Understanding insurance and hearing aids: A complete guide

“Does insurance cover hearing aids?” It’s a common question. But the answer can be somewhat complicated. Read our guide to hearing aids and insurance to better understand what your options are and get tips to affordably access the hearing care you need. 

• Most private insurance does not cover hearing aids, but seems to be evolving
• Original Medicare does not cover hearing aids, but some Medicare Advantage (Medicare Part C) plans do
• Whether hearing aids are covered by Medicaid varies by state
• If your insurance doesn’t cover hearing aids, there are still options to make them more accessible, including payment plans and using HSA/FSA funds
• There can be upsides to purchasing hearing aids without the limitations put in place by some insurance plans, including greater freedom to select your hearing care professional and which models you want to buy

While the question is a simple one, the answer is anything but straightforward. Whether hearing aids are covered by insurance depends on multiple factors, including your age and health conditions, the details of your personal insurance plan, the state where you live and more. In this guide, we’ll help you understand a bit more about situations in which hearing aids might be covered, as well as how you can save money if they’re not.

Hearing aid insurance coverage is relatively rare among private plans, but to understand your particular coverage, you should speak to a plan administrator or your HR department if you get insurance through your employer. Some plans might cover hearing aids for children but not adults, and if there is coverage for adults, it might come in the form of a set amount or an allowance that is only usable with a particular provider.

Some states have mandates that require private insurance to cover hearing aids for children, while others have insurance mandates for both children and adults.

Another common question is, “Does Medicaid cover hearing aids?” The answer to that question also varies by state, as each has its own Medicaid program that works within federal guidelines. Whether you can get coverage for hearing aids depends on whether you meet specific criteria, outlined below.

• Age: Children are more likely to be covered, but some states might cover adults with particular conditions.
• Medical necessity: A licensed audiologist or physician might be required to determine that hearing aids are medically necessary for you.
• Income and other eligibility factors: Whether you qualify is based on both income (Medicaid is designed for low-income people) and other things like family size and disability status.
• State-specific policies: Because each state’s Medicaid program is different, hearing aid coverage—as well as specifics about how often they can be replaced and service coverage for fittings and follow-up care—will vary.

To get precise information, it's best to check with the Medicaid office in your state or consult with a healthcare provider familiar with Medicaid policies.

Wondering whether Medicare covers hearing aids? Original Medicare does not cover. However, Medicare Advantage (or Medicare Part C) plans might include hearing aid coverage—check your plan details or speak with an agent to make sure you know the details.

There are so many factors that affect hearing aid insurance coverage—no wonder it can be confusing. In general, however, there are a few groups of people who may be more likely to have coverage:

• Children: Given the importance of hearing in brain development, it’s more common for their hearing assistive devices to be covered for children.
• Medicare Part C plan holders: If you choose to purchase a Medicare Advantage (Medicare Part C) plan, you’ll have the option to select one that provides the amount of hearing care coverage that you want.
• People with certain medical conditions: In many cases, qualification for insurance coverage—even with Medicaid—depends on the medical necessity of hearing aids.

Wondering how to afford hearing aids without insurance? The good news is that you have options—and you might even find some upsides to buying without the complexity of insurance. From tapping into tax-advantaged savings accounts to payment plans and retailer sales, there are ways to save money while still getting the hearing care you need.

If you’re shopping for hearing aids without insurance, think long-term and find out what you’re getting for your investment. Some options that have lower prices up front might have hidden or added costs for maintenance and care, while others have future costs already factored in. 

At Miracle-Ear, you’ll get support throughout your hearing journey, including finding an affordable solution to get the care you need. Even if your hearing aids aren’t covered by insurance, the Miracle-Ear Advantage ensures that you get the most for your money with a wider range of choices, more flexibility and long-term personal care, plus upfront, what-you-see-is-what-you-get pricing.