Hearing Loss Resource Guide for Medicare Beneficiaries

Tips and resources for Medicare beneficiaries suffering from hearing loss

Approximately 1 out of every 3 people between the ages of 65 and 74 have hearing loss, and hearing loss affects half of all people age 75 and older. Unfortunately, Original Medicare (Medicare Part A and Part B) doesn’t cover most routine hearing care services or hearing aids.

There are options, however, for older adults who have hearing loss. Many Medicare Advantage plans (Medicare Part C), for example, may cover routine hearing care, hearing exams and hearing aids.

In this guide, we outline the hearing services and devices that Medicare beneficiaries may be able to access. We also offer additional resources that can help older adults better understand hearing loss, ways to slow the progression of hearing loss and how various types of insurance provide coverage for hearing care.

What Hearing Care Does Original Medicare (Parts A and B) Cover?

Original Medicare does not cover routine hearing care such as preventive exams or hearing aids. Medicare Part B does, however, cover diagnostic hearing exams and balance exams when ordered by a doctor or other health care provider to see if you may need medical treatment for an illness or injury. 

If Part B covers your hearing or balance exam, you’re typically responsible for paying a 20% coinsurance of the Medicare-approved amount for the doctor’s appointment, after you meet your annual Part B deductible (which is $203 for the year in 2021).

Medicare Part B covers cochlear implants for beneficiaries who need them replace proper hearing function. In order for Part B to cover the implant, your doctor or health care provider must be enrolled in Medicare and order them because they are medically necessary. The same Part B costs outlined above apply to the cost of your cochlear implants if they’re covered by Medicare.

Will Original Medicare Eventually Cover More Hearing Benefits?

When the Medicare program was introduced in 1965, people didn’t live as long as they do today, so fewer people experienced age-related hearing loss. Hearing exams were also very inexpensive, and at the time, there was little understanding of the role that hearing loss played in conditions like depression, social isolation and dementia.

Older adults and politicians alike would like to see more hearing coverage be added to Original Medicare. A bill that would require Medicare to cover certain audiological services, H.R. 4056, was introduced to Congress in 2019. It has yet to make it to the House floor for a vote. 

Another bill, H.R. 576, or the Seniors Have Eyes, Ears and Teeth Act, was also introduced in 2019 but has not yet been voted on. This bill would expand Medicare coverage to include benefits for eyeglasses, hearing aids and routine dental care.

Although these three items are currently not covered by Original Medicare, many privately-sold Medicare Advantage plans already offer benefits to cover dental care, vision care and hearing care that Original Medicare doesn’t cover.

What Hearing Care Can Medicare Advantage Plans Cover?

Because Original Medicare coverage of hearing care is so thin, many beneficiaries turn to Medicare Advantage plans for hearing coverage. 

Medicare Advantage plans, or Medicare Part C, are sold by private insurance companies. They are required by law to include all of the same basic benefits as Original Medicare. Beyond that basic requirement, Medicare Advantage plans may then offer some additional coverage for things not found in Original Medicare.

Most Medicare Advantage plans include prescription drug coverage, and many plans may cover routine hearing care benefits.

Some of the hearing benefits that may be offered by some Medicare Advantage plans include:

  • Routine hearing exams and tests
  • Hearing aids
  • Hearing aid fittings
  • Hearing aid maintenance
  • Follow-up exams
  • Hearing aid adjustments 
  • Hearing aid cleanings 

Because plan benefits, costs and availability can vary from one Medicare Advantage plan to the next, you should check with your plan carrier to find out exactly what hearing care is covered by your plan.  

Does Medicaid Cover Hearing Care?

Medicaid benefits can vary by state, because each state administers its own Medicaid program. Medicare hearing benefits are not required for adults under federal law. As a result, 21 states do not currently offer any hearing coverage for adults on Medicaid. 

Among the states that do offer some Medicaid benefits for hearing, the types of things that may be covered include:

  • Hearing exams
  • Hearing aids
  • Hearing aid replacement and repair
  • Hearing aid accessories 
  • Ear molds and hearing aid fittings
  • Cochlear implants
  • Follow-up appointments for hearing aids or cochlear implants 

The Hearing Loss Association of America offers a detailed list of Medicaid hearing coverage in all 50 states and Washington D.C.

How Does Veterans Insurance (VA Benefits) Cover Hearing Aids?

Veterans Administration (VA) benefits cover diagnostic hearing tests and will also cover hearing aids for veterans who:

  • Have a compensable service-connected disability

  • Are former Prisoners of War (POW)

  • Were awarded a Purple Heart

  • Receive benefits under Title 38 United States Code (U.S.C.) 1151

  • Receive an increased pension because they are permanently housebound or in need of regular aid and attendance

  • Have hearing impairment due to a disease or medical condition for which care is being received from the VA or which resulted from treatment for that condition

  • Have hearing impairments that interfere with receiving or actively participating in medical care being received from the VA

  • Have a service-connected disability that contributes to a loss of communication ability

It’s important to note that TRICARE does not provide any coverage for the cost of hearing aids.

The Department of Veterans Affairs provides more information about how the VA covers hearing aids.

Other Coverage and Financial Assistance for Hearing Care

Most employer-sponsored or marketplace insurance plans provide some routine hearing benefits but generally don’t cover the cost of hearing aids for adults. 

Insurance plans that do cover hearing aids may allot a specified amount of money that you can put toward the cost of hearing aids, such as $500 or $1,000. You’re typically responsible for paying any additional difference in the cost for your hearing aids. 

Some insurance carriers may contract with a hearing aid company to offer discounts to plan members who purchase hearing aids from that particular company.  

Many hearing aid companies offer financing plans so you do not have to pay for the full cost of your hearing aids at once. If you are still enrolled in a group or individual health insurance plan, contact your plan directly to inquire about any hearing aid coverage. 

There are also a number of charitable organizations that provide new or used hearing aids at discounted prices for those who meet certain financial criteria. See our list of hearing resources at the bottom of this page for more information. 

What Is Age-Related Hearing Loss? 

Age-related hearing loss, or presbycusis, is a common symptom of aging. It generally happens gradually, and many people remain unaware of any changes in their hearing during the early stages of presbycusis. The ability to hear low-pitched noises often goes unaffected. But high-pitched sounds such as from a telephone or microwave become more difficult to hear. 

The effects of hearing loss include more than just having to turn up the volume on the TV. Hearing loss can contribute to isolation, strained relationships and depression.

Diminished hearing can also increase the likelihood of accidents and injuries, as balance is affected and awareness of surroundings is reduced. Hearing loss has even been linked to dementia and diminishing cognitive abilities. And unfortunately, unlike many other health conditions, hearing loss is usually not reversible. 

What Causes Hearing Loss?

Hearing loss happens as a result to changes in the inner ear, middle ear or along the nerve pathways to the brain.

In addition to aging, some of the things that may be linked to presbycusis include:

  • Long-term exposure to loud noises
  • Loss of the sensory receptors, or hair cells, in the inner ear
  • Inherited factors
  • Health conditions such as diabetes and heart disease
  • Side effects from certain medications such as aspirin, chemotherapy treatments and antibiotics
  • Certain genetic factors (Caucasians are at increased risk for age-related hearing loss)
  • Infections
  • Smoking
  • Ruptured eardrums
  • Buildups of earwax or fluids
  • Strokes, brain injuries and tumors
  • Viruses and bacteria

What Are Common Hearing Loss Symptoms?

A person with age-related hearing loss may experience some of the following symptoms:

  • Hearing other’s people’s speech as mumbled or slurred
  • Trouble hearing high-pitched sounds
  • Difficulty following a conversation, especially when there is background noise present
  • More difficulty hearing women’s voices than men’s
  • A ringing sound (tinnitus) inside the ears
  • Certain sounds being very loud or annoying
  • Trouble talking on the phone

How Is Age-Related Hearing Loss Diagnosed?

To diagnose hearing loss, a doctor will use an otoscope to examine your ears to look for damage to the eardrum, blockage of the ear canal, impacted earwax, infection or inflammation.

If any of the above are present, you may then be referred to an audiologist for a hearing test which can confirm a loss of hearing.

What Are the Main Types of Hearing Loss?

Hearing loss can be categorized into two main types.

  1. Sensorineural
    Sensorineural hearing loss is usually permanent and occurs when there is damage to the inner ear or the auditory nerve.

  2. Conductive
    Conductive hearing loss occurs when sound waves are unable to reach the inner ear due to a buildup of earwax or fluid or a punctured eardrum. Conductive hearing loss can often be restored by treatment or surgery.  

What Are Common Hearing Loss Treatments?

Age-related hearing loss is typically treated with:

  • Hearing aids
  • Assistive devices
  • Speech reading training
  • Methods to prevent earwax buildup

How Much Do Hearing Aids Cost?

The cost of hearing aids varies a lot, with factors such as style, features, additional services and brand all playing a role.

Generally speaking, you can expect to pay somewhere between $1,000 per device and up to $5,000 or more per device for the higher-end hearing aids. It should be noted that these estimates are per ear, and many people require hearing aids in both ears. 

Additional hearing aid costs can also include the price of the fitting, battery changes, cleanings, adjustments and maintenance, although some of these services may be included in the total cost of the hearing aid.

Types of Hearing Aides

Not all hearing aids are the same. There are multiple different types and styles, and each comes with its own benefits and purpose.

Completely in the Canal (CIC)

As the name suggests, a completely-in-the-canal (CIC) hearing aid fits inside your ear canal and is designed to improve mild to moderate hearing loss. 

CICs are the smallest and least visible type of hearing aid. And because these hearing aids are placed inside the ear, they are less likely to pick up wind noise. 

However, because they are so small, CIC hearing aids require very small batteries that have a shorter life than other types of hearing aids and can be difficult to handle. These hearing aids typically don’t include any extra features such as volume control or a directional microphone and are susceptible to earwax clogging the speaker. 

In the Canal (ITC)

The in-the-canal (ITC) hearing aid is not positioned as far into the ear canal as the CIC. These hearing aids are custom molded to your ear and are designed for mild to moderate hearing loss. 

ITC hearing aids are slightly more visible than CIC hearing aids but still less visible than other styles. These hearing aids often include some extra features but can be difficult to adjust given the small size. And because they are also located inside the ear, they too are susceptible to clogging from earwax. 

In the Ear (ITE) 

An in-the-ear (ITE) hearing aid is positioned outside of the canal and is equipped for mild to severe hearing loss. 

These hearing aids include volume control and other features, and the larger size equates to a longer battery life and easier handling. Despite not being in the ear canal, ITE hearing aids may still be susceptible to clogging. Because they are larger and outside the canal, they are more visible and tend to pick up more wind noise. 

Behind the Ear

Behind-the-ear (BTE) hearing aids are positioned behind the ear with a small hook over the top of the ear to keep them in place. A tiny earpiece is placed in the ear canal with a tube connecting the two parts. BTE hearing aids are effective for any type of hearing loss. 

BTE hearing aids have directional microphones and are capable of stronger amplification than other styles. Being outside the ear, they are more visible and may pick up more wind noise. 

Receiver in Canal (RIC) and Receiver in the Ear (RITE)  

These hearing aids are similar to the BTE style but typically have a smaller and less visible portion of the device behind the ear. Manual control options and directional microphones are common in these styles, as are rechargeable batteries. Like other types of hearing aids, RIC and RITE devices remain susceptible to earwax clogging. 

Open Fit

Open fit hearing aids are similar to the BTE, RIC and RITE designs but with an open dome in the ear that keeps the ear canal open. This allows for low frequency (easier to hear) sounds to enter the ear naturally and for higher frequency sounds to be amplified by the device before entering the ear. 

Open fit hearing aids are ideal for those with better low-frequency hearing but mild to moderate high frequency hearing loss. They tend to make speaking easier, as they can improve how you hear your own voice. However, they are more visible and can be difficult to insert. 

Surgery to Correct Hearing Loss

There are a few types of surgical procedures designed to address hearing loss. 

Implantable Hearing Aids

This unique type of hearing aid is implanted near the eardrum and may be worn for up to several months at a time, including while showering. 

Cochlear Implants

A cochlear implant is a small electronic device that is inserted under the skin behind the ear and is connected to electrodes placed inside the cochlea of the ear. A microphone captures sound and translates it into electrical signals which are then sent the electrodes in the cochlea.

While hearing aids amplify sound, a cochlear implant bypasses the damaged part of the auditory system and stimulates the auditory nerve directly. 

Bone-Anchored Hearing Systems

Similar to a cochlear implant, a bone-anchored hearing system is implanted into the bone behind the ear with a hearing aid fit over it. Sound is captured, and vibrations are sent to the inner ear through the bone.  

Pressure Equalization (PE) Tubes

Tiny cylinders can be placed through the eardrum to allow air into the middle ear to combat chronic ear infections. While PE tubes are typically more common in children, adults with a malformed ear drum or Eustachian tube, Down Syndrome or a cleft palate are also good candidates for PE tubes. 

Stapedectomy

This procedure implants a prosthetic device that bypasses abnormal hardening of the bone tissue in the middle ear, a common symptom of otosclerosis that affects hearing. 

Other Forms of Hearing Assistance Technology

Hearing aids are far from the only technology designed to benefit the hearing impaired. There are a number of additional devices that can assist older adults who have suffered age-related hearing loss. 

Assistive Listening Device (ALD)

An assistive listening device amplifies sounds you want to hear, particularly when there’s a lot of background noise. They are kind of like a large hearing aid that may be held or worn on the hip, often with a set of headphones or earpieces. 

Frequency Modulation (FM) System

An FM system is like a small radio station with its own frequency. The speaker will speak into a microphone, which sends the signal to a receiver in your ear. 

Augmentative and Alternative Communication (AAC) Devices

These devices use computer programs or picture boards to synthesize speech from text, or vice versa. 

Connected Alerting Devices

An alerting device connects to a doorbell, telephone or alarm and emits a sound, flashing light or vibration to notify someone with hearing loss. 

Teletype (TTY) Machines

These adapters connect to a telephone to help a hearing impaired person have a phone conversation using text to type and read, much like text messaging with a cell phone. 

How Can You Prevent Hearing Loss?

Hearing loss is a part of the natural aging process. However, there are things older adults can do to slow the process of age-related hearing loss. 

  • Avoid loud noises
    Loud noises damage cells and membranes in the cochlea and can accelerate hearing loss in older adults.

  • Don’t smoke
    Smoking can lead to complications in your eustachian tube, neurotransmitters and blood pressure, all of which play a role in hearing. Smokers have a 70% greater chance of developing hearing loss than non-smokers. 

  • Get timely care for ear infections
    Ear infections are more common in children, but they tend to be more serious in older adults. Repeated ear infections can cause permanent hearing damage.

  • Wear ear plugs
    Wearing ear plugs when not engaged in conversation can protect your ears from unwelcome noise and slow hearing loss. 

Tips for Living with Hearing Loss

Aside from using a hearing aid or other assistive device, there are a few things that an older adult with hearing loss can do to improve their quality of life and engagement with others and the world around them.

  1. Position yourself to directly face a person you are communicating with.

  2. Eliminate all other distracting background noise.

  3. Find quiet and isolated settings to visit and engage with others.

  4. Choose areas with good lighting for visits, as it’s easier to pick up facial expressions, lip movements and gestures.

  5. After listening to someone speak, repeat the information back to them for confirmation.

  6. When communicating with someone new, start by informing them that you are hard of hearing and describe anything they can do to help the conversation.

  7. Bring a loved one to important meetings such as doctor’s appointments or anything involving your finances so you can have an extra set of ears on hand for help. 

  8. There are a number of support groups available for people with hearing loss. Consult the resource list below for more information.

Hearing Resources 

Below is a list of resources that may be beneficial to the hearing impaired.

American Speech-Language-Hearing Association (ASHA)

www.asha.org

800-638-8255

ASHA provides hearing rehabilitation to help those with hearing loss make lifestyle adjustments and learn how to use hearing technology. They also offer support groups for the hearing impaired. 

AUDIENT

www.audientalliance.org

1-866-956-5400

AUDIENT provides hearing aids at partial cost to low-income individuals. They are administered by EPIC Hearing Healthcare and affiliated with the Northwest Lions Foundation for Sight and Hearing. 

Easter Seals

www.easterseals.com

Easter Seals provides hearing aids to adults with limited financial resources. Check the website for information about your local chapter. 

CareCredit

www.carecredit.com

1-800-677-0718

CareCredit is a patient finance program that works like a credit card but is exclusive to health care services including hearing care. 

Telecommunications Equipment Distribution Program Association (TEDPA)

www.tedpa.org 

Text Telephones (TTY) are available free of charge to people with hearing loss and other disabilities. Use the state directory link to contact your state program. 

Hear Now

www.starkeyhearingfoundation.org

866-354-3254; 303-695-7797 (TTY)

Hear Now distributes new and refurbished hearing aids to those in financial need. They also offer financial assistance for cochlear implants. 

Center for Hearing Communication

www.chchearing.org

The Center for Hearing Communication is the oldest hearing rehabilitation center in the country and offers a variety of hearing services and hearing aids. 

Hearing Education and Awareness for Rockers (H.E.A.R.)

www.hearnet.com

H.E.A.R. is a non-profit organization founded by musicians and doctors that offers information about hearing safety for musicians, referrals and a free hearing clinic program.

Hearing Loss Association of America

www.hearingloss.org

Hearing Loss Association of America offers advocacy, self-help and information about hearing loss and communication. 

Online Hearing Loss Simulation

www.phonak.com

This resource allows you to hear what speech sounds like to a hearing impaired person. This can be a helpful tool for family members and caregivers. 

American Academy of Audiology

www.audiology.org

The American Academy of Audiology offers consumer resources related to hearing care. 

American Tinnitus Association

www.ata.org 

800-634-8978

The American Tinnitus Association provides education, advocacy, research and support for those living with tinnitus.