Hearing Aids for Seniors: What Older Adults Need to Know
About one in three adults ages 65 to 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing, according to NIDCD. Age-related hearing loss (presbycusis) is gradual and usually affects both ears. This guide covers when to get a hearing exam versus trying OTC devices, what Medicare and Medicaid actually cover, features that matter with age such as rechargeable batteries and simple controls, and how hearing and cognition are connected.
Key takeaways
- Age-related hearing loss is common. About one in three adults ages 65 to 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing (NIDCD).
- Presbycusis is gradual and usually affects both ears. NIA says age-related hearing loss usually occurs in both ears, affecting them equally, and because the loss is gradual, people may not realize they have lost some of their ability to hear.
- Medicare Part B covers diagnostic hearing exams, but Original Medicare does not cover hearing aids. You can see an audiologist once every 12 months without an order for non-acute hearing loss. Medicare Advantage hearing benefits vary by plan.
- Veterans enrolled and eligible for VA care can get hearing aids through VA audiology, with devices, batteries, and repairs at no cost; visit copays may apply.
- Features that matter: rechargeable batteries, simple controls, telecoil, and physical size. Dexterity, vision, and ease of handling become more important than invisibility for most older adults.
- Observational research links untreated hearing loss to cognitive decline, and the 2024 Lancet Commission identifies hearing loss as a modifiable dementia risk factor, but the first randomized trial found no overall benefit from hearing aids in its primary analysis.
Older adults and their families search for information about hearing aids for seniors when difficulty hearing conversations, missing phone calls, or turning up the TV volume becomes a daily frustration. NIDCD calls age-related hearing loss (presbycusis) one of the most common conditions affecting adults as they age, and because it is gradual, you may not realize you have lost some of your ability to hear. This guide explains what is specific to older adults: how age-related hearing loss develops, when to get a hearing exam versus trying over-the-counter devices, Medicare and Medicaid coverage, VA benefits for veterans, features that matter with age, how hearing loss and cognition are connected, and adjusting to hearing aids.
Age-related hearing loss (presbycusis): what it is and how it develops
Age-related hearing loss, called presbycusis, is hearing loss that occurs gradually as you age. It is one of the most common conditions affecting older adults: about one in three people ages 65 to 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing, according to the National Institute on Deafness and Other Communication Disorders (NIDCD Age-Related Hearing Loss page, updated March 17, 2023).
What causes presbycusis
NIDCD explains that many things affect hearing as we age: changes in the inner ear are common, and age-related changes in the middle ear and along the nerve pathways from the ear to the brain can also affect hearing. Long-term exposure to noise and some medical conditions can play a role, and certain genes may make some people more susceptible (NIDCD Age-Related Hearing Loss page, updated March 17, 2023).
According to the National Institute on Aging (NIA), factors that contribute to age-related hearing loss include repeated exposure to loud sounds, heredity, and certain health conditions such as high blood pressure or diabetes (NIA Hearing Loss page, reviewed January 19, 2023).
How presbycusis develops
Age-related hearing loss usually develops gradually over years. NIDCD notes that hearing loss typically occurs in both ears as we age and that, because the loss is gradual, you may not realize you have lost some of your ability to hear (NIDCD Age-Related Hearing Loss page, updated March 17, 2023).
NIA notes that people with hearing loss may miss certain high-pitched sounds and have trouble understanding children and people with higher-pitched voices. Consonant sounds in speech (s, f, th, sh, p, t, k) are high frequency and carry much of the meaning in spoken words, so losing high-frequency hearing makes it harder to distinguish words that sound similar. This is why people with age-related hearing loss often say they can hear someone talking but cannot understand what is being said, especially in noisy environments.
Signs of age-related hearing loss
Common signs include difficulty understanding speech in noisy places, trouble hearing on the phone, needing to turn up the TV or radio volume, asking others to repeat themselves, and certain sounds seeming too loud while others are hard to hear. For a full list of early warning signs and when to get tested, see our signs of hearing loss guide.
If hearing loss comes on suddenly, especially in one ear, or if you have ear pain, drainage, dizziness, or other symptoms along with hearing loss, see a doctor right away. According to NIDCD, sudden sensorineural hearing loss is a medical emergency. Age-related hearing loss is gradual; sudden changes need prompt medical evaluation.
When to get a hearing exam versus trying OTC hearing aids
Since October 2022, adults 18 and older with perceived mild to moderate hearing loss can purchase over-the-counter hearing aids without a medical exam or professional fitting, under the FDA final rule establishing the OTC category (Federal Register Vol. 87, No. 158, August 17, 2022). This created two paths: try OTC devices first, or get a hearing exam from a licensed audiologist and pursue professionally fitted prescription hearing aids.
OTC hearing aids: who the rule covers
The FDA rule allows adults 18 years of age or older who have perceived mild to moderate hearing impairment to purchase OTC hearing aids directly without a prescription. The rule requires OTC devices to include user instructions, volume controls, and warnings about red-flag symptoms that require medical evaluation. OTC hearing aids are output-limited for safety and are not appropriate for severe or profound hearing loss.
OTC hearing aids usually cost less than prescription devices. For current price ranges by channel, see our hearing aid cost guide, and for who each category suits, see our OTC vs prescription hearing aids guide.
When to get a hearing exam first
Even though OTC devices are available without an exam, getting a hearing evaluation from a licensed audiologist is recommended. A hearing exam confirms that your hearing loss is in the mild to moderate range, rules out treatable causes such as impacted earwax or middle ear fluid, and produces an audiogram that documents your hearing thresholds at each frequency. The audiogram is essential if you later decide to pursue prescription hearing aids, and it provides a baseline for tracking changes over time.
Medicare Part B covers a diagnostic hearing exam; see the coverage section below.
Red-flag symptoms that require medical evaluation
Do not purchase any hearing aid, OTC or prescription, until you see a physician or audiologist if you have any of the following red-flag conditions. These may indicate a treatable cause or a condition that amplification will not address:
- Sudden hearing loss, especially in one ear. NIDCD says to consider sudden deafness a medical emergency and see a doctor immediately.
- Hearing loss in one ear only, or a noticeable difference between ears (asymmetric hearing loss).
- Ear pain, drainage, blood, or visible deformity of the ear.
- Dizziness, vertigo, or balance problems.
- Ringing, roaring, or buzzing in the ear (tinnitus) that is constant or bothersome.
- Suspected impacted earwax or foreign body in the ear canal.
- Hearing that fluctuates over days or weeks rather than being stable.
For help recognizing early warning signs of hearing loss and understanding when testing is urgent, see our signs of hearing loss guide.
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Features that matter with age: dexterity, batteries, controls, and size
When choosing hearing aids, older adults and families often prioritize different features than younger adults do. Invisibility matters less than ease of handling, battery maintenance, and control simplicity. Here are the features that make hearing aids easier to use as you age.
Rechargeable batteries versus disposable batteries
Rechargeable hearing aids use built-in lithium-ion batteries that you charge nightly in a case, similar to charging a smartphone. Disposable-battery hearing aids use small zinc-air button cells (commonly size 312 or 13) that you replace when they run down.
For older adults, rechargeable batteries eliminate the need to handle tiny batteries, peel adhesive tabs, and remember to purchase replacements. Rechargeable models are especially helpful for users with arthritis, reduced fine motor control, or vision impairment. For the full trade-offs, costs, and lifespan comparison, see our rechargeable vs battery hearing aids guide.
Simple controls: buttons and wheels versus smartphone apps
Many modern hearing aids offer smartphone apps for adjusting volume, changing programs, and accessing features. Apps are useful for tech-comfortable users, but not everyone finds them intuitive or easy to use.
Hearing aids with physical controls (a button or wheel on the device itself) let you adjust volume or switch programs without opening an app or navigating menus. For older adults who are less comfortable with smartphones, physical controls reduce frustration and make the devices more usable. Ask your audiologist which models offer physical controls if app-only adjustment is a concern.
Telecoil for hearing loops in public venues
A telecoil is a small coil of wire inside a hearing aid that picks up magnetic signals from hearing loop systems (also called induction loop systems). Hearing loops are installed in theaters, auditoriums, places of worship, airports, and other public venues. When you activate the telecoil in your hearing aids, sound from the venue's microphone or sound system is transmitted directly to your hearing aids, reducing background noise and improving clarity.
Telecoil is more common in larger hearing aid styles such as behind-the-ear (BTE) and receiver-in-canal (RIC) devices. Smaller custom in-the-ear styles may not have room for a telecoil. If you regularly attend venues with hearing loop systems, ask your audiologist whether the hearing aids you are considering include a telecoil.
Bluetooth streaming: optional but useful
Bluetooth-enabled hearing aids can stream phone calls, TV audio, and music directly from your smartphone, tablet, or TV streaming device into your hearing aids. Streaming can make calls and TV easier to hear.
Bluetooth is not essential for hearing aid function, but it can improve quality of life for users who spend time on the phone or want to hear the TV without turning up the volume for others in the room. Bluetooth is less common in the smallest custom styles (invisible-in-canal or completely-in-canal) due to size constraints. For details on Bluetooth connectivity, pairing, and the newer Auracast broadcast standard, see our Bluetooth and Auracast hearing aids guide.
Physical size and ease of handling
Hearing aids range from invisible-in-canal (IIC) devices that sit deep in the ear canal to behind-the-ear (BTE) devices with a case that rests on top of the ear. Smaller devices are less visible but harder to insert, remove, clean, and adjust. Larger devices are easier to handle.
For older adults with arthritis, tremor, reduced fine motor control, or vision impairment, ease of handling often matters more than invisibility. Test-handle the device in the clinic before committing. Practice inserting and removing it yourself. If you cannot comfortably put it in or take it out, choose a larger, easier-to-handle style. For a comparison of all hearing aid styles, their size, visibility, power, and feature trade-offs, see our types of hearing aids guide.
Caregiver involvement
Some older adults need help with hearing aid insertion, cleaning, or battery changes from a spouse, family member, or caregiver. If a caregiver will assist, involve them in the fitting appointment so they learn how to put the devices in, take them out, check that they are working, and perform daily cleaning. Caregivers should also know how to replace batteries or place devices in the charger, and how to recognize when something is wrong. Your audiologist can demonstrate the daily routine and provide written instructions.
Medicare, Medicaid, and VA coverage: how older adults pay for hearing aids
Paying for hearing aids is a common concern for older adults and families. Original Medicare does not cover hearing aids, but Medicare Advantage plans often offer supplemental hearing benefits. Medicaid coverage varies by state, and VA audiology covers hearing aids for enrolled, eligible veterans. Here is what each program provides.
Original Medicare (Parts A and B): diagnostic exams covered, hearing aids not covered
Original Medicare does not cover hearing aids. Medicare.gov states: "Medicare doesn't cover hearing aids or exams for fitting hearing aids."
Medicare Part B does cover diagnostic hearing and balance exams when your doctor or other health care provider orders them to find out if you need medical treatment. You can also visit an audiologist once every 12 months without an order, but only for non-acute hearing conditions such as hearing loss that happens over many years. After the Part B deductible, you pay 20% of the Medicare-approved amount (Medicare.gov Hearing & balance exams).
This means you can use Medicare Part B to get the hearing evaluation, which confirms your hearing loss and produces an audiogram, but you pay out of pocket for the hearing aids themselves. For the full breakdown of what Medicare covers, what it does not, and Medicare Advantage hearing benefits, see our does Medicare cover hearing aids guide.
Medicare Advantage hearing benefits: widely available but varies by plan
Medicare Advantage plans (Part C) are private insurance plans that replace Original Medicare and often add supplemental benefits that Parts A and B exclude. Hearing is one of the most common supplemental benefits: 95% of individual Medicare Advantage enrollees are in plans that offer hearing exams and/or hearing aids in 2026, according to KFF (Medicare Advantage in 2026, June 5, 2026).
Check your plan's Evidence of Coverage or call the member services number on the back of your card to find out your specific hearing benefit amount, how often it renews, which hearing network administers it, and whether a referral is required. For detailed guidance on checking your Medicare Advantage hearing benefit, see our does Medicare cover hearing aids guide.
Medicaid coverage: varies by state
Medicaid is a joint federal-state program, and hearing aid coverage for adults varies by state.
Contact your state Medicaid office or your Medicaid managed care plan for your specific benefit. If you are covered by both Medicare and Medicaid (dual eligible), ask how the benefits coordinate and whether one program covers what the other does not. For a broader discussion of hearing aid insurance coverage, see our does insurance cover hearing aids guide.
VA health care: comprehensive coverage for enrolled veterans
VA audiology provides comprehensive hearing healthcare, including hearing aids, to Veterans who are enrolled and eligible for VA care (VHA Audiology Services). Devices, batteries, and repairs are provided at no cost to eligible enrolled Veterans, though visit copays may apply. For eligibility and how to apply, see our VA hearing aid benefits guide.
Paying out of pocket: when you have no coverage
If you have no hearing aid coverage, you pay out of pocket, and prices vary widely by channel and technology level. Ask several providers for itemized quotes before committing. For a full breakdown of hearing aid costs by channel, technology tier, and ways to pay less, see our how much do hearing aids cost guide. For payment plan options, see our hearing aid financing guide.
Hearing and cognition: what older adults and families should know
Many older adults and families ask whether untreated hearing loss contributes to cognitive decline or dementia. The connection between hearing and cognition has been studied extensively, and the evidence shows consistent associations, though causation is not yet proven.
Observational research shows a correlation
Observational studies link hearing loss with faster cognitive decline and higher dementia risk; NIA notes that older adults with hearing loss have a greater risk of developing dementia (NIA), and the 2024 Lancet Commission lists hearing loss among 14 modifiable dementia risk factors. Association is not proof of causation. In the ACHIEVE randomized trial of 977 adults aged 70 to 84, a hearing intervention did not reduce 3-year cognitive decline in the primary analysis, although a prespecified analysis suggested a possible benefit in a higher-risk cohort (Lin et al., The Lancet, 2023). Hearing aids should not be treated as dementia prevention; trouble hearing in daily life is reason enough to address it. For the full research summary, see our hearing aids and dementia guide.
Adjusting to hearing aids: what to expect in the first weeks
Getting used to hearing aids takes time. Your own voice may sound odd, everyday sounds seem loud, and listening can feel tiring at first. These sensations are normal parts of the adjustment period and typically improve with consistent wear.
NIDCD emphasizes that adjusting to hearing aids takes time and patience, and that wearing them regularly helps you adjust (NIDCD Hearing Aids page, last updated October 11, 2022). The FDA says the same: it takes time and patience to get used to hearing aids (FDA How to Get Hearing Aids).
Ask your audiologist how long to wear your hearing aids at first and how quickly to build up wearing time. Attend all scheduled follow-up appointments so your clinician can fine-tune the programming and fit based on your real-world experience. For what is normal during the adjustment period, when to see your clinician for adjustments, and how long adaptation takes, see our getting used to hearing aids guide.
Frequently asked questions
What causes age-related hearing loss? +
NIDCD says changes in the inner ear are common as we age, and age-related changes in the middle ear and along the nerve pathways from the ear to the brain can also affect hearing. Long-term noise exposure, some medical conditions such as high blood pressure and diabetes, and certain genes can also play a role. NIA notes that age-related hearing loss comes on gradually and usually affects both ears equally.
Should I get a hearing exam or try over-the-counter hearing aids? +
If your hearing loss came on gradually, affects both ears similarly, and you have no ear pain, drainage, dizziness, or sudden hearing changes, the FDA OTC rule allows adults 18 and older with perceived mild to moderate loss to try OTC devices first. However, getting a hearing exam from a licensed audiologist rules out treatable causes such as earwax buildup or middle ear problems, confirms your loss is in the mild to moderate range, and provides an audiogram that every hearing aid provider will ask for. Medicare Part B covers diagnostic hearing exams, and you can see an audiologist once every 12 months without an order for non-acute hearing loss. For more on the OTC rule and who it suits, see our OTC vs prescription hearing aids guide.
Does Medicare pay for hearing aids for seniors? +
Original Medicare (Parts A and B) does not cover hearing aids or fitting exams. But 95% of individual Medicare Advantage enrollees are in plans that offer hearing exams and/or hearing aids as supplemental benefits (KFF, June 5, 2026). Benefit amounts, how often they renew, and network rules vary by plan. Check your plan's Evidence of Coverage or call the member services number on your card. For the full breakdown, see our does Medicare cover hearing aids guide.
Does Medicaid cover hearing aids for older adults? +
Medicaid hearing aid coverage for adults varies by state. Contact your state Medicaid office or managed care plan for your specific benefit, and see our insurance coverage guide.
Are hearing aids covered for veterans? +
Yes. Veterans enrolled in VA health care who have qualifying hearing loss receive hearing aids, fitting, batteries, repairs, and follow-up care at no cost for the devices (visit copays may apply). Eligibility depends on enrollment in VA health care and an audiological evaluation that documents hearing loss. For details, see our VA hearing aid benefits guide.
What features should seniors look for in hearing aids? +
Rechargeable batteries eliminate the need to handle tiny disposable batteries and are easier for users with arthritis or reduced fine motor control (see our rechargeable vs battery comparison). Simple controls (button or wheel on the device) are helpful if smartphone apps are difficult. Telecoil helps in venues with hearing loops, such as theaters and places of worship. Bluetooth streaming is optional but useful for phone calls and TV. Avoid styles that are too small to handle comfortably. For style trade-offs, see our types of hearing aids guide.
Is hearing loss linked to dementia? +
Observational research consistently shows that untreated hearing loss is associated with cognitive decline and higher dementia rates, and the 2024 Lancet Commission on Dementia identifies hearing loss as a modifiable risk factor. However, the first large randomized trial (ACHIEVE) found that hearing aids did not reduce cognitive decline overall in its primary analysis, though a prespecified analysis suggested a possible benefit in a higher-risk cohort. Current evidence does not support treating hearing aids as dementia prevention, but if hearing loss interferes with your life, that is a sufficient reason to address it. For the full research summary, see our hearing aids and dementia guide.
How long does it take to get used to hearing aids? +
NIDCD and FDA both note that adjusting to hearing aids takes time and patience, and that wearing them regularly helps you adjust. Expect your own voice to sound odd, everyday sounds to seem loud at first, and some listening fatigue at first. These sensations typically improve with consistent wear. Ask your audiologist how long to wear the devices at first and how quickly to build up. For what is normal during the adjustment period, see our getting used to hearing aids guide.
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Sources
- National Institute on Deafness and Other Communication Disorders (NIDCD), Age-Related Hearing Loss (Presbycusis), updated March 17, 2023. Accessed November 2, 2026.
- National Institute on Aging (NIA), Hearing Loss: A Common Problem for Older Adults, reviewed January 19, 2023. Accessed November 2, 2026.
- National Institute on Deafness and Other Communication Disorders (NIDCD), Sudden Deafness. Accessed November 2, 2026.
- U.S. Food and Drug Administration, Medical Devices; Ear, Nose, and Throat Devices; Establishing Over-the-Counter Hearing Aids, Federal Register Vol. 87, No. 158, August 17, 2022. Accessed November 2, 2026.
- U.S. Food and Drug Administration, How to Get Hearing Aids. Accessed November 2, 2026.
- Medicare.gov, Hearing aids. Accessed November 2, 2026.
- Medicare.gov, Hearing & balance exams. Accessed November 2, 2026.
- KFF, Medicare Advantage in 2026: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization, June 5, 2026. Accessed November 2, 2026.
- U.S. Department of Veterans Affairs, VHA Audiology Services. Accessed November 2, 2026.
- National Institute on Deafness and Other Communication Disorders (NIDCD), Hearing Aids, last updated October 11, 2022. Accessed November 2, 2026.
- Lin FR, Pike JR, Albert MS, et al. Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. The Lancet. 2023;402(10404):786-797. PubMed 37478886.
- Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet. 2024;404(10452):572-628. PubMed 39096926.