Helping an elderly parent with hearing loss comes down to three things you can start now: the right hearing aid, a captioned phone, and asking for communication aids at medical visits. Whether Medicare, Medicaid or the VA pays for hearing aids is a separate question, and none of these steps has to wait for it.

In This Guide

Who Pays for Hearing Aids?

That depends on your parent's coverage, and each payer has its own page: Does Medicare Cover Hearing Aids?, Does Medicare Cover Dental, Vision, and Hearing?, VA Hearing Aids and Vision Care, Medicaid Hearing Aid Coverage, Georgia Medicaid Hearing Aid Coverage and Does Medicare Cover Cochlear Implants?.

Is an Over-the-Counter Hearing Aid Right for Your Parent?

The National Institute on Deafness and Other Communication Disorders (NIDCD), the federal hearing research institute, says sudden hearing loss, often in only one ear, should be treated as a medical emergency: see a doctor immediately, not a store.

Gradual loss is easier to miss. The National Institute on Aging says to see a doctor if a person has trouble on the phone or following two or more people talking, often asks people to repeat themselves, turns the TV up so loud others complain, or thinks others mumble.

Under the FDA's rule (21 CFR 800.30), an OTC hearing aid is meant for a person 18 or older with perceived mild to moderate hearing impairment, who can buy one in a store or online without seeing an ear-nose-throat (ENT) doctor or an audiologist.

When OTC hearing aids aren't the right starting point

FDA says OTC hearing aids aren't for severe or profound hearing loss, because their maximum output is limited. NIDCD says to see a hearing health professional if your parent has trouble hearing conversations in quiet settings, or hearing loud sounds like cars, trucks, noisy appliances or loud music.

Every OTC hearing aid package must carry a "red flag" warning; FDA's list says to see a doctor, preferably an ENT, if any of these apply.

How to tell a real OTC hearing aid on the shelf

The words "OTC" and "hearing aid" have to appear on the front of the package, and federal rules prohibit selling an OTC hearing aid to anyone under 18. FDA also warns that package claims like "FDA Registered" or "FDA Certified," or an FDA logo, may be misleading.

A personal sound amplification product (PSAP) is not a hearing aid: NIDCD says PSAPs are for people without hearing loss and aren't regulated as medical devices, and FDA says PSAPs are not alternatives to hearing aids.

Read the return notice before you pay

The outside of every OTC hearing aid box must carry a notice of the manufacturer's return policy, but FDA's required wording lets that notice say there is no return policy, and FDA's OTC rules don't require a warranty. FDA advises knowing any return or warranty period up front, so your parent has time to test the aids in different listening situations.

The middle route: test with a professional, buy OTC

The federal rule bars states from requiring a licensed person's involvement for OTC hearing aids, but a licensed professional can still sell and service them. FDA says an audiologist or hearing aid dispenser can do a hearing test and evaluation, and your parent can request those records and buy the hearing aid elsewhere.

If an OTC hearing aid causes a problem, such as skin irritation, a battery burn or hearing that suddenly gets worse with use, FDA asks you to report it through its online MedWatch form or at 1-800-FDA-1088.

If your parent won't admit there's a problem, start with our guide on what to do when an aging parent refuses help.

Getting a Parent With Hearing Loss a Phone They Can Hear

Telecommunications relay service lets people with hearing or speech disabilities make and take phone calls, and the Federal Communications Commission (FCC)'s relay guide says it's available in all 50 states, DC, Puerto Rico and the territories.

For a parent who can still talk, the commission describes two captioned phone services and a related relay option.

Service How it works What your parent uses
Captioned Telephone Service (CTS) A communications assistant re-voices what the other person says, and speech recognition turns that into captions on the phone's screen. It's run state by state, the FCC doesn't require states to offer it, and many have ended it, so check whether yours still does. A special telephone with a text screen
IP Captioned Telephone Service (IP CTS) Captions travel over the internet instead of the phone network, so your parent listens and reads at the same time. A smartphone or computer version, or an existing phone plus a computer or other web-enabled device
Voice Carry Over Your parent speaks directly to the caller, and a communications assistant types the caller's words back. The commission calls this particularly useful for seniors who have lost their hearing but can still speak. Their own voice for speaking, with the replies arriving as text

Why 711 isn't the answer

The commission's consumer guide says 711 reaches certain forms of relay anywhere in the country, but 711 access is not available for CTS or IP CTS, so your parent needs to sign up for a captioned phone service.

What it costs, and what the provider will ask for

Federal relay rules say relay users pay no more than they would for a comparable voice call, and IP CTS caption minutes are paid from a federally administered fund, the TRS Fund. For the phone or device itself, ask the captioning provider what it costs and what certification it needs from your parent.

Before an IP CTS provider can be paid for your parent's service, federal rules require it to collect your parent's full name, date of birth, the last four digits of their Social Security number, home address and phone number for a federal eligibility database, and your parent self-certifies a hearing or speech disability that requires IP CTS. The FCC says the Social Security details are discarded once verified, and someone without a Social Security number can use other documents.

Not every request for those digits is genuine: if someone your parent didn't contact asks for them, hang up and call the captioning provider directly. Our guide to scams targeting older adults covers the common pitches.

The captions are your parent's, not the household's

Federal rules require new IP CTS equipment to carry a label reading "FEDERAL LAW PROHIBITS ANYONE BUT REGISTERED USERS WITH HEARING LOSS FROM USING THIS DEVICE WITH THE CAPTIONS ON." At sign-up, your parent certifies that, to the best of their ability, they won't let unregistered people make captioned calls on the service. If you're the one picking up Mom's captioned phone, turn the captions off.

If captioning or relay service goes wrong, your parent can file a complaint with the FCC online, by phone at 888-225-5322, by videophone at 844-432-2275, or by mail.

Calling 911

The FCC says to call 911 by voice if you can. Text-to-911 works only where the local 911 call center accepts texts; elsewhere, the FCC says to use a TTY or relay service if possible, and a text sent where it isn't available generally gets an automatic bounce-back message saying text-to-911 isn't available. The FCC's relay guide says that for most forms of relay, the provider must be able to handle 911 calls and relay them to emergency services.

What to Ask For at the Doctor's Office and Hospital

When you book the appointment, ask for what your parent needs by name: real-time captioning, an assistive listening device, written notes or an interpreter. The Americans with Disabilities Act rule for businesses and nonprofits that serve the public (Title III, 28 CFR 36.303) calls these "auxiliary aids" and requires a public accommodation to supply them where needed for effective communication, unless that would fundamentally alter what the provider offers or be an undue burden. The Justice Department's hospital guidance covers deaf and hard-of-hearing patients and visitors, and its effective communication guidance uses a doctor's office as an example. Under the ADA's Title III rule, wearing hearing aids doesn't count against your parent: whether hearing loss is a disability is assessed case by case, without regard to the help hearing aids give.

Besides sign language interpreters, the rule's list includes notetakers, written materials and notes, telephone handset amplifiers, assistive listening devices, phones compatible with hearing aids and captioned telephones. The Justice Department calls real-time captioning (CART) particularly useful for people with hearing loss who don't use sign language.

One major exception: Title III's rule doesn't apply to a health care provider that a religious organization operates or controls, and the Justice Department says the factual test is whether it controls the operations. If such a provider receives federal funds, Section 504 may still apply: HHS's Section 504 rule requires a recipient to provide aids, give primary consideration to the person's request, and not require them to bring someone to interpret.

Your parent shouldn't pay for them

If a bill shows a charge for the interpreter or captioner, question it. The Justice Department says hospitals can't charge patients with hearing disabilities an extra fee for interpreters or other communication aids. Under Title II of the ADA, a public entity, such as a public hospital, can't add a surcharge for them, and under Title III neither can a public accommodation. HHS's nondiscrimination rule for health programs (Section 1557, at 45 CFR 92.202) says a covered entity must provide these aids free, on time, and in a way that protects your parent's privacy and independence.

You shouldn't be the interpreter

If staff turn to you to relay what the doctor said, you can decline. Under the ADA Title III rule (with the religious exception above), a hospital or other public accommodation can't require your parent to bring someone along to interpret. Under that rule, a provider can rely on an accompanying adult only in an emergency involving an imminent threat to someone's safety when no interpreter is available, or when your parent specifically asks for that person, the person agrees, and it's appropriate under the circumstances. The rule allows relying on a minor child to interpret only in that kind of emergency.

The Justice Department's hospital guidance calls it inappropriate to ask family members to interpret, because they may not interpret accurately in the emotional situation of a medical emergency.

If you have hearing loss too

Tell the staff if you're hard of hearing yourself: the Title III rule requires effective communication with a companion with a disability, meaning a family member, friend or associate the provider should be communicating with.

Who picks the aid

Ask for the specific aid that works for your parent, and say why. Under Title III, a private provider should consult your parent whenever possible, but the final decision is the provider's as long as the method it picks actually communicates. A state or local government provider, such as a public hospital, must, per the Justice Department, give primary consideration to the aid your parent requests and honor it unless another equally effective method is available or the choice would be a fundamental alteration or undue burden. HHS's Section 1557 rule applies those Title II standards to its covered entities.

If a provider says your parent's preferred aid is too hard or too expensive, ask what it will offer instead. A provider doesn't have to take a step it can show would be an undue burden (significant difficulty or expense) or a fundamental alteration, but the Justice Department says that when one aid would be an undue burden, the provider must offer another effective aid, if possible, that wouldn't be.

In the hospital room and the nursing home

If a hospital provides phones and TVs in patient rooms, the Justice Department says it must provide comparable accessible equipment on request, including hearing-aid-compatible phones with volume control and TVs with closed captioning. Ask at admission. Our hospital discharge planning guide covers the rest of a hospital stay.

Justice Department ADA guidance treats a privately run nursing home, unless a church or other religious organization operates it, as a public accommodation that owes communication aids. If the nursing home takes Medicare or Medicaid, federal rules also require it to give your parent information in a form they can access and understand (with limited exceptions) and reasonable phone access, including TTY and TDD services; CMS's inspector guidance says staff must interact in a way that assures communication, and gives using a hearing amplification device, when a resident needs one, as an example. The same rules give your parent a place to call without being overheard and the right to keep a cell phone at their own expense. The full list is in our guide to nursing home residents' rights.

Home health and video visits

If a Medicare-certified home health agency sends nurses or therapists home, federal rules require it to provide communication aids at no cost and tell your parent about that right. If it falls short, complain to the agency, which must investigate family complaints too, then to the state home health hotline it must tell your parent about.

For video visits, HHS and Justice Department guidance says providers these laws cover must communicate effectively and provide aids at no cost. Its examples: a provider may need a platform that supports real-time captioning and can't make your parent bring their own captioner, and a doctor's office may have to let a family member join where needed. If an aid would be an undue burden or a fundamental alteration, the provider must pursue an alternative if one exists. The Title III religious exception and its Section 504 caveat above apply to video visits too.,

If a Provider Says No

The Justice Department takes ADA complaints through an online report or a paper complaint form, and may refer a complaint to its confidential, voluntary mediation program. Its ADA Information Line is 800-514-0301 (voice) and 1-833-610-1264 (TTY).

The HHS Office for Civil Rights takes civil rights complaints about health care providers. An OCR complaint must be in writing (by mail, fax, email or the OCR online portal), name the provider, and be filed within 180 days of when you knew about the problem, though the office may extend that for good cause.

State Equipment Programs and Trying Devices First

Some states hand out phones and listening equipment through their own programs, each with its own rules. Here are the three we've verified; for any other state, check your state's equipment program.

State Program Key rules
Texas Specialized Telecommunications Assistance Program (STAP), run by the Texas Health and Human Services Commission A voucher for a category of equipment, exchanged with a registered vendor. Applicant must be at least 5, prove Texas residency, and have the application certified by a listed professional. Processing can take up to 6 months, there are 30 days to return equipment for any reason, and one voucher every five years.
North Carolina Equipment Distribution Service, from the North Carolina Department of Health and Human Services Division of Services for the Deaf and Hard of Hearing Income up to 250% of the poverty level, a certificate of disability, and North Carolina residency. Lists captioned phones, adaptive phones, personal amplifiers and, for those who qualify, a hearing aid with a telecoil switch.
Georgia Georgia Telecommunications Equipment Distribution Program (GATEDP), managed by the Georgia Public Service Commission and distributed by the Georgia Center of the Deaf and Hard of Hearing Free specialized telecommunications equipment, subject to medical and financial eligibility rules.

For hearing aids themselves, the Georgia Public Service Commission's Hearing Aid Distribution Program, run under contract by the Georgia Charitable Care Network (GCCN), serves Georgians of all ages. An adult applicant's income can't exceed 200% of the federal poverty guidelines (400% for children); applicants must have lived in Georgia at least one year and bring a recommendation from a state-licensed hearing care provider, and the aids are dispensed only through a state-licensed provider. Call or text GCCN at 888-521-1231 (outside metro Atlanta) or 678-389-3333.

Try before you buy

Every state gets a federal grant under the Assistive Technology Act to run a statewide assistive technology program, which can include short-term device loans to try a device before buying, demonstrations, and reuse of equipment a previous owner no longer needs, though a state doesn't have to run every one of those activities. Ask your state's program what it has on hand; our guide to state assistive technology programs explains how to find yours.

Helping a Parent With Hearing Loss Around the House

NIDCD says trouble hearing can make it hard to respond to warnings and hear phones, doorbells and smoke alarms. The National Institute on Aging says alert systems can work with doorbells, smoke detectors and alarm clocks to flash a light or vibrate instead. For larger rooms, NIDCD says assistive listening systems include hearing loops, FM systems and infrared systems, and they work with or without hearing aids. See also our home safety guide.

If your parent can't hear the smoke alarm, the U.S. Fire Administration suggests one with a different sound, a bed shaker or a strobe light. For smoke alarms in general, it says some fire departments offer free or reduced-price smoke alarms or install them at no cost (call the nonemergency number), and the American Red Cross offers free smoke alarm installation visits where available.

By NIDCD's measure of disabling hearing loss (35 decibels or more in the better ear), 22% of people ages 65 to 74 and 55% of those 75 and older have it.

NIDCD says fewer than 1 in 3 (30%) adults 70 and older with hearing loss who could benefit from hearing aids have ever used them.

The National Institute on Aging says older adults with hearing loss have a greater risk of developing dementia than those with normal hearing, and cites an analysis of several studies that found people who used hearing aids or cochlear implants had a lower risk of long-term cognitive decline than those with uncorrected hearing loss. That's a link, not a promise.

The National Institute on Aging says older people who can't hear well may become depressed or withdrawn, and are sometimes mistakenly thought to be confused, unresponsive or uncooperative, which can lead to social isolation and loneliness. The institute lists vision or hearing problems among the risk factors for both. Other changes to watch for are in signs your aging parent needs help, and if dementia is in the picture, see communicating with someone who has dementia.

Frequently Asked Questions

Does a doctor's office have to provide captioning for a hard of hearing patient?

Yes, if the ADA's Title III rule covers the office and captioning is what your parent needs, unless it would be an undue burden or a fundamental alteration. The rule doesn't cover an office a religious organization operates or controls, though Section 504 may if it receives federal funds., Ask when you book.

What if my parent has both vision and hearing loss?

The federal National Deaf-Blind Equipment Distribution Program, or iCanConnect, provides communications equipment to low-income people with both significant vision loss and significant hearing loss. The hearing bar is high: a loss so severe that most speech can't be understood even with amplification, or one progressing toward that. To qualify for iCanConnect, income must be no more than 400% of the federal poverty guidelines, or your parent can qualify through a program like Medicaid, SNAP or Supplemental Security Income. The disability must be verified by a professional's attestation or by existing documentation such as a Social Security determination letter. Find your state's program at icanconnect.org or 1-800-825-4595.

Learn More

MedicareDoes Medicare Cover Hearing Aids?Does Medicare cover hearing aids? Original Medicare doesn't pay for hearing aids or fitting exams. See what Part B covers and where Advantage plans may help. VA BenefitsVA Hearing Aids and Vision Care: What's CoveredVA hearing and vision care in 2026: routine exams cover every enrolled veteran, but hearing aids and eyeglasses are eligibility-gated under 38 CFR 17.149. CaregiverBorrow or Reuse Equipment Through Your State Assistive Technology ProgramEvery state has a federally funded assistive technology program. Depending on the state, it may lend a device to try, offer reused gear or help finance one. CaregiverDoes Medicare Cover Medical Alert Systems? Who Pays and How to ChooseOriginal Medicare won't pay for a medical alert system, but some Medicare Advantage plans and state Medicaid programs can. What to ask before you buy one. Care TypesNursing Home Residents' Rights: What Federal Law GuaranteesMedicare and Medicaid nursing homes owe residents federal rights: dignity, visitors, records in 24 hours, no abuse or convenience restraints. How to use them.

Find personalized help sorting out hearing aids, captioned phones and doctor's-office accommodations for your parent at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.