Hearing aids are not always covered by health insurance, but most insurance providers will cover the cost of a diagnostic hearing exam to determine whether you have hearing loss.

Hearing care coverage often depends on your insurance program, your specific plan, and your state. But keep your eyes peeled for changes — this topic is evolving quickly. Here’s why.

 

How Hearing Aid Coverage Is Changing

Over-the-counter (OTC) hearing aids are relatively new to the industry. In August 2022, the FDA released new regulations that allow hearing aids to be sold over the counter. Brands like Jabra Enhance and Eargo emerged with their OTC hearing aids, which treat people with mild to moderate hearing loss for less than $3,000 per pair. This cost is significantly lower than prescription hearing aids, which generally range from $3,000 to $7,500 per pair, based on our reviews team’s research.

Competition in the hearing aid industry has grown rapidly in the months following the FDA ruling. Brands are changing their product offerings, services, and business-to-business relationships to keep up. And some are strategically improving relationships with insurance companies and intermediaries, offering more opportunities for people to access care and find coverage.

For example, Eargo formed a partnership with supplemental benefits provider NationsBenefits in January 2023, which allows its members to purchase Eargo OTC hearing aids using supplemental benefits purchased outside of their traditional private insurance. You can read more about the NationsBenefits hearing care program, NationsHearing, on its website.

Other hearing aid brands are making moves too. MDHearing recently partnered with healthcare company Medline to bring OTC hearing aids to Medicare Advantage and Medicaid subscribers. In 2024, subscribers to these insurance programs should be able to use their supplemental benefits toward MDHearing hearing aid purchases.

Hearing Aid Coverage in Five Common Types of Insurance

Insurance policies have differing approaches to hearing care coverage. This list covers five common insurance categories: private health insurance, Medicare, Medicaid, VA healthcare, and workers’ compensation.

1. Private Health Insurance

Most major private insurance plans cover diagnostic testing to see if you have hearing loss and to what degree, but many don’t provide coverage for the treatment of hearing loss. If you need hearing aids, you likely will not receive assistance unless you live in one of five states that mandate hearing aid coverage. And even if you do live in a state that mandates hearing aid coverage, always check with your insurance company first. According to the American Speech-Language-Hearing Association, some insurance plans are exempt from state mandates.

If your plan does cover hearing aids, you may still need to be prepared to pay part of the cost, depending on your insurance company’s policies. “Different plans will have different levels of coverage,” says Ruth Reisman, a licensed audiologist and co-owner of Urban Hearing in Brooklyn, New York. “They will cover a percentage of the hearing aid, but only after the deductible and out-of-pocket is paid, or they will only cover a new set every certain number of years.”

Hearing aids for children are one of the exceptions to those policies. Dr. Reisman points out that many insurance plans, including Medicaid, cover the cost of hearing aids for those younger than 18. According to a review published in the Journal of the American Medical Association in December 2020, children depend on sound to develop speech and language skills, and the same research found that prescription hearing devices can improve quality of life and self-esteem for children with impaired hearing.

It’s important to note that although OTC hearing aids have become more accessible to adults, the FDA does not recommend them for children; all insurance-approved hearing devices for children are by prescription only.

Other policy exceptions or limitations will depend on your state’s insurance laws, which are listed on the Hearing Loss Association of America website. Most insurance policies that cover hearing care will provide details regarding their policies online, like Aetna’s Hearing Aids Policy, which includes:

• The criteria that must be met to verify that hearing aids are medically necessary for the insured person

• Which types of hearing devices are considered medically necessary

• Information on each hearing device listed in the policy

• Research that supports the policy

Reading these policies can help you to understand what is covered, what is not, and why. If you can’t find your insurance company’s hearing aid policy online, contact an agent to see if they offer a hearing aids policy and request that it be emailed (or mailed) to you.

Most workplaces offer their full-time employees health insurance coverage through a specific provider, so you may be able to add hearing care coverage to your policy through your employer during the annual open enrollment period.

If you’re shopping for health insurance independently, you can only enroll in a new policy between November 1st and January 15th of each year, according to Healthcare.gov. Otherwise, the only way to make changes to an existing policy is to qualify for special enrollment due to a life event, such as adopting a child, having a baby, or getting married.

2. Medicare

Medicare is a government-funded insurance program for U.S. residents age 65 or older, or for those under age 65 with qualifying conditions. The two primary parts of Medicare are:

• Part A, or original Medicare, which mostly covers hospital care

• Part B, which covers services deemed medically necessary by your doctor

If you enroll in Part A, you’ll also have the option to enroll in Part B. Most, but not all, people 65 and older are eligible for free Part A coverage. Part B is an addition to Part A and has a monthly premium based on income. View Medicare costs in 2023 for up-to-date premiums and deductibles.

Original Medicare (Parts A and B) explicitly states that it does not cover hearing aids or exams, so you will have to pay the entire cost out-of-pocket. Medicare Part B will cover diagnostic hearing and balance exams to determine whether you need hearing loss treatment, but only if your doctor deems it medically necessary.

Medicare Advantage plans (Part C) work differently. You can enroll in a Medicare Advantage plan through a private insurer that contracts with Medicare to provide all of the services covered under Parts A and B, along with extra benefits that may include hearing care. These extra benefits may include:

• Hearing aids

• Professional fittings to ensure your hearing aids work properly

• Routine exams to check your hearing

Similar to other types of private insurance, policy terms for Part C plans differ between insurance companies, states and ZIP codes. For example, Blue Cross Blue Shield (BCBS) provides a comprehensive list of all Medicare Advantage plans offered across the United States in 2024. Not all plans have hearing benefits, and plans that do have hearing benefits may not offer the same coverage as other plans.

Some insurers partner with third-party managed care companies that cover hearing services at a low up-front cost for hearing devices, with varying coverage for long-term care. But don’t forget to verify which healthcare providers accept Medicare Advantage plans, especially if a third-party managed care company provides hearing services. Only some audiologists are credentialed providers.

Medicare Part D, or prescription drug plans, are also offered through private insurers. These plans do not offer any coverage for hearing exams or aids, but they may be useful if your hearing loss requires prescribed medications.

If you’re unsure if a Medicare plan will cover your hearing care, check with the insurance provider before purchasing the plan to see if it will address your needs at a fair cost to you. And it’s important to keep in mind that some medical providers don’t take Medicare or Medicare Advantage plans, so find out who’s in your network through Medicare’s Medicare provider search tool before you make an appointment. Otherwise, you may be left holding the bag for the full cost of the exam.

See the chart below for a breakdown of each Medicare plan and its hearing care coverage.

Medicare Type	Diagnostic Exam Coverage	Hearing Aid Coverage	Routine Exam Coverage
Original Medicare (Part A)	No	No	No
Medicare Part B	Yes*	No	No
Medicare Advantage (Part C)	Yes**	Yes**	Yes**
Medicare Part D (Drug coverage)	No	No	No

Note that you must enroll in Medicare Parts A and B three months before, during, or three months after your 65th birthday month. You can enroll later, but you’ll pay a higher monthly premium, according to Medicare.gov. The annual enrollment period between October 15 to December 7 is your window of opportunity to make changes to your existing Medicare plan, such as switching from original Medicare to Medicare Advantage or changing your Medicare Advantage provider.

You can contact Medicare via phone at 800-633-4227; representatives are available 24/7.

If you need assistance regarding a Medicare Advantage plan, call the private insurer that’s providing the plan instead.

Medigap or Medicare Supplement Plans

Medicare Supplement plans, or Medigap, help cover out-of-pocket costs that Medicare Parts A and B don’t cover. They’re often sold by private insurers, similar to Medicare Advantage plans, and you can enroll during your 65th birthday month or up to five months after as long as you’re enrolled in Part B.

Medicare explicitly states that Medigap policies do not cover the cost of hearing aids, nor does Medigap cover Medicare Advantage copayments, deductibles, or premiums, so Medicare discourages having both Medigap and Medicare Advantage.

3. Medicaid

Medicaid is a federal- and state-funded insurance program that provides free or low-cost coverage for eligible adults and children in low-income households. Medicaid may cover the cost of hearing aids, but this benefit depends on your age and your location. If you have both Medicare and Medicaid coverage, you may be eligible for plans that cover certain hearing aids in full through insurance providers like United Healthcare or Blue Cross Blue Shield.

Coverage for children is the easiest to find. The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program is a Medicaid service that is mandated across all states. It provides screening and treatment services, like hearing aids and regular hearing exams, to children from birth through age 21.

For adults, coverage varies by state. Some states do not cover hearing aid services or devices at all, while others cover specific products and services only. Jump to the next section to learn more about insurance coverage by state.

States that do cover hearing aids often have limitations, so check:

• What criteria you must meet for coverage (hearing loss of a certain level)

• How many hearing aids are covered (some states only cover one pair per term)

• What type of hearing aids are covered

• How often your plan covers new hearing aids

• Which specific services are covered, like diagnostic exams and fittings

• How often you can schedule routine exams

• If your plan covers hearing aid accessories, repairs, and cleanings

The Hearing Loss Association of America lists Medicaid coverage for adults by state, along with each state’s limitations.

Medicaid’s eligibility requirements differ between locations, so contact your state to see if you may qualify for coverage and to ask how you can apply.

4. Veterans Affairs (VA) Healthcare

VA healthcare is the largest employer of hearing professionals in the nation, with more than 1,370 audiologists and 410 audiology health technicians, according to VA.gov. All United States military veterans who are enrolled in VA healthcare receive full coverage for a hearing evaluation anywhere in the nation.

Hearing devices (often top-of-the-line) are covered if your audiologist determines that they are medically necessary. The VA healthcare system also covers fittings, repairs, disposable batteries, and accessories like wax guards that protect the ear piece from earwax. You can find instructions on ordering replacement batteries and accessories on the VA website.

To enroll in VA healthcare, you’ll need to check your eligibility and apply to the U.S. Department of Veterans Affairs. You can apply for VA health benefits online, in person at your local VA Medical Center or Clinic, or by mailing Form 10-10EZ to the VA Medical Center near you.

If your hearing changed during your military service, you may be eligible for compensation. To qualify, you must show that you’ve served on active duty and have a service-connected condition, which is a medical condition that began during your service. The VA will also give you a disability rating based on factors like your doctor’s medical reports. Your disability rating determines the severity of your condition, with more severe conditions receiving more compensation. You can learn more about VA disability compensation online.

Contact VA healthcare online or by phone at 800-698-2411. Representatives are available 24/7 to discuss your benefits or to help you find out if you’re eligible for compensation.

5. Workers’ Compensation

The Occupational Safety and Health Administration (OSHA) requires employers to enact protective measures, like the use of hearing protection devices, if working conditions are consistently loud. OSHA considers 85 decibels to be the maximum sound intensity before requiring protective equipment to protect workers’ hearing. According to OSHA noise exposure standards, “If you need to raise your voice to speak to someone three feet away, noise levels might be over 85 decibels.”

If work duties have caused hearing changes, you may be eligible for workers’ compensation. This is a form of insurance that covers your wages and medical treatment if you’re injured on the job. To qualify, you must alert your employer to any new injury or condition as soon as you’re aware of it. After notifying your employer, you’ll visit an audiologist for an evaluation to determine whether you’re eligible for coverage.

Our reviews team asked different audiologists how often they see workers’ compensation cases in their clinics. Because insurance companies want proof that the hearing loss is a direct result of workplace conditions, it can be difficult to get approval for workers’ compensation. Unless your hearing loss occurred due to a traumatic event, like a blast, it’s hard to prove that hearing loss is a result of work. This is because other environmental factors, like listening to loud music, can also cause hearing loss. Although it is rare, there are cases where job-related hearing loss claims are approved.

All states offer coverage for hearing loss through workers’ compensation, but the terms are different in each state. Visit the U.S. Department of Labor to learn how you can contact your local division.