Medicare Advantage hearing aid coverage varies by plan and is usually limited
Most Medicare Advantage plans do cover some hearing aid costs, but the coverage is narrower than Original Medicare combined with a Medigap plan. Medicare Advantage (also called Part C) is run by private insurance companies approved by Medicare, and each company sets its own rules about what hearing aids cost you and how much they pay.
Unlike Original Medicare, which covers diagnostic hearing tests but not the aids themselves, some Medicare Advantage plans will pay toward the actual hearing aids. However, you will typically pay a copay or coinsurance for each aid, and many plans limit coverage to one pair every few years rather than annually. The amount your plan covers depends entirely on which plan you chose and which insurance company runs it.
Key Takeaways
- Medicare Advantage plans vary widely — some cover hearing aids with a copay, others cover nothing, so you must check your specific plan's coverage document.
- Plans that do cover hearing aids usually charge a copay per aid (often $500 to $2,000 per pair) and may limit replacements to once every two to five years.
- You can only change your Medicare Advantage plan during the annual enrollment period (October 15 to December 7) or if you have a may have access to life event.
- If your current plan does not cover hearing aids, you may be able to switch to one that does, or you can use Original Medicare with a Medigap plan that includes hearing benefits.
- Some Medicare Advantage plans partner with specific hearing aid retailers or networks, so you may have to use their contracted providers to receive the benefit.
How to find out what your plan covers
The only way to know whether your Medicare Advantage plan covers hearing aids is to check your plan's coverage document, called the Summary of Benefits and Coverage (SBC). This document lists what is covered, what you pay, and any limits. You can find it on your plan's website or by calling the customer service number on your insurance card.
When you call or search online, look for sections labeled "Hearing Services," "Durable Medical Equipment," or "Hearing Aids." Some plans list hearing aids under preventive services (usually lower cost) and others under specialty services (usually higher cost). If the document does not mention hearing aids at all, your plan does not cover them.
If you cannot find the information online, call your plan's customer service line and ask directly: "Does my plan cover hearing aids, and if so, what is my copay or coinsurance per aid?" Write down the answer and the date you called, in case you need to refer back to it.
What you typically pay if your plan covers hearing aids
Plans that cover hearing aids usually require you to pay a copay per aid, meaning you pay a fixed amount ($500 to $2,000 or more per hearing aid) and the plan pays the rest. Some plans instead use coinsurance, where you pay a percentage of the cost (often 20 to 50 percent) and the plan covers the remainder.
Most plans also set a frequency limit — you can get a new pair covered once every two, three, or five years, depending on the plan. A few plans cover one aid per year, but this is less common. If you need new aids before the plan's time limit is up, you will pay the full cost out of pocket.
Some Medicare Advantage plans also require you to use a hearing aid provider in their network. If you go to an out-of-network provider, the plan may not cover any of the cost, or it may cover less. Check whether your preferred hearing aid provider is in your plan's network before scheduling an appointment.
Switching plans to get hearing aid coverage
If your current Medicare Advantage plan does not cover hearing aids and you want coverage, you can switch to a different plan during the Annual Enrollment Period, which runs from October 15 to December 7 each year. The new coverage starts January 1. You can also switch if you have a may have access to life event, such as moving out of your plan's service area, losing employer coverage, or becoming may be able to access for Medicaid.
Before you switch, compare the hearing aid coverage in other plans available in your area. Medicare's Plan Finder tool (at Medicare.gov) lets you enter your zip code and see all available Medicare Advantage plans and their benefits. You can also call 1-800-MEDICARE to ask which plans in your area cover hearing aids and what the copay is.
Keep in mind that switching plans means changing your doctor network, prescription drug coverage, and other benefits. Make sure the new plan covers your doctors and medications before you switch just for hearing aid coverage.
Original Medicare and Medigap as an alternative
If you are currently in a Medicare Advantage plan and hearing aid coverage is important to you, you may want to consider switching to Original Medicare (Parts A and B) paired with a Medigap supplemental plan. Original Medicare itself does not cover hearing aids, but some Medigap plans do.
Medigap Plan G, Plan K, Plan L, Plan M, and Plan N may include hearing aid coverage, though the benefit varies by insurance company and state. Some cover up to $500 per year toward hearing aids, others cover a percentage of the cost, and some cover nothing. You would need to compare Medigap plans in your area to see which ones offer hearing benefits and what the monthly premium is.
Switching from Medicare Advantage to Original Medicare with Medigap is permanent — you cannot switch back to Medicare Advantage after you leave it, with limited exceptions. Before you make this change, talk to your doctor to make sure they accept Original Medicare and Medigap, and compare the total cost of premiums, copays, and deductibles.
What to ask your doctor and insurance company
Before you buy hearing aids, contact your Medicare Advantage plan and ask these specific questions: Does my plan cover hearing aids? If yes, what is my copay or coinsurance per aid? How often can I get a new pair covered? Do I have to use a specific provider or network? Is a hearing test covered, and do I need a referral?
Also ask your hearing aid provider whether they accept your Medicare Advantage plan and what they charge for the aids themselves. Some providers offer discounts to Medicare Advantage members, and some charge less for certain brands. Get a written quote before you commit.
If your plan does not cover hearing aids, ask whether you can switch to a plan that does during the next enrollment period, and what the important date is to make that change.
When to seek help from Medicare
If your plan says it covers hearing aids but then denies the claim, or if you believe your plan is not following its own coverage rules, you can file a complaint with Medicare. Call 1-800-MEDICARE or visit Medicare.gov to report the issue. You can also contact your State Health Insurance information Program (SHIP), which offers free help with Medicare questions and disputes.
If you are having trouble understanding your plan's coverage document or comparing plans, SHIP can walk you through it at no cost. To find your state's SHIP, call 1-800-MEDICARE and ask for the number, or search "SHIP" plus your state name online.
Frequently Asked Questions
Does Medicare Advantage cover hearing tests?
Some plans cover the diagnostic hearing test (audiogram) as a preventive service with no copay, while others charge a copay or do not cover it at all. Check your plan's coverage document or call customer service to confirm. If your plan covers the test, you may still need a referral from your primary care doctor.
Can I use my Medicare Advantage coverage at any hearing aid store?
Not always. Many plans require you to use providers in their network. If you go out of network, the plan may not cover any of the cost. Before you schedule an appointment, ask your plan whether your preferred provider is in network, or ask the hearing aid store whether they accept your specific plan.
What if I need new hearing aids before my plan's coverage period is up?
You will have to pay the full cost out of pocket. Some hearing aid providers offer payment plans or discounts for cash customers. Ask about these options before you buy. You can also wait until your plan's coverage period resets to get the plan to pay.
Can I switch to a different Medicare Advantage plan mid-year to get hearing aid coverage?
Only during the Annual Enrollment Period (October 15 to December 7) or if you have a may have access to life event such as moving or losing coverage. Otherwise, you are locked into your current plan until the next enrollment period. If hearing aids are urgent, you may need to pay out of pocket now and use the plan's coverage later.
Is hearing aid coverage better with Original Medicare and Medigap?
It depends on the Medigap plan you choose and the cost of premiums in your area. Some Medigap plans cover up to $500 per year toward hearing aids, which may be more than your Medicare Advantage plan offers. However, Medigap premiums can be higher than Medicare Advantage premiums, so compare the total cost before you switch.