Your father keeps the TV loud enough to hear from the driveway, and he's stopped going to his weekly card game because he can't follow the conversation. You suggest hearing aids, and he says Medicare won't pay for them anyway. He's mostly right about Original Medicare, but that's not the end of the story.
Here's what Medicare covers, what it doesn't, and how families find affordable ways to help a parent hear better.
The short answer
Original Medicare (Part A and Part B) doesn't cover hearing aids or exams for fitting hearing aids, and people with only Original Medicare pay all costs for them1. That surprises many families, since hearing loss is so common with age. Medicare does cover some hearing care, though: Part B covers diagnostic hearing and balance exams when a doctor or other provider orders them to find out whether your parent needs medical treatment2.
Some Medicare Advantage plans (Part C) offer extra benefits that Original Medicare doesn't cover, including hearing1. And since over-the-counter hearing aids became available, many adults with mild to moderate hearing loss can buy a device without a prescription or a professional fitting3. For an overview of how hearing changes with age, see hearing loss in the elderly.
What Part B covers
Part B covers diagnostic hearing and balance (fall risk) exams if your parent's doctor or other provider orders them to find out whether medical treatment is needed2. After the Part B deductible, your parent generally pays 20 percent of the Medicare-approved amount, and a copayment may apply in a hospital outpatient setting2. Your parent can also visit an audiologist once every 12 months without an order, but only for non-acute hearing conditions, such as hearing loss that develops over many years, and for diagnostic services related to surgically implanted hearing devices2.
This means a hearing test to diagnose a problem can be covered, but the exam to fit and adjust hearing aids, and the hearing aids themselves, are not2. Ask the audiologist's office ahead of time which parts of a visit Medicare will treat as diagnostic. A sudden change in hearing, ear pain, drainage, ringing in one ear, or dizziness should be checked by a doctor promptly, since those can signal a medical problem rather than ordinary age-related loss. See dizziness in the elderly.
Medicare Advantage hearing benefits
Many Medicare Advantage plans include hearing benefits that go beyond Original Medicare, such as routine hearing exams, fittings, and an allowance or discount toward hearing aids. Details vary a lot from plan to plan: some limit you to certain brands or a network of hearing providers, some cover one pair every few years, and some offer only a modest discount. The only way to know is to contact the plan and read its Evidence of Coverage1.
If hearing aids matter to your parent, compare hearing benefits during open enrollment along with doctors, drugs and overall costs. Don't choose a plan for hearing benefits alone, since networks and other coverage often matter more. See Medigap vs. Medicare Advantage and the Medicare open enrollment guide.
Over-the-counter hearing aids
Over-the-counter hearing aids are available without the supervision, involvement or prescription of a licensed health care professional3. They're intended for people 18 and older with perceived mild to moderate hearing loss3. Your parent can buy one in a store or online without seeing an ear, nose and throat doctor or an audiologist3. Some OTC models are self-fitting and use hearing tests, software or smartphone apps to customize the sound3.
OTC hearing aids aren't right for everyone. If your parent's hearing loss makes it hard to hear loud sounds, an OTC device may not be the best choice without help from a professional3. Any hearing aid that is not an OTC hearing aid is a prescription hearing aid3. Signs of mild to moderate loss include trouble following conversations in groups or noisy places, asking people to repeat themselves, and turning up the TV3. Medicare doesn't cover OTC hearing aids either, but they generally cost much less than professionally fitted devices.
OTC or prescription: how to decide
A good first step is a hearing test, even if your parent ends up choosing an OTC device. A test can show how severe the loss is, whether it's in one ear or both, and whether there's a medical cause, like earwax buildup or an infection, that can be treated. If the hearing loss is severe, uneven between ears, or came on suddenly, a prescription device fitted by an audiologist or hearing instrument specialist is usually the better path.
Prescription hearing aids typically include a professional fitting, follow-up adjustments, and cleaning and repairs over time. That support helps people who struggle with small controls, have memory problems, or need fine-tuning to get used to new sound. OTC devices put more of the setup on the user or family. Think about your parent's vision, hand dexterity and comfort with technology. Someone with arthritis or macular degeneration may find tiny batteries and buttons hard to manage; see arthritis in the elderly and vision loss in the elderly.
Why treating hearing loss matters
Hearing aids help people with hearing loss hear better1, and that affects much more than conversation. Older adults who can't hear well may withdraw from family gatherings, stop calling friends, and miss what doctors tell them. Hearing loss is linked with loneliness and depression, and it can make memory problems look worse than they are. Some families find that what seemed like confusion was partly a parent not hearing the question. See loneliness in the elderly and early signs of dementia.
Hearing is a safety issue too. A parent who can't hear a smoke alarm, a doorbell, a car horn or a caregiver's warning is at higher risk. Balance problems sometimes travel with inner-ear conditions, which is one reason Medicare covers fall-risk balance exams2. See fall prevention for the elderly.
Other ways to get help
If your parent has Medicaid, check the state's rules: many state Medicaid programs cover hearing aids for adults, though coverage varies. Veterans may qualify for hearing aids through VA health care. Some nonprofits, service clubs and hearing aid makers run assistance programs for people with limited income, and some state vocational rehabilitation programs help people who are still working. Ask the audiologist about refurbished or lower-cost models, payment plans, and whether a trial period with a return option is offered.
Your area agency on aging can point you to local hearing assistance programs; find it through the Eldercare Locator4. Hearing aid batteries, repairs and replacement parts add up over time, so ask about those costs before buying.
Questions to ask before buying
Whether your parent buys OTC or prescription, ask: Is there a trial period, and what is the return policy? What does the warranty cover, and for how long? Are fittings and adjustments included? Are batteries rechargeable or replaceable? Does the device work with a phone, TV streamer or hearing loop? Who do we call if it stops working? With OTC devices, also check whether the app is easy to use and whether customer support is available by phone, not only online.
Keep receipts. Hearing aids may count as a medical expense for tax purposes in some situations, and a flexible spending or health savings account may help if your parent or a family member has one. See claiming an elderly parent as a dependent.
Helping your parent adjust
Many people buy hearing aids and then leave them in a drawer. New hearing aids can make the world sound loud, tinny or strange at first, because the brain has to get used to sounds it hasn't heard clearly in years. Encourage your parent to wear them a few hours a day at first, in quiet settings, and build up. Schedule follow-up adjustments; most problems with comfort or whistling can be fixed.
Help with the practical parts: a set place to keep the case, a routine for charging or changing batteries, and regular cleaning. Label the left and right aids if your parent has trouble telling them apart. In a care setting, make sure staff know your parent uses hearing aids and help put them in each morning; lost hearing aids are a common problem in nursing homes and assisted living. See assisted living services.
Communicating with a parent who has hearing loss
Even with hearing aids, a few habits help. Face your parent when you speak, in good light, so they can see your face. Get their attention before talking. Speak clearly and a little more slowly, without shouting, which distorts sound. Turn off the TV or move away from background noise. If they don't understand, rephrase rather than repeating the same words. At doctor visits, ask for written instructions, and consider going along to listen. Captioned phones and TV captions can help too.
Be patient. Hearing loss can be frustrating and embarrassing, and some people deny it for years. Framing hearing aids as a way to stay connected with grandchildren or stay sharp at the card table often goes over better than pointing out what they're missing.
When your parent resists
Some older adults avoid hearing aids because they think the devices look old, worry about cost, or tried a bad pair years ago. Today's devices are smaller and more capable, and OTC options have widened choices. Suggest starting with a hearing test, which Part B may cover when ordered by a doctor2, so the decision is based on facts. Offer to go along. If cost is the barrier, look into Medicare Advantage benefits, Medicaid, the VA and assistance programs before assuming it's out of reach. See when an elderly parent refuses help.
An example
When Lena's father insisted Medicare wouldn't pay for hearing aids, she asked his doctor to order a hearing exam, which Part B covered as diagnostic. The audiologist found moderate loss in both ears and no medical problem. Her father's Medicare Advantage plan had a hearing aid allowance, so he chose a pair through the plan's network with a trial period and follow-up adjustments. After a few weeks of getting used to them, he was back at his card game. This is an illustration; coverage depends on the plan.
