Does Aetna Medicare Cover Hearing Aids?

Medicare Benefits Solutions
Jan 10, 2021

Based on data reported by the American Speech-Language-Hearing Association (ASHA) during the Healthy People 2020 initiative, “32.46% of adults 70 years and older self-reported that they have used or currently use a hearing aid.” The process of getting hearing aids involves exams and fittings to ensure the features and characteristics meet your needs. Hearing loss can lead to withdrawal from social settings, which can impact your overall well-being. So it’s important to get it right.  

Original Medicare covers neither hearing aids nor the exams needed to get fitted for hearing aids. But if you are enrolled in Medicare Part C, which you may know as Medicare Advantage, you may be covered.

Medicare Advantage plans (Medicare Part C)

Medicare Advantage, also known as MA or Medicare Part C, is a type of Medicare-approved plan offered by private insurance companies to Medicare recipients. Once you join an MA plan, you will receive your Part A and Part B coverage from the plan, along with additional benefits.Many MA plans also cover Part D as well as other benefits that Original Medicare does not cover. As an MA plan member, you may be covered for hearing as well as vision, dental and wellness programs. These extra benefits vary among the different MA plans across the states. The best way to check what benefits you can expect is to examine your Evidence of Coverage document.

Evidence of Coverage

Evidence of Coverage (EOC) is a legal document that every plan must provide to its members. The document delineates what is covered, what you pay in and out of network, company contact information, and your membership rights and responsibilities. The Centers for Medicare & Medicaid Services (CMS) permits the plan to make changes every calendar year, which the CMS must approve before release. 

Changes may include costs and benefits. If you are an MA plan member, it’s a good idea to review your EOC annually and look for any updates. Aetna makes their EOC available online, so it’s easy to check what hearing benefits are included in your plan.  

Aetna Medicare Advantage plans

Aetna is one of the primary private insurance companies that sells Medicare Advantage plans. The Aetna Medicare website tells visitors that in addition to vision care, “most of our plans also include coverage for hearing aids, usually through a network provider.” To see how this applies to you, access your EOC, and look for the medical benefits chart, which shows what is covered and what you pay.

Usually, you will find a considerable variance between in-network and out-of-network benefits. For example, an Aetna Preferred Provider Organization (PPO) plan may offer in-network hearing exams and fittings with no copay while going out-of-network will require coinsurance after the deductible. The hearing aid itself may only be covered if purchased through an Aetna-specific vendor. Hearing aid prices generally increase as you climb the scale from devices that work well in quiet surroundings to those designed for a noisy environment.