Hearing plans and the cost of being heard

Part B covers diagnostic hearing and balance exams when a physician orders them to determine whether medical treatment is needed. That is the whole of the benefit. Hearing aids, the exams that fit them, and the follow-up adjustments are excluded by statute.

A hearing aid fitting is not a small diagnostic charge. The device, the fitting, the follow-up visits and the warranty are usually bundled into one price, which is why a pair can cost more than a year of many premiums.

A hearing insurance policy works like dental coverage: an annual allowance toward aids, a defined replacement schedule, and often a discount on the fitting appointment. Allowances commonly run between $500 and $1,500 per ear, with a new device every three to five years.

A Medicare Advantage plan is the second route. Many now include a hearing aid allowance or a discount through a national network, and some contract with specific brands. Read the allowance per ear, not per pair, and check the replacement schedule.

Over-the-counter hearing aids are the third. Since 2022, mild to moderate hearing loss can be addressed with devices sold without a prescription, at a fraction of the cost of a fitted aid. They are not a substitute for an audiologist when the loss is significant or uneven between ears.

Cochlear implants are a different matter entirely. They are medical devices implanted surgically, and Medicare covers them along with the evaluation and programming. Nothing about the hearing aid exclusion changes that.

If you suspect a change, the first step is a diagnostic exam ordered by your physician, which Medicare covers. The results tell you whether you are in over-the-counter territory or whether a fitted device and an audiologist are the right path.

Bring the audiogram to the conversation about coverage. An allowance that looks generous can be small against a specific recommendation, and it is easier to compare when you are holding the number.