Over-the-Counter Hearing Aids and Medicare: 2026 Plan Filings by State and Insurer

Buying over the counter does not change Original Medicare

"Over the counter" is a sales category set by the FDA, not a coverage category. Under 21 CFR 800.30, an OTC hearing aid is an air-conduction device intended for a person age 18 or older to compensate for perceived mild to moderate hearing impairment. The user controls and customizes it through tools, tests or software.

Medicare.gov describes the payment side separately: Original Medicare does not cover hearing aids or exams for fitting them, and the person pays all costs for those non-covered items. Nothing in the FDA rule creates an insurance benefit, so a device bought in a pharmacy, a big-box store or online is paid out of pocket under Original Medicare, the same as a prescription aid.

Coverage for an OTC device can only come from a plan that adds it, which in the Medicare world means a Medicare Advantage plan filing a hearing benefit of its own.

OTC hearing aid benefit filings, state by state

Each Medicare Advantage plan files a Plan Benefit Package with CMS. Its hearing section has a field for over-the-counter hearing aids, separate from the one for prescription hearing aids. Our state table counts the 2026 plan segments that list the OTC benefit as mandatory supplemental, meaning it comes with the plan rather than as a paid add-on.

The share swings widely by service state:

• Highest: North Dakota, 19 of 29 segments (65.5%); Wyoming, 9 of 14 (64.3%); Kentucky, 70 of 114 (61.4%).
• Largest markets: Texas, 217 of 423 (51.3%); California, 130 of 402 (32.3%); Florida, 198 of 611 (32.4%); Pennsylvania, 86 of 332 (25.9%); New York, 50 of 218 (22.9%).
• Lowest among states: Massachusetts, 18 of 103 (17.5%); Michigan, 35 of 192 (18.2%); Hawaii, 8 of 44 (18.2%).
• Puerto Rico: 0 of 63 segments.

Small denominators move fast. Vermont's 33.3% rests on 1 segment out of 3, so one plan change would rewrite the row. A plan serving several states appears in each of them, which is why state rows cannot be added into a national figure.

OTC and prescription flags are two fields, not one total

The same filings show prescription hearing aids far more often than OTC ones. In Alabama, the prescription flag covers 100.0% of 98 segments and the OTC flag 52.0%. In California the pair is 76.1% and 32.3%; in Connecticut, 76.6% and 53.2%.

The two shares measure different fields over the same segments. A segment can carry both flags, only one, or neither, so adding the shares double-counts every plan that files both. The table shows them side by side for that reason and never as a sum.

A second limit matters more to a buyer. Carrying both flags does not tell you whether a member can use both benefits in the same period, must pick one, or loses one by using the other. Those choice rules sit in the plan's benefit text, which these summary fields do not include. Until that text is read for a given plan, the flags say a benefit was filed, not how it works.

Insurer groups run from every segment to none

Grouped by company name (parent or marketing) in the CMS files, the OTC flag splits the large Medicare Advantage insurers into three clusters:

• Nearly all segments: Cigna, 224 of 224 (100.0%); UnitedHealthcare, 825 of 846 (97.5%).
• A majority: Humana, 596 of 887 (67.2%); Elevance/Anthem, 208 of 345 (60.3%).
• A minority or none: Blue Cross Blue Shield entities, 168 of 598 (28.1%); Aetna/CVS, 0 of 652; Wellcare/Centene, 0 of 303; Kaiser, 0 of 126.

The prescription flag tells a different story for the same groups. Aetna/CVS files it for 99.7% of its segments and Wellcare/Centene for 93.7%, while Kaiser's mandatory prescription share is 38.9%.

Read these rows with three cautions. The groups overlap: some Elevance/Anthem segments also carry a Blue name and count in the Blue group, so group rows cannot be summed. A group is built from company names in CMS records, not from a product catalog. And a 0 means no mandatory OTC benefit was filed; hearing coverage sold as an optional package is outside the count. This page lists counts for information only and does not compare plans for enrollment.

What a filed OTC benefit does not promise

A flag in a plan filing is not a reimbursement promise. On its own it does not answer four questions:

1. The form of the benefit: is it an allowance, a discount, a set device list or a copay?
2. The amount and the period it renews on.
3. Where you can buy: any store, or only a vendor the plan names?
4. Which devices qualify, and what proof of purchase the plan asks for.

The counts also describe plans, not people: each segment counts once whatever its enrollment, and employer-only plans and PACE are left out. For a plan you already have, its Evidence of Coverage is the document that answers these four questions. No device prices appear on this page.

Related coverage pages

For the prescription benefit, its caps and copays, see Medicare Advantage hearing aid coverage. The Original Medicare rules sit on Medicare hearing aid coverage, and pending legislation on will Medicare cover hearing aids in 2026. Insurer detail for one of the groups above is on Humana hearing aid coverage, and OTC and prescription devices are compared on types of hearing aids.