Why Aren't Hearing Aids Covered by Insurance?

If hearing aids are one of the most common treatments for hearing loss, why aren’t they routinely covered by insurance?

It’s a question that repeatedly surfaces in hearing loss communities, along with questions around Medicare benefits, out-of-pocket costs, and denied claims. People are often surprised to learn that while an insurance plan may cover a hearing test, specialist appointment, or even certain surgically implanted hearing devices, it may provide little or no coverage for hearing aid themselves.

The answer is more complicated than many people realize: Today’s hearing aid coverage landscape is the result of decades-old Medicare policy, evolving views of hearing loss, insurance cost considerations, and ongoing debate about whether hearing aids should be treated like other healthcare interventions.

To better understand why coverage remains inconsistent, and whether that may be changing, I spoke with audiologists about how these policies affect patients in the real world.

In this article, we’ll explore how Medicare helped shape today’s hearing aid coverage system, why many insurance plans still limit benefits, how audiologists define medical necessity, and what options may be available for people seeking coverage today.

Why won't insurances pay for hearing aids?

There is no single reason hearing aid coverage is often limited, inconsistent, or excluded.

Instead, today’s coverage landscape is the result of several overlapping factors, including Medicare’s original policy decision, cultural attitudes toward hearing loss, insurance cost considerations, and an ongoing debate about how hearing aids fit within the healthcare system.

Many hearing professionals argue that these policies have not kept pace with modern understanding of hearing loss and its impact on communication, safety, employment, social participation, and quality of life.

“Hearing care has historically been treated differently from other areas of healthcare, even though hearing loss has a direct impact on communication, safety, cognition, employment, social engagement, and quality of life,” says audiologist Dr. Ruth Reisman of Urban Hearing. “Hearing aids are often categorized as ‘elective’ or ‘supplemental’ rather than essential medical devices, which is a major disconnect from what we see clinically every day.”

To understand how we got here, it helps to start with a decision made over 60 years ago.

Medicare's Hearing Aid Exclusion Set the Precedent

The most important reason hearing aid coverage has historically been limited in the United States is Medicare's longstanding exclusion. The hearing aid exclusion is written into federal law dating back to Medicare's creation within the Social Security Act of 1965, and it would literally take an Act of Congress to change it. 

Original Medicare does not cover hearing aids or procedures for fitting hearing aids. However, Medicare Part B may cover certain diagnostic hearing and balance exams when ordered by a physician or other qualified provider to determine whether medical treatment is needed.

When Medicare was established, lawmakers focused primarily on hospital care, physician services, and medically necessary treatment. At the time, hearing loss was often viewed as an expected part of aging rather than a health condition requiring treatment.

"When Medicare was established in the 1960s, hearing loss was often viewed as a normal part of aging rather than a condition with broad impacts on health, communication, cognition, and quality of life," says Dr. Amy Sarow, AuD. "Nowadays, we know that untreated hearing loss impacts health and quality of life in a number of ways, but insurance plans have not yet fully adjusted."

Although hearing technology, research, treatments, costs, and public understanding of hearing loss have changed dramatically, Medicare's hearing aid exclusion remains largely unchanged, continuing to shape how millions of Americans access and pay for hearing care over 60 years later.

How Medicare Helped Shape Today's Hearing Aid Coverage Landscape 

Although Medicare does not determine what every insurance plan covers, it has played a significant role in shaping how hearing benefits developed across the broader healthcare system.

As Dr. Sarow explains, "When Medicare includes or excludes a particular service, private insurers often take notice."

Today, coverage varies widely among Medicare Advantage plans, Medicaid programs, employer-sponsored insurance, and private health plans. Some offer hearing aid allowances, discounts, or partial reimbursement, while others provide little or no meaningful coverage.

The result is a patchwork system. A plan may cover a diagnostic hearing exam but not the hearing aids recommended afterward, while another may provide only a limited allowance toward the total cost.

This ultimately means that two people with the same hearing loss may have very different access to hearing care depending on the type of insurance they have.

Why Hearing Aids Are Treated Differently Than Other Healthcare Services

If audiologists often view hearing aids as medically necessary, why is coverage still so limited?

Hearing Loss Was Viewed as a Normal Part of Aging

While age-related hearing loss is common, for decades it was often viewed as an inconvenient and inevitable consequence of getting older rather than a health condition that warranted treatment. That perception influenced policy decisions, insurance design, and public attitudes.

Today, medical professionals recognize that even when hearing loss is age-related, it can have meaningful consequences for communication, workplace participation, social connection, safety, overall health, and quality of life. Yet public attitudes, and most insurance policies, have not always kept pace with that evolving understanding.

Hearing loss also carries stigma. Some people delay getting hearing aids because they associate them with aging, disability, or loss of independence. Insurance coverage gaps can reinforce that delay by making hearing aids feel like a luxury purchase rather than a legitimate healthcare need.

The Cost of Covering a Common Condition

Insurers must also consider the cost of covering a common condition.

According to the Hearing Loss Association of America, more than 50 million Americans have some degree of hearing loss, and the National Institute on Deafness and Other Communication Disorders estimates that approximately 29 million adults could benefit from hearing aids.

“Health insurance is a business and covering hearing aids for 20% of the population affects their bottom line,” says Dr. Hinson.

Insurers may also consider the full cost of care, not just the devices themselves. Prescription hearing aids often involve testing, fitting, programming, verification, counseling, follow-up appointments, repairs, and eventual replacement. Depending on how hearing care is delivered, those services may be bundled into the price of the hearing aids or billed separately.

This does not necessarily mean the current system is fair or clinically ideal. Rather, it reflects the challenge insurers face when evaluating a common, ongoing healthcare need.

The Question of Medical Necessity

Another challenge is that patients, hearing care professionals, and insurers do not always define “medical necessity” the same way.

The American Speech-Language-Hearing Association (ASHA) and the American Academy of Audiology (AAA) note that medical necessity is often determined by payer policies and documentation requirements, which may differ from how clinicians evaluate a person’s communication needs and functional limitations.

“As an adult, there is not one accepted definition of ‘medical necessity’ when it comes to hearing loss,” says Dr. Sarow. “In my experience, hearing aids are medically necessary when hearing loss negatively affects a person’s communication, relationships, employment, independence, safety, or well-being.”

Dr. Reisman agrees that medical necessity extends beyond an audiogram alone. “When I define medical necessity in hearing care, I look at both the audiologic findings and the functional impact. If a patient has measurable hearing loss and reports difficulty...then amplification is medically necessary,” she says. “The goal is not luxury or convenience. The goal is access to communication, reduced auditory strain, improved participation, and better overall quality of life.”

Dr. Hinson adds that hearing aids may not be life-saving in the traditional medical sense, but their impact on health and social engagement can still be profound.

“Hearing aids can be life saving in terms of quality of life,” she says. “And ongoing research regarding falls risk and cognitive decline can very quickly escalate hearing aids’ status from elective to necessary.”

In short, audiologists often evaluate hearing loss based on both measurable impairment and real-world communication challenges, while insurers may focus on whether those needs meet specific coverage criteria. That disconnect remains one of the central debates in hearing aid coverage today.

Why Hearing Aids Don’t Fit Neatly Into the Insurance System 

Hearing aids are FDA-regulated medical devices, but they also increasingly resemble consumer technology. Modern devices may include Bluetooth streaming, rechargeable batteries, smartphone apps, artificial intelligence features, and personalized settings.

Over-the-counter hearing aids have further expanded the consumer-facing side of the market by allowing adults to buy certain devices without a prescription or professional fitting.

This creates a classification challenge. Hearing aids are not simply devices; they are often paired with professional services such as hearing evaluations, fitting, programming, verification, counseling, and follow-up care.

Some hearing professionals believe this overlap between medical care, technology, and consumer products has contributed to ongoing uncertainty about how hearing aids should be reimbursed and covered.

When and why are hearing aids covered?

Although hearing aids are often excluded from coverage, some people do receive help paying for them.

In many cases, coverage exists because lawmakers, employers, insurers, or government programs have determined that hearing care serves a specific public health, educational, or workforce need.

For example, children often have greater access to hearing aid coverage than adults. According to Let California Kids Hear, 35 states currently require private insurance plans to provide some level of hearing aid coverage for children. These mandates are often based on the understanding that hearing plays a critical role in speech, language, learning, and educational development.

A small number of states—including Arkansas, Connecticut, Illinois, New Hampshire, and Rhode Island—also require some level of hearing aid coverage for adults. Veterans who qualify for Veterans Affairs (VA) healthcare may be eligible for hearing aids and related hearing care services, while some employers choose to offer hearing benefits as part of their health plans.

Medicare Advantage plans may also offer hearing benefits that Original Medicare does not provide. Because these plans are administered by private insurers, they have greater flexibility to include hearing aid allowances, discounts, or other hearing-related benefits.

The result is a complex and highly variable system that often depends less on a person’s hearing loss and more on the type of insurance they have, where they live, whether they qualify for a specific program, or whether their state requires coverage.

For a detailed breakdown of hearing aid coverage by insurance type, see Hearing Tracker’s guide to hearing aid insurance coverage.

For people trying to navigate hearing aid coverage and explore ways to pay for hearing aids, audiologists recommend taking a proactive approach before purchasing devices.

What happens when hearing aid coverage is limited?

When hearing aids are not covered, cost barriers can delay or prevent treatment, creating disparities in access to care. People with limited income may still have options. Depending on where they live, Medicaid and state programs, as well as local organizations, such as Lions Clubs may help cover or reduce the cost of hearing aids and hearing care. HearingTracker reviews some of these resources in our Guide to Paying for Hearing Aids.

However, many people who cannot afford hearing aids out of pocket will postpone purchasing a device, try lower-cost alternatives that may not fully meet their needs, or simply forgo treatment because the expense is too high.

Those delays can have consequences that extend beyond hearing itself. Research has linked untreated hearing loss to social isolation, depression, and a higher risk of falls. Studies have also found associations between hearing loss and cognitive decline, although researchers continue to investigate the nature of that relationship.

For many audiologists and advocates, the question is no longer whether hearing aids have value. It is whether access to hearing care should depend primarily on a person’s ability to pay out of pocket.

Is Hearing Aid Coverage Changing?

While hearing aid coverage remains limited, there are signs that hearing healthcare is receiving greater attention from policymakers, insurers, researchers, and advocacy groups.

One of the most significant developments is the continued push to expand Medicare coverage. In 2025, lawmakers reintroduced the Medicare Hearing Aid Coverage Act (H.R.500), a bill that, if passed, would require Medicare to cover hearing aids and related hearing care services.

Audiologists say broader awareness of the consequences of untreated hearing loss may continue to influence future coverage decisions.

“I do think hearing aid coverage will continue to evolve, but I expect the progress to be gradual,” says Dr. Reisman. “There is growing awareness that untreated hearing loss is not a minor inconvenience…[and] as more research and public health attention focus on hearing loss, there will likely be more pressure on insurers to treat hearing care as an essential part of healthcare.”

At the same time, some insurers have expanded hearing benefits through Medicare Advantage plans, discount programs, and alternative coverage models.

As Dr. Sarow notes, “I expect coverage to continue evolving gradually rather than changing overnight. We’re already seeing some insurers explore OTC reimbursement, expanded hearing benefits, and alternative delivery models.”

Still, coverage remains highly variable. As Dr. Reisman notes, “Medicare, Medicare Advantage, Medicaid, and private insurance all operate differently, and hearing benefits are still often viewed as supplemental rather than core medical coverage.”

While still limited, these developments suggest that hearing aid coverage is no longer a niche policy issue. The debate is increasingly shifting away from whether hearing aids have value and toward whether access to hearing care should depend on a person’s ability to pay.