Hearing problems are common among older adultsone in three people over 65 and nearly half of those 75 and older complain of hearing difficulties. The majority of hearing issues come on gradually, and unfortunately, that loss is usually permanent. Hearing aids are the most common solution, but theres a catch: theyre not covered by traditional Medicare.
Until recently, hearing aids were only available by prescription. But, prescription hearing aidswhich includes assessment, testing, and fitting by an audiologistare expensive, averaging several thousand dollars per pair. And, because traditional Medicare wont pay for the devices, three-quarters of Medicare beneficiaries who need hearing aids dont 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 theyre not appropriate for everyone, and since most are self-fitting through a smartphone app, you wont benefit from a full assessment and personalization from a trained hearing specialist. As with prescription devices, traditional Medicare wont cover these hearing aids either.
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 struggle 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 which 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. Theyre much smaller, 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 dont know how they functioned without them.
What Medicare beneficiaries can do about hearing aid costs
- Traditional Medicare will cover hearing testing with a physicians 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 youre still covered under a current or former employers health plan, you may be eligible for hearing aidscheck 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 have 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 levelyou shouldnt 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
