this before you commit to a purchase.

Common coverage limits and exclusions

Even plans that cover hearing aids usually have limits. The most common structure is a dollar cap per ear every two or three years — for example, $500 per ear every three years. Some plans cover a percentage (like 50%) up to a maximum amount. A few plans cover the full cost of hearing aids, but this is rare.

Most Aetna plans exclude coverage for hearing aid batteries, repairs, adjustments, and follow-up appointments. Some plans also exclude certain brands or styles of hearing aids, or require you to choose from a limited list of approved devices. Check your plan documents for these details.

Plans also typically exclude coverage if you're seeking hearing aids for cosmetic reasons or if your hearing loss is related to a condition that's not covered under your plan. This is uncommon, but it's worth checking.

What to do if your Aetna plan doesn't cover hearing aids

If your plan excludes hearing aids, you have several options. Some employers offer a separate hearing aid benefit through a different company — ask your HR department whether your employer has a hearing benefit plan outside of Aetna. These plans sometimes cover hearing aids even when your main health insurance doesn't.

You can also explore hearing aid discount programs like TruHearing, Amplifon, or Costco Hearing Centers. These programs offer reduced prices on hearing aids (usually 20% to 50% off retail) without requiring insurance. Costs typically range from $1,000 to $3,000 per pair instead of the full $2,000 to $6,000.

Some hearing aid manufacturers offer patient information programs or financing options if you buy directly. Phonak, Widex, Starkey, and Oticon all have programs that reduce the upfront cost or let you pay over time.

Frequently Asked Questions

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

Some Aetna plans require a referral from your primary care doctor before you see an audiologist, while others don't. Call Aetna with your member ID to ask. If a referral is required, your doctor can send it electronically to the audiologist, or you can request it and deliver it yourself.

Will Aetna cover hearing aids if I buy them online?

Aetna will only cover hearing aids purchased through an in-network provider or audiologist. If you buy hearing aids online or from an out-of-network seller, Aetna won't pay anything toward them. Always confirm the provider is in-network before you buy.

Can I use my Aetna coverage at any audiologist?

No — you need to use an in-network audiologist or hearing aid provider for Aetna to cover the cost. Call Aetna or search their website for "hearing aid providers near me" to find in-network options. Out-of-network providers may bill you the full amount.

What if Aetna denies my hearing aid claim?

If Aetna denies coverage, ask for the reason in writing. Common reasons include: the provider was out-of-network, you exceeded your benefit limit, or your plan doesn't cover hearing aids. You can file an appeal with Aetna if you believe the denial was wrong. The appeal process usually takes 30 to 60 days.

Does Aetna cover hearing aid batteries?

Most Aetna plans do not cover hearing aid batteries. You'll typically buy them yourself from the audiologist, a pharmacy, or online. Batteries cost $5 to $15 per pack depending on the size and type, and you may need new batteries every one to two weeks.