What Insurance Does & Doesn’t Cover

Understanding hearing aid coverage can be frustrating — every plan is different, terminology is confusing, and many people are surprised to learn what isn’t covered.

This page breaks everything down simply so you know exactly what to expect before you begin your hearing care journey.

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At Clarity Hearing Care, we prioritize transparency. There are no surprises, no hidden fees, and no “gotchas.” Here’s how hearing aid coverage works across the major insurance categories.

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Private Insurance Plans

Coverage varies widely depending on the carrier and the specific plan. Some offer excellent benefits, while others offer none at all.

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What private insurance often covers:

• A portion of the hearing aid cost (either annually or every 2–3 years)

• A set dollar amount (e.g., $500, $1,000, or $3,000 per ear)

• A benefit through a third-party administrator

• Diagnostic hearing evaluations (often fully covered)

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What private insurance often doesn’t cover:

• Premium-tier technology

• Full service packages or long-term care

• Rechargeable upgrades or accessories

• Loss & damage replacement fees

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Important note:

Even when insurance does offer benefits, many carriers route patients through restrictive third-party networks that limit your choice of technology and provider. We always verify your benefits in advance so you know exactly what you’re entitled to — and what your options are outside the third-party system.

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Medicare (Traditional Medicare Part A & B)

This is the area where most people are surprised.

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What Medicare covers:

• Diagnostic hearing evaluations (when medically necessary)

• Testing ordered by a physician

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What Medicare does not cover:

• Hearing aids

• Hearing aid fittings

• Hearing aid supplies

• Routine follow-up care related to hearing aids

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Medicare does not pay for hearing aids under any circumstances. Supplemental plans generally follow the same rules unless your specific plan includes an exception.

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Medicare Advantage Plans (Part C)

Medicare Advantage plans often advertise hearing aid benefits — but the details matter.

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What they typically cover:

• A preset hearing aid allowance through a third-party provider

• Basic or mid-level technology

• Yearly hearing tests

• Discounted pricing through the plan’s vendor network

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What they usually don’t cover:

• Premium technology levels

• Direct care with the provider of your choice

• Unlimited adjustments or follow-up service

• Custom molds and advanced features

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Most Medicare Advantage “benefits” are controlled by third-party companies, not the hearing care provider — meaning the choices, technology, and warranty terms are often limited.

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Medicaid

Medicaid benefits vary by state.

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What Medicaid may cover:

• Basic hearing aids

• Hearing testing

• Replacement every few years (depending on the state)

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What Medicaid often excludes:

• Higher-end technology

• Rechargeable models

• Premium noise-management features

• Certain custom styles

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We always verify your exact coverage so you know which options are available.

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Third-Party Administrators (TPAs)

Many insurance plans outsource their hearing aid benefits to companies like:

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• TruHearing

• Hearing Care Solutions

• NationsHearing

• Amplifon

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What TPAs provide:

• Lower upfront cost

• Restricted device list

• Fixed pricing

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What TPAs limit:

• Technology levels

• Choice of manufacturer

• Access to premium devices

• Freedom to choose your provider

• Long-term care and service

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At Clarity Hearing Care, we explain the pros and cons of each so you can choose what’s best for your hearing — not what’s cheapest for the insurer.

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The Bottom Line

Insurance coverage for hearing aids is inconsistent and often limited, but you are never left guessing at Clarity Hearing Care.

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We always:

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• Verify your benefits before your visit

• Explain your exact coverage in plain language

• Offer transparent pricing for every technology level

• Provide financing options for all budgets

• Help you make the most of any insurance benefit you do have

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You’ll know exactly what to expect before making any decision.