Does Medicare Cover Cochlear Implants? 

Thousands of people in the United States have improved their sense of hearing with cochlear implants – surgically implanted electronic hearing devices. These devices produce hearing sensations for people with varying degrees of nerve deafness to help them improve their quality of life.

A cochlear implant consists of two components: An external microphone, sound processor, and transmitter system; and an implanted receiver and electrode system. Together these systems stimulate nerves in the inner ear by sending in electrical currents.  

If you are living with severe hearing loss, you might be trying to decide whether to get cochlear implants or hearing aids. There are some differences to consider: Hearing aids make sounds louder through amplification, whereas cochlear implants transmit sound signals directly into the inner ear. Hearing aids are worn either inside the ear canal or behind the ear, and they aren’t surgically implanted like cochlear implants. 

Another difference to consider is that hearing aids are good for those who have mild to moderate hearing loss, while cochlear implants are better for those who have severe hearing loss and don’t easily understand speech. 

And finally, you may need to consider whether your Medicare insurance plan covers the cost of cochlear implants and/or hearing aids. Here’s a look at how Medicare can help you. 

Does Medicare cover cochlear implants? 

Original Medicare Part B (medical insurance) covers cochlear implants for beneficiaries who meet the eligibility requirements. Part B covers surgically implanted prosthetic devices such as cochlear implants under the category of prosthetic devices. 

To be eligible for this coverage, your physician must accept Medicare assignment and must certify that you have severe hearing loss in one or both ears and that this hearing loss can be improved by cochlear implants. You must also have the procedure done at a medical facility that accepts Medicare assignment. 

Original Medicare Part B pays 80 percent of the Medicare-approved amount for surgically implanted prosthetic devices. You are responsible for the remaining 20 percent of the amount after you meet your annual Part B deductible. If you have the surgical procedure done as an outpatient in a hospital that accepts Medicare assignment, you are also responsible for paying the hospital copayment. This amount can vary depending on the facility.

Original Medicare Part B does not cover hearing aids or exams for fitting hearing aids. However, Part B covers diagnostic hearing and balance exams if your physician orders them to determine whether you need medical treatment. 

Does Medicare Advantage (Part C) cover cochlear implants and hearing aids? 

If you have your health care insurance through a Medicare Advantage (Part C) plan sold by a private insurance provider, you have all the same benefits as you would through Original Medicare Parts A and B. This means that if you meet Medicare’s eligibility requirements for cochlear implants, your plan must cover its portion of the cost of the surgical procedure and the devices. 

Your final out-of-pocket cost depends on what your individual plan charges for coinsurance and copayments. Also, you may be required to use health care providers, physicians, and medical facilities that are in your plan’s network of approved providers. 

Depending on the type of Part C plan you have, you may also have coverage for routine hearing care, hearing aids, and hearing aid fitting appointments. Many Medicare Advantage plans offer extra benefits like hearing care for their enrollees, so you might want to check out your options before making a final decision about cochlear implants.