Blue Cross coverage for hearing aids varies by plan and state
Blue Cross does cover hearing aids under some plans, but not all. Whether your plan includes hearing aid coverage depends on which Blue Cross plan you have, which state you live in, and whether you chose coverage when you enrolled. There is no single Blue Cross policy — each state's Blue Cross licensee sets its own rules, and coverage ranges from no hearing aid benefit at all to partial or full coverage with limits on how often you can replace them.
The first step is to check your own plan documents or call the member services number on your insurance card. They can tell you in minutes whether your specific plan covers hearing aids, what percentage they pay, whether you need a referral, and whether there is an annual limit on what they will cover.
Key Takeaways
- Blue Cross hearing aid coverage is not standard across all plans — you must check your own plan documents or call your member services number to know what you have.
- Some Blue Cross plans cover 50 percent of hearing aid costs, some cover a fixed dollar amount per ear per year, and some do not cover hearing aids at all.
- Many Blue Cross plans require you to see an audiologist in their network and may require a referral from your primary care doctor.
- Medicare Advantage plans sold by Blue Cross typically do not cover hearing aids, though some offer limited coverage or discounts through partner programs.
How to find out what your Blue Cross plan covers
Your member ID card or the back of your insurance card lists a customer service phone number. Call that number and tell them you want to know about hearing aid coverage. Have your member ID ready. Ask them: Does my plan cover hearing aids? If yes, what percentage do they pay, or is there a dollar limit per ear per year? Do I need a referral from my doctor? Do I have to use an in-network audiologist?
You can also log into your Blue Cross account online — most Blue Cross plans have a member portal where you can search your plan documents or use a benefits lookup tool. Look for "hearing aids" or "durable medical equipment" in the search box. If you cannot find it online, the phone call is faster than searching.
Write down the answers you get, including the date you called and the name of the person who helped you. If you later disagree with a denial, you will have proof of what you were told.
What Blue Cross plans typically cover
Plans that do cover hearing aids usually fall into one of two categories. Some cover a percentage of the cost — often 50 percent — after you meet your deductible. Others cover a fixed dollar amount per ear per calendar year, such as $500 or $1,000. A few plans cover both ears up to a total annual limit, such as $2,000 per year.
Most plans that cover hearing aids require you to use an audiologist or hearing aid provider in their network. If you go out of network, you may pay the full cost yourself or get a smaller reimbursement. Some plans also require a referral from your primary care doctor before you can see an audiologist, while others let you go directly.
Coverage usually resets each calendar year, so if your plan covers $1,000 per ear per year and you buy one hearing aid in January, you may have another $1,000 available in January of the next year. Check your plan documents to confirm whether the year runs January to December or follows a different schedule.
Medicare Advantage plans and hearing aid coverage
If you have a Medicare Advantage plan through Blue Cross, standard hearing aid coverage is rare. Medicare itself does not cover hearing aids, and most Medicare Advantage plans follow that rule. However, some Blue Cross Medicare Advantage plans offer limited hearing aid benefits — such as a discount on hearing aids from a partner provider, or coverage of a small dollar amount per year.
A few Blue Cross Medicare Advantage plans in certain states do include hearing aid coverage as a supplemental benefit. The only way to know is to check your plan documents or call the number on your Medicare card. If your plan does not cover hearing aids, you may still be able to get discounts through programs like the Hearing Aid Partnership or through retailers like Costco, which offer hearing aids at lower prices to anyone with a membership.
What happens after your plan covers part of the cost
Once you know your coverage, you will need to find an in-network audiologist or hearing aid provider. Your Blue Cross website usually has a provider search tool where you can enter your zip code and see who is in your network. Call ahead and tell them you have Blue Cross coverage — they will know how to bill your plan and can tell you what your out-of-pocket cost will be.
When you buy the hearing aids, the provider will submit the claim to Blue Cross. Blue Cross will pay their portion directly to the provider, and you will pay the rest. If the hearing aids cost more than what your plan covers, you are responsible for the difference. Some providers offer payment plans if the out-of-pocket cost is high.
Keep your receipt and any paperwork the provider gives you. If Blue Cross denies the claim or pays less than expected, you will need those documents to file an appeal or ask for a review.
What to do if your plan does not cover hearing aids
If your Blue Cross plan does not cover hearing aids, you have several options. You can pay out of pocket — hearing aid prices range widely depending on the type and features, from around $1,000 to $6,000 per pair. Some audiologists and hearing aid retailers offer discounts for cash customers or payment plans.
You can also look into whether you may have access to for other programs. Some states have hearing aid programs for low-income seniors or people with disabilities. The Hearing Loss Association of America has a state-by-state directory of programs and discounts. Costco, Sam's Club, and some other retailers offer hearing aids at lower prices than traditional audiologists, and you do not need to be a member at all retailers to use their hearing aid services.
If you think your plan should cover hearing aids or if you believe you were wrongly denied coverage, you can file a complaint with your state's insurance commissioner. The commissioner's office can investigate whether Blue Cross is following state insurance laws.
Frequently Asked Questions
Do I need a referral from my doctor to get hearing aids through Blue Cross?
It depends on your plan. Some Blue Cross plans require a referral from your primary care doctor before you can see an audiologist, while others let you go directly to an in-network audiologist without one. Call your member services number to ask whether your plan requires a referral.
Will Blue Cross cover a hearing aid if I already have one ear?
Most plans cover both ears separately, so yes — if your plan covers hearing aids, you can usually get coverage for a second aid even if you already have one. However, there may be a waiting period between purchases, such as a rule that you can only replace hearing aids every three or five years. Check your plan documents for any replacement rules.
What if Blue Cross denies my hearing aid claim?
Ask Blue Cross in writing why they denied it. Common reasons include: the audiologist was out of network, you did not have a required referral, or you exceeded your annual limit. If you disagree with the denial, you can file an appeal. Your member services number can tell you how to start an appeal and what documents to send.
Can I use my Blue Cross coverage at any audiologist?
No — most plans only cover hearing aids from in-network providers. If you go to an out-of-network audiologist, Blue Cross may not pay anything, or they may pay a smaller amount. Use your plan's provider search tool to find in-network audiologists near you before you schedule an appointment.
Does Blue Cross cover hearing aid batteries or repairs?
Hearing aid coverage usually means the device itself, not ongoing supplies or repairs. Some plans may cover a small amount toward batteries or repairs, but most do not. Ask your member services number specifically about what is and is not covered after you buy the hearing aids.