Does Aetna Medicare Cover Hearing Aids?

Does Aetna Medicare cover hearing aids? Yes, and this article explains how. We cut through the complexities of insurance coverage in 2025 to outline when Aetna Medicare aids with hearing aids, what’s included, and the potential costs you might encounter.

 

Key Takeaways

  • Aetna Medicare covers a range of hearing-related services including annual hearing exams, hearing aid fittings, and purchases for eligible members, often with significant cost coverage up to 100 percent.

 

  • Aetna Medicare Advantage plans offer comprehensive care that goes beyond Original Medicare, including additional benefits for hearing aids, subject to varying costs like premiums, deductibles, and copays.

 

  • Direct Member Reimbursement (DMR) offers Aetna Medicare members flexibility to choose out-of-network providers for hearing aids, with an annual allowance available for reimbursements, albeit with potential out-of-pocket costs if not covered by the plan.

Compare Plans in One Step!

Enter Zip Code

 

 Advertisement

Aetna Medicare Hearing Aid Benefits: What’s Covered?

 

Does Aetna Medicare Cover Hearing Aids?, Aetna Medicare Hearing Aid Benefits: What's Covered?

 

If you’re dealing with hearing loss, Aetna Medicare can significantly aid your return to better health. Aetna Medicare offers coverage for various services related to hearing aids, including hearing exams, hearing aid fittings, and hearing aid purchases for eligible members.

The coverage includes essential fitting services, post-fitting care, and necessary repairs or replacements for hearing aids. Following the fitting and programming of the hearing aids, the in-network provider also provides the necessary hearing care and follow-up services.

These benefits, known as hearing aid benefits, are significant for those dealing with hearing loss, as they can help lessen the financial burden related to hearing aid purchases and services.

With Aetna Medicare, you can receive the necessary hearing care without bearing the brunt of the costs, allowing you to focus on your hearing health and overall well-being.

 

Hearing Exams

Hearing exams are a fundamental part of diagnosing and treating hearing loss. Aetna’s Medicare Advantage plans provide coverage for one annual routine hearing exam as part of the hearing benefits.

This annual exam is an opportunity for healthcare professionals to assess your hearing health and recommend necessary interventions, ensuring your hearing needs are met.

The coverage for a routine hearing exam typically includes the exam and a hearing aid fitting. Most Aetna Medicare plans cover these services at 100 percent, including those for Bose hearing aids. These benefits make it easier for individuals to maintain their hearing health without worrying about the financial implications.

 

Hearing Aid Fittings

Securing the right fit for your hearing aid is vital for achieving the best hearing performance. Aetna Medicare provides coverage for all types of hearing aid fittings, including one annual routine hearing exam and hearing aid fitting at 100 percent.

This coverage ensures that you can get the most out of your hearing aids, enhancing your auditory experience.

The process for acquiring a hearing aid fitting involves a hearing assessment by an audiologist to determine the extent of hearing impairment, followed by a fitting appointment for the hearing aid, which is reimbursed at 100 percent by Aetna Medicare annually.

This comprehensive process ensures that your hearing aids are personalized to meet your specific hearing needs, optimizing their efficacy.

 

Hearing Aid Purchases

 

Does Aetna Medicare Cover Hearing Aids?, Hearing Aid Purchases

 

Hearing aids can be a substantial investment, yet with Aetna Medicare, the financial load is noticeably lessened. Aetna Medicare provides coverage for the cost of hearing aid purchases for members who have a confirmed diagnosis of hearing loss, subject to certain limitations and exclusions.

However, it is important to note that the cost of batteries or other accessories for hearing aids and the cost of hearing tests or other diagnostic services are not covered.

Aetna Medicare provides coverage for both digital and analog hearing aids, including those with Bluetooth capabilities through Nations Hearing.

This broad coverage ensures that you have the freedom to choose the hearing aid that best meets your needs and lifestyle, further enhancing your auditory experience.

 

Medicare Advantage Plans and Hearing Aid Coverage

 

Does Aetna Medicare Cover Hearing Aids?, Medicare Advantage Plans and Hearing Aid Coverage

 

Medicare Advantage plans, such as the Medicare advantage plan offered by Aetna, are private health insurance plans authorized by Medicare to offer fundamental coverage provided by original Medicare, along with supplementary benefits.

Among these offerings are Aetna’s Medicare Advantage plans, which provide coverage for routine hearing services. These plans offer a comprehensive approach to healthcare, covering not just your basic health needs but also additional services like routine hearing exams and fittings.

In addition to the fundamental coverage provided by Original Medicare Part A and B, Aetna Medicare Advantage plans may encompass additional benefits such as hearing, vision, and dental care. However, the expenses related to Aetna Medicare Advantage plans can vary and may encompass premiums, deductibles, and copays that are specific to hearing services and hearing aid devices.

Therefore, it is advisable to confirm the extent of hearing aid coverage included in your plan before proceeding with ordering a hearing aid or scheduling a hearing test.

 

Basic Coverage

The basic coverage for hearing aids under Aetna Medicare generally includes one annual routine hearing exam and hearing aid fitting covered at 100 percent. This coverage ensures that you can receive the necessary hearing care annually without having to worry about the financial implications.

It also includes coverage for FDA-cleared over the counter and prescription hearing aids prescribed by a healthcare professional, further expanding your options for hearing aid devices.

However, it is important to note that most Aetna plans have exclusions or lack coverage for hearing aids. However, certain plans may offer reimbursement for prescription or over the counter (OTC) hearing aids if they are determined to be medically necessary.

Therefore, it’s essential to review your individual plan to understand the extent of your coverage.

 

Additional Benefits

Aetna Medicare Advantage plans provide substantial supplementary benefits for hearing aid services. Typically, most plans cover one annual routine hearing exam and hearing aid fitting at 100 percent.

This can help individuals manage their hearing health without worrying about additional costs. Some plans may also feature a $0 monthly premium, making it even more affordable for individuals to maintain their hearing health.

Additionally, Aetna offers coverage for hearing aid repairs and replacements for individuals enrolled in Original Medicare Part B and Medicare Advantage plans.

This ensures that if your hearing aid is damaged or requires replacement, you can receive the necessary services without worrying about the financial implications.

Direct Member Reimbursement (DMR) for Hearing Aids

 

Does Aetna Medicare Cover Hearing Aids?, Direct Member Reimbursement (DMR) for Hearing Aids

 

Aetna Medicare offers Direct Member Reimbursement (DMR) for out-of-network hearing aid providers.

This allows members to:

  • Select their preferred brands and providers, regardless of whether they are within or outside the Aetna network

 

  • Providers are not restricted by networks

 

  • Members receive an annual allowance for hearing aids, which establishes the basis for reimbursement

 

This means that members have the freedom to choose the hearing aid provider that best meets their needs, without being restricted by network requirements.

Members are eligible for reimbursement for approved services up to an annual limit, allowing for greater flexibility and personalization in their hearing care.

 

Choosing an Out-of-Network Provider

When it comes to selecting a provider for your hearing aid needs, Aetna Medicare allows for the freedom to choose an out-of-network provider.

This means you can choose a provider based on your personal preference, rather than being limited to providers within the Aetna network.

However, it is important to be aware of potential disadvantages when selecting an out-of-network provider.

For instance, Aetna Medicare may not provide coverage for the cost of hearing aids if the plan does not include hearing aid coverage. Therefore, it is advisable to confirm your coverage details before selecting an out-of-network provider.

 

Reimbursement Process

The reimbursement process for Direct Member Reimbursement (DMR) involves submitting a claim to Aetna Medicare for covered services. You can do this by filling out the reimbursement form online at AetnaMedicare.com/reimburse, or selecting another electronic submission option that is most suitable for your needs.

To initiate a reimbursement claim, you need to:

  • Obtain the relevant forms from the Aetna Medicare website.

 

  • These forms include a prescription reimbursement form or a signed medical reimbursement form.

 

  • Submit the form along with the claim.

 

The completion of an Aetna Medicare reimbursement claim typically takes around 10 minutes, and you can then receive reimbursement for the covered costs by submitting the receipt to Aetna.

Compare plans and enroll online

 

 Advertisement

Speak with a licensed insurance agent

1-833-641-4938
TTY 711

Mon-Fri : 8am-9pm ET

compare medicare advantage plans

Navigating Aetna Medicare Hearing Aid Eligibility and Costs

Does Aetna Medicare Cover Hearing Aids?, Navigating Aetna Medicare Hearing Aid Eligibility and Costs

Grasping the eligibility requirements and cost factors for Aetna Medicare hearing aid coverage is key to maximizing your benefits.

The eligibility criteria for Aetna Medicare hearing aid coverage involves:

  • One annual routine hearing exam, covered at 100 percent

 

  • Hearing aid fitting, covered at 100 percent

 

  • Coverage for FDA-cleared OTC and prescription hearing aids prescribed by a healthcare professional

 

In terms of costs, Aetna Medicare Advantage plans may cover up to 80% of the cost of hearing aids. However, the specific cost coverage may vary between plans. Aetna Medicare offers coverage for a variety of hearing aids, encompassing both digital and analog devices, with potential variations in price.

Therefore, understanding these eligibility and cost factors is crucial for optimizing the benefits provided by Aetna Medicare hearing aid coverage.

 

Eligibility Requirements

To be eligible for Aetna Medicare hearing aid coverage, you need a confirmed diagnosis of hearing loss and a prescription from a licensed audiologist or parapsychologist.

The diagnosis is obtained through a comprehensive hearing assessment by a licensed audiologist or physician, which determines the extent of your hearing impairment.

By understanding these eligibility requirements, you can ensure that you qualify for the hearing aid benefits offered by Aetna Medicare. This can help you access the necessary hearing care and services to improve your hearing health and overall quality of life.

 

Cost Factors

The costs of hearing aids covered by Aetna Medicare plans can vary depending on the specific plan and type of hearing aid.

Here are some factors to consider:

  • In-network providers: The costs of hearing aids may be lower when using in-network providers under Aetna Medicare.

 

  • Out-of-network providers: Using out-of-network providers may result in higher rates for hearing aids.

 

  • Plan coverage: Different Aetna Medicare plans may have different coverage levels for hearing aids.

 

It is important to review your specific plan details and consult with Aetna Medicare to understand the costs and coverage for hearing aids.

However, certain Aetna Medicare plans provide more economical alternatives for obtaining hearing aids, including leasing options. Furthermore, numerous Aetna Medicare Advantage plans with hearing coverage feature a $0 monthly premium.

Therefore, understanding the cost factors associated with your Aetna Medicare plan can help you manage your expenses effectively while accessing the necessary hearing care.

Tips for Maximizing Your Aetna Medicare Hearing Aid Coverage

Taking full advantage of your Aetna Medicare hearing aid coverage hinges on grasping your benefits and using them effectively. One key tip is to confirm the coverage details for your Aetna Medicare hearing aid benefits.

This involves understanding the extent of your coverage, including any limitations or restrictions, which can help you make the most of the benefits available to you.

Choosing an in-network provider can also help you maximize your benefits, as Aetna plans typically offer coverage for hearing aids through network providers.

Furthermore, understanding your reimbursement options can help you take advantage of benefits through network providers or utilize direct member reimbursement options if applicable.

By following these tips, you can ensure you’re getting the most out of your Aetna Medicare hearing aid coverage.

The Pros and Cons of Aetna Medicare Hearing Aid Coverage

Does Aetna Medicare Cover Hearing Aids?, The Pros and Cons of Aetna Medicare Hearing Aid Coverage

 

Aetna Medicare Hearing Aid Coverage offers significant benefits, such as covering 80% of the expenses related to hearing aids and associated services, including hearing tests and fittings.

This coverage can go a long way in helping individuals with hearing loss access the necessary hearing care without worrying about the financial burden.

However, it’s important to note that there are some limitations and exclusions to consider. For instance, individuals without a qualifying hearing loss, those not enrolled in Medicare Part B, or those who are not Aetna members may not be eligible for coverage.

Furthermore, many Aetna benefit plans have exclusions for certain types of hearing aids, such as air conduction hearing aids, implantable hearing aids, and semi-implantable hearing aids. It’s essential to review your plan details to understand what is and isn’t covered.

Applying for Aetna Medicare Hearing Aid Coverage: A Step-by-Step Guide

Does Aetna Medicare Cover Hearing Aids?, Applying for Aetna Medicare Hearing Aid Coverage: A Step-by-Step Guide

Applying for Aetna Medicare hearing aid coverage is a simple process that includes a few important steps. First, you need to check your eligibility for the coverage.

This generally involves one annual routine hearing exam and hearing aid fitting, both covered at 100 percent, and coverage for FDA-cleared OTC and prescription hearing aids prescribed by a healthcare professional.

Next, you’ll need to find an in-network provider. This can be done by accessing your account on the Aetna Medicare website and using the search function to identify providers within your current plan.

Once you’ve found a provider, you can then submit a prescription for your hearing aids. This involves selecting a provider and then filing a claim for reimbursement to Aetna, who offers coverage of up to 80% of the cost of hearing aids.

Finally, you’ll need to claim your reimbursement. This can be done by following these steps:

  • Fill out the reimbursement form available on the Aetna Medicare website.

 

  • Attach any original receipts and itemized bills.

 

  • Mail or fax your claim to the medical claims address on your Aetna Medicare member ID card.

 

By following these steps, you can apply for your Aetna Medicare hearing aid coverage and start on your journey towards improved hearing health with cover hearing aids.

Summary

In conclusion, Aetna Medicare offers comprehensive hearing aid coverage that can greatly benefit individuals with hearing loss. From covering routine hearing exams and fittings to providing benefits for hearing aid purchases, Aetna Medicare ensures that you can receive the necessary hearing care without worrying about the financial burden.

Despite some limitations and exclusions, the benefits offered by Aetna Medicare can significantly enhance your auditory experience and overall quality of life. So, don’t let hearing loss hold you back – take advantage of Aetna Medicare hearing aid coverage and experience the world of sound again.

 

Frequently Asked Questions

 

  Does Aetna Medicare cover hearing tests?

Yes, Aetna Medicare typically covers hearing tests as part of its Medicare Advantage plans, including routine hearing exams and potential coverage for hearing aids.

The specifics of coverage may vary depending on the plan.

 

→  Is Aetna Medicare the same as Aetna Medicare Advantage?

No, Aetna Medicare Advantage is a type of Medicare Advantage plan offered by Aetna, a private insurance company, which provides benefits beyond Original Medicare.

 

  Does Medicare cover the cost of hearing aids for seniors?

No, Medicare does not cover the cost of hearing aids or the exams for fitting them. However, there may be lower-cost options available with the FDA’s approval of over-the-counter hearing aids.

 

→  How come hearing aids are not covered by insurance?

Insurance companies often consider hearing aids as an optional expense, categorizing them as “elective” rather than essential medical devices.

This leads to a lack of coverage for hearing aids in many insurance plans.

 

 What is the process for submitting a claim for reimbursement with Aetna Medicare?

To submit a claim for reimbursement with Aetna Medicare, you can fill out the reimbursement form online at AetnaMedicare.com/reimburse or choose another electronic submission option that works best for you.

call today for help

 

 ZRN Health & Financial Services, LLC, a Texas limited liability company

Find & Compare Plans Online 

 

 Advertisement

Speak with a licensed insurance agent

 1-833-641-4938
TTY 711

Mon-Fri : 8am-9pm EST

Russell Noga
( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.