Does insurance cover hearing aids?
Wondering if hearing aids would be right for you, but discouraged by confusion around insurance coverage? Hearing loss can be a big issue that goes unchallenged by many people, often because of high costs. It's estimated that more than 28 million adults across the U.S. could benefit from a hearing aid, especially older adults, but many of us don't do anything about it because we're on a budget.
But there are certain insurance plans and benefits out there that may cut the cost of new hearing aids -- both prescription-grade hearing aids and their newer counterparts that you can buy directly: over-the-counter, or OTC hearing aids. If you want to know more about the best makes and models, you can start here. Many of them cost a lot less than models you'd get through a doctor, eliminating the need for insurance.
Does insurance cover hearing aids?
The short answer is that insurance companies do not typically cover hearing aids. Exceptions exist, however, depending on a number of personal factors. One of these is your location: Health-care laws in five states currently require coverage by insurance companies for hearing aids for adults:
- Arkansas
- Connecticut
- Illinois
- New Hampshire
- Rhode Island
This requirement may be applied to individual and group health insurance policies, as well as employers who can opt out (as is the case in Arkansas). If you have any questions about the details or limitations of insurance coverage for hearing aids in your state, contact your insurance provider directly for more info.
Is there hearing aid coverage offered by Medicare and Medicaid?
Medicare and Medicaid may offer select hearing aid coverage, but whether this applies to you can be determined by factors like which state you live in. For Medicaid users, some covered services may be covered for adults who need hearing aids depending on your state of residence, including:
- Hearing exams
- Hearing aid repair and replacement services
- Hearing tests for cochlear implants
- Hearing aid fittings
- Hearing aid accessories
- Select hearing aid brands and devices
Basic Medicare does not cover most types of hearing aids or fittings for hearing aids. That includes Original Medicare (Part A and B). While Medicare Parts A and B do not cover hearing exams specifically for the purpose of buying a new hearing aid, they do cover exams for diagnostic purposes that include a doctor's referral. In this case, you pay 20% of the final amount after the deductible and any copayments.
There may also be some limited exceptions for Medicare Advantage (Part C) plans.
Medicare has four parts, with Parts A and B making up what's known as Original Medicare -- a federally provided health plan with more traditional medical and hospital insurance coverage options. Parts C and D are a little different and exist independently of Original Medicare. Here is a breakdown of the Medicare plans and services that are available today:
- Medicare Part A: Hospital insurance. This can cover expenses related to hospital stays, nursing facility care, hospice care, and some additional health care benefits.
- Medicare Part B: Medical insurance. This covers the things you'd expect with most medical insurance plans including select doctors' services, outpatient care, medical supplies, and some preventative services.
- Medicare Part C: Medicare Advantage. These Medicare coverage plans are provided by private companies that have contracts with Medicare and are therefore not federally provided. These plans still include Parts A and B but may include additional benefits (see below).
- Medicare Part D: Prescription drug coverage. This Medicare Supplement plan covers the cost of prescription drugs, as well as many recommended shots and vaccines.
Some Medicare Advantage Plans do offer extra benefits not covered by Original Medicare. These can include coverage for hearing aids and related services such as a hearing exam with an audiologist. Talk with your doctor to find out what you may need in terms of hearing aid devices and services, then consider browsing the different types of Medicare Advantage Plans out there such as a health maintenance organization (HMO), preferred provider organization (PPO), and more.
What coverage options do private insurance companies offer?
Most private insurance companies regard hearing aids as optional, so insurance coverage may not be a part of your insurance plan. Some notable exceptions include:
- Aetna: Some plans may offer payment support or reimbursement for OTC hearing aids that are deemed medically necessary by an audiologist.
- Blue Cross Blue Shield: Some plans may offer hearing aid coverage, but this varies state by state. The Federal Employee Program (FEP), however, does offer an allowance of $2,500 every five years that can go towards hearing aid devices and accessories. Members of the FEP can also find reduced hearing aid prices through the Blue365 Discount offering.
- Cigna: Select insurance plans may include hearing benefits.
- Humana: Humana Medicare Advantage plans may come with hearing aid coverage through Humana Extend, a program that bundles benefits together including vision, dental, and hearing options.
- United Healthcare: One of the best insurance companies for hearing benefits, United Healthcare offers plans that typically include full coverage for major prescription-grade hearing aids. A hearing test from a licensed audiologist is usually required.
Ways to save on hearing aids without insurance coverage
If you are not covered by Medicare, Medicaid, or a provider that offers hearing benefits, there may still be a few ways to avoid paying full price for a new, high-quality hearing aid. U.S. veterans who have healthcare coverage through the Department of Veterans Affairs may qualify for free access to select hearing aids, supplies and hearing exams.
Some other alternative options to hearing aid insurance coverage include:
- Government benefits: There are several federal programs that may help with the price of hearing aids. Federal employees may qualify for free exams and discounts on select hearing aid brands like Starkey and Oticon. American Indians and Alaska Natives may qualify for audiology services through the Indian Health Service program.
- State programs: There may be a vocational rehabilitation program in your state that can provide payment for hearing aids (if its relevant to your employment).
- Membership discounts: International groups like the AARP and Lions Club may offer perks like free hearing exams and discounted prices on select hearing aid brands or accessories.
- Payment plans: A number of OTC hearing aid brands and manufacturers offer payment plans that allow you to spread out the cost of a new hearing aid across multiple months or years. Lexie Hearing is one brand that provides customers with flexible subscription plans.
One increasingly popular way to save money on hearing aids is to purchase them directly. OTC hearing aids like the impressive Jabra Enhance Select 50R ($995 and up) are a relatively new category where customers can get their hands on decent devices for much lower costs -- typically less than $1,000 a pair. Compare this to the average out-of-pocket costs for prescription hearing aids and you'll find the potential for significant savings, with or without insurance coverage.
