Original Medicare does not cover hearing aids or the exams needed to fit them. This exclusion is written directly into the Medicare statute, meaning Parts A and B will not pay any portion of the cost for hearing aids regardless of your level of hearing loss. However, Medicare Advantage plans, diagnostic hearing exams, and surgically implanted devices each follow different rules, and understanding those distinctions can save you thousands of dollars.
Why Original Medicare Excludes Hearing Aids
The exclusion isn’t a policy choice that administrators can reverse on their own. Federal law specifically prohibits Medicare from paying for “hearing aids or examinations therefor.” That language covers not just the devices themselves but also the fitting appointments, adjustments, and follow-up exams related to getting hearing aids. Under Original Medicare, you pay 100% of these costs out of pocket.
This puts hearing aids in the same category as routine eye exams and eyeglasses, which are also excluded by statute. Changing the rule requires an act of Congress, not just an administrative update from the Centers for Medicare & Medicaid Services.
What Medicare Does Cover for Hearing
While hearing aids are excluded, diagnostic hearing and balance exams are covered under Part B when a doctor orders them to determine whether you need medical treatment. The key distinction is purpose: if the exam is figuring out whether you have a medical condition affecting your hearing, Medicare pays its share. If the exam is specifically about prescribing or fitting a hearing aid, it does not.
Starting recently, you can also see an audiologist once every 12 months without a doctor’s referral, but only for two specific situations: non-acute hearing conditions (the kind of gradual hearing loss that develops over years) and diagnostic services related to hearing loss that would be treated with a surgically implanted device. These visits are for evaluation, not for hearing aid fitting.
Cochlear Implants Are Covered
Medicare draws a line between hearing aids and surgically implanted hearing devices like cochlear implants. Cochlear implantation is covered when you have bilateral moderate-to-profound sensorineural hearing loss and get limited benefit from regular hearing aids. “Limited benefit” has a specific threshold: scoring 60% or lower on recorded open-set sentence recognition tests in your best-aided condition.
You also need to be free of middle ear infection, have a cochlea suitable for implantation, and be willing to go through an extended rehabilitation program afterward. If you qualify, Medicare Part B covers the surgery and the device itself, which represents a significant benefit since cochlear implants can cost $30,000 to $50,000 or more without coverage.
Medicare Advantage Plans Often Include Hearing Aids
This is where the picture changes dramatically. Medicare Advantage (Part C) plans are sold by private insurers and are required to cover everything Original Medicare covers, but they can add extra benefits. Hearing aid coverage is one of the most common additions. As of 2021, 97% of Medicare Advantage enrollees (roughly 17.1 million people) had access to some form of hearing benefit through their plan. Among those enrollees, 95% were in plans covering both hearing exams and hearing aids.
The catch is that coverage comes with limits. Nearly every plan with hearing aid benefits imposes annual dollar caps, frequency limits, or both. The average annual dollar limit is $960, though plans range widely from as low as $66 to as high as $4,000. The most common frequency limit allows one set of hearing aids per year.
Cost sharing varies too. About 60% of enrollees are in plans that require copays or coinsurance for hearing aids, with amounts ranging from $5 up to $3,355. On the other end, roughly 22% of enrollees pay no cost sharing at all for hearing aids, though virtually all of those members are in plans with a maximum annual dollar limit on the benefit.
Some Medicare Advantage plans also cover over-the-counter hearing aids, which became widely available after the FDA created a new OTC category in 2022. If your plan includes a hearing benefit or a flexible spending allowance, check whether OTC devices qualify. Coverage for OTC hearing aids varies significantly from plan to plan.
Medigap Plans Do Not Help
If you have Original Medicare and a Medigap (Medicare Supplement) policy, don’t expect it to cover hearing aids. Medigap plans are designed to fill gaps in Original Medicare, covering things like copayments, coinsurance, and deductibles for services Medicare already pays for. Since Original Medicare excludes hearing aids entirely, there’s no “gap” for Medigap to fill. The exclusion passes straight through.
How to Reduce Your Out-of-Pocket Costs
A pair of prescription hearing aids typically costs $2,000 to $7,000, making this one of the larger out-of-pocket health expenses Medicare beneficiaries face. Several strategies can bring that number down.
Switching to a Medicare Advantage plan with a generous hearing benefit is the most direct route. During the annual enrollment period (October 15 through December 7), compare plans in your area and look specifically at the hearing aid allowance, frequency limits, and required cost sharing. A plan with a $2,000 to $4,000 annual hearing benefit can cover a significant portion of the cost.
Over-the-counter hearing aids are another option. These devices, available without a prescription for adults with mild to moderate hearing loss, typically cost $200 to $1,700 per pair. They’re sold at pharmacies, electronics retailers, and online. OTC hearing aids won’t work for severe hearing loss, but for many people they provide meaningful improvement at a fraction of the price.
State programs, nonprofit organizations, and some veteran’s benefits also provide hearing aids at reduced cost or free of charge. Vocational rehabilitation programs in many states cover hearing aids if hearing loss affects your ability to work.
Pending Legislation to Watch
In January 2025, the Medicare Hearing Aid Coverage Act (H.R. 500) was introduced in the House of Representatives. The bill would add hearing aids and related exams to the list of benefits Medicare covers. Similar bills have been introduced in previous congressional sessions without passing, so there’s no guarantee this version will become law. For now, the statutory exclusion remains in effect, and Original Medicare does not cover hearing aids.