Yes, Medicare Part B does cover cochlear implants if they are deemed medically necessary by a doctor.
Medicare Advantage (Part C) plans also cover cochlear implants when they are medically necessary. Medicare Advantage plans must at least cover the same services as Medicare Part A and Part B.
Medicare Advantage plans also include an annual out-of-pocket spending limit, which can help cap what you spend on out-of-pocket Medicare costs each year.
Original Medicare (Part A and Part B) doesn’t include an out-of-pocket spending limits.
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Who is eligible for cochlear implants?
Cochlear implants are covered by Medicare for beneficiaries who have severe hearing loss in one or both ears, as long as a doctor who is enrolled in Medicare orders the implants.
Cochlear implants are surgically implanted electronic medical devices that replace the function of the damaged inner ear to provide sound signals to the brain.
Generally, those who need prosthetic cochlear implants don’t just struggle with the volume of sound, their brains are actually missing pieces of sound signals.
Cochlear implants cost
If you are enrolled in Original Medicare, you typically pay 20 percent of the Medicare-approved price for cochlear implants once you meet your Part B deductible (which is $240 per year in 2024).
This is called your Part B coinsurance or copayment.
If you have a Medicare Advantage plan, your coinsurance or copay costs may vary.
Depending on the type of Medicare Advantage plan you have, you may be required to get your cochlear implants from a doctor in your plan network.
Speak with your doctor about specific pricing information regarding your specific cochlear implants, including whether or not they are covered by Original Medicare or your Medicare Advantage plan. There may be specific rules or selection criteria that apply.
Does Medicare cover hearing care?
Original Medicare does not cover most routine hearing services and supplies, including hearing aids and routine hearing care.
Medicare Advantage plans can offer benefits Original Medicare doesn't cover, but availability varies. Be sure to find out what plan benefits are available where you live.
Find Medicare Advantage plans
A licensed insurance agent can help you find Medicare Advantage plans in your area and discuss your options.
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