Until recently, hearing aids were only available by prescription. But prescription hearing aids—which include assessment, testing, and fitting by an audiologist—are expensive, averaging several thousand dollars per pair. And because traditional Medicare won’t pay for the devices, three-quarters of Medicare beneficiaries who need hearing aids don’t get them, a report from the Commonwealth Fund finds. 

Yet not addressing hearing loss can put you at greater risk of other health disorders, including falls, cognitive decline, depression, and social isolation, according to Dr. Erika Walsh, director of the division of otology and neurotology at the University of Alabama at Birmingham School of Medicine.

New over-the-counter hearing aids could be a low-cost solution

“For those with mild to moderate hearing loss, over-the-counter hearing aids might be a lower-cost solution,” says Louise Norris, a health policy analyst for medicareresources.org.

However, experts caution that they’re not appropriate for everyone, and since most are self-fitting through a smartphone app, you won’t benefit from a full assessment and personalization from a trained hearing specialist. As with prescription devices, traditional Medicare won’t cover these hearing aids.

The aging/hearing connection

Age-related gradual hearing loss, or presbycusis, happens due to changes to the inner ear, hearing nerves, and the way the brain processes speech and sounds. Diabetes, poor circulation, noise exposure, and certain medications can also affect hearing, according to the American Academy of Audiology. You may first notice difficulty hearing higher-pitched sounds, and eventually have trouble with softer voices, understanding children, or struggling to hear others over background noise, like in a busy restaurant.

Hearing aids not only address the immediate challenge of improving sound processing, but also the parallel physical and mental health issues. Processing sounds helps your brain stay active, according to the National Council on Aging. As your hearing deteriorates, the part of the brain that controls that function starts to atrophy. This can lead to balance issues, which can make some people avoid physical activity. Hearing loss also impacts social isolation and mental health.

Hearing aids have come a long way in the past 20 years. They’re much smaller, and come in a variety of different options and prices, depending on your lifestyle and the technology required. 

Walsh notes that once her patients try them, many don’t know how they functioned without them.

What Medicare beneficiaries can do about hearing aid costs

• Traditional Medicare will cover hearing testing with a physician’s referral, but not the actual devices.
• Medicaid, many Medicare Advantage plans, private insurance carriers, and some charitable organizations may pay for all or part of the cost of hearing aids. High copays or coinsurance may apply.
• Most audiologists have financing or payment plans available to help with the costs of hearing aids.
• Some Medigap insurers offer memberships in hearing care discount programs, with savings that can be quite substantial.
• If you’re still covered under a current or former employer’s health plan, you may be eligible for hearing aids—check your policy or with your plan administrator.

Medicare coverage for cochlear implants

Medicare Part B will cover cochlear implants for severe hearing loss. These electronic devices can restore hearing by directly stimulating the nerve responsible. One of the requirements for this procedure is that you must have tried hearing aids but they were ineffective.

Some members of Congress have been trying to pass legislation to include Medicare coverage of hearing aids, as well as dental and vision services, for years. However, lobbying by industry groups and commercial insurers has pressured other lawmakers to vote against these bills. Representative Debbie Dingell of Michigan reintroduced legislation in early 2023 to allow Medicare to cover hearing aids. The bill has since gone to the House Subcommittee on Health.

How to protect your hearing

Experts suggest these steps to safeguard your hearing:

• Get a baseline hearing test (covered by Medicare).
• Wear hearing protection if you are around loud noises (like at a concert or when lawn-mowing).
• Keep the volume of your TV and audio devices at a reasonable level—you shouldn’t be able to hear them from another room.
• Consider custom earphone molds if you frequently use headphones to listen to audio; they conform specifically to your ear canal and will block external noise.