Updated August 7, 2026. Quick answer: Medicare excludes hearing aids by statute — including the exam to fit them. 🔴 But since October 2022 there has been an over-the-counter category, and for adults with perceived mild-to-moderate loss it removes the prescription and the fitting appointment from the purchase entirely.
The exclusion, and how far it reaches
Medicare may not pay for:
hearing aids or examinations therefor
⚠️ Read the second half. The exclusion covers the examination for the aid, not only the device. That is why a hearing test ordered to diagnose a medical problem may be covered while the same test performed to fit an aid is not — the purpose of the visit changes the answer.
What changed in 2022
The FDA established an over-the-counter hearing aid category by final rule, effective 17 October 2022. The codified definition is narrow and worth reading precisely: it covers air-conduction hearing aids for adults with perceived mild to moderate hearing impairment, available without a prescription and without supervised fitting.
🔴 Three limits inside that sentence do most of the work:
- Adults only. Devices for children remain prescription.
- Perceived mild-to-moderate. The category is defined by what the buyer perceives, which is precisely why an unexplained or sudden change in hearing is a reason to see a clinician rather than to buy a device.
- Air conduction. Other device types are outside the category.
How to think about the money
The OTC category changed the price structure more than the technology. A prescription aid is usually a bundle — device, fitting, adjustments and follow-up in one price. An OTC device is the device.
So the honest comparison is not sticker to sticker. It is: how much fitting and adjustment do you expect to need, and what would it cost separately? For a straightforward mild loss, the unbundling is a real saving. For a complex loss or a first-ever aid, the support in the bundle is the part being paid for.
⚠️ And a Medicare Advantage hearing allowance is a plan benefit, not a Medicare benefit — same structure as the dental benefit, and the same question applies: what is the allowance, in dollars, per how many years?
Sources
Hearing exclusion: 42 U.S.C. §1395y(a)(7). The OTC category: FDA final rule, 87 Fed. Reg. 50698, codified at 21 CFR §800.30, effective 17 October 2022 — read from the rule text itself via govinfo.gov, as fda.gov was unreachable to us this session. All read 7 August 2026. General information, not insurance or legal advice. Plan benefits vary and rules change; confirm anything decision-critical with the plan or agency itself.