It’s not always possible to prevent hearing loss as we age. In fact, by the time we hit our 70s, an estimated two-thirds of us will have developed a type of hearing loss known as presbycusis.¹

Still, it is possible to treat it. And there are many convincing reasons why we should. 

“Hearing well is about so much more than being able to participate in a conversation or follow along with a TV show,” explained Gretchen Tanbonliong, Associate Director of Health & Wellness at NCOA. “Good hearing health helps us stay engaged and sharp. It boosts our happiness, keeps us safe, and supports our autonomy and independence.” 

It also may ward off dementia. As part of the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study, researchers discovered something pretty significant: Among certain participants, addressing previously untreated hearing loss effectively put the brakes on cognitive decline.² This hearing intervention slowed the loss of thinking and memory abilities by 48% over three years.³ 

“Three additional years of meaningful interactions with family, friends, the community—simply by recognizing and treating hearing loss—it’s truly priceless for everyone involved,” Tanbonliong said. “And there are options available, even for those of us with more severe loss.” 

Are you hard of hearing? Do you wear hearing aids—but they just don’t seem to work as well as they used to? Then you may want to learn more about cochlear implants for hearing loss.

What is a cochlear implant? 

A cochlear implant is a medical device designed to improve hearing in one or both of your ears. Unlike traditional hearing aids—which many people can now buy over the counter—cochlear hearing aids require surgery. 

All cochlear implants have two pieces: 

• Internal: This piece includes a tiny receiver with a thin wire and electrodes that attach to your cochlea—the part of your inner ear that’s shaped like a snail.
• External: This piece includes a microphone, sound processer, and transmitter that connects to the internal receiver. 

Together, these two pieces capture the sounds of life—speech, ringing phones, traffic noise, purring cats, whistling tea kettles—and turn them into electrical signals that your brain can understand. 

How do cochlear implants for hearing loss work?

Put simply, these devices improve or replace the function of your auditory (hearing) nerve. 

In two of the three most common types of hearing loss—including presbycusis—this nerve is damaged. At first, good hearing aids and the right hearing aid accessories can compensate for this damage. In cases of progressive impairment, however, hearing aids often stop working well. 

This is where hearing implants shine. Rather than simply amplifying sounds (making them louder), cochlear implants carry the electrical signals mentioned above directly to your inner ear. Here’s how:

1. The external microphone picks up sounds and passes them to the external processor.
2. The processor converts the sounds into electrical signals and passes them to the external transmitter.
3. The transmitter sends the signals to the internal receiver.
4. The wire attached to the receiver conducts the signals to electrodes implanted in your cochlea.
5. The electrodes stimulate your auditory nerve, which sends the signals to your brain.

This begs a question: if the auditory nerve doesn’t work right, why would a cochlear implant for hearing loss make a difference? 

Because it’s usually the tiny sound receptacles (hairs) on the ends of the auditory nerve that are damaged. The transmitter bypasses those hairs and the electrodes replace their function. Then, the working parts of your auditory nerve take back over.

What types of cochlear implants are there?

Most cochlear implants are pretty similar. The biggest difference is the kind of external unit you can choose.

• Two-piece unit: In this type, the microphone, processor, and transmitter are separate. The microphone and processor (one piece) usually sit behind your ear and the transmitter (the second piece) sits above it on your scalp. Both connect to each other with a small wire.
• One-piece unit: In this type, the microphone, processor, and transmitter are combined into a single wireless unit. Usually shaped like a disc, the unit sits on your scalp with no need for an ear piece.

In most cases, both of these units connect to the internal receiver through a magnet. 

How much do cochlear implants cost?

According to a national study conducted by the health financing company CareCredit, it can cost an average of $51,072 to get cochlear implants in the United States in 2025.⁴

• Initial hearing and surgical evaluations
• Cochlear implant device and batteries
• Surgeon’s and other providers’ fees
• Hospital fees
• Anesthesia
• Occupational therapy / rehabilitation
• Follow-up care

As with most medical costs, what you pay depends largely on where you live; how much choice you have in providers and medical facilities; and whether and what health insurance you may have. If you’re considering cochlear implants for hearing loss, an audiologist often can guide you toward local resources to help determine cost.

Does Medicare cover cochlear implants?

Yes.⁵ But there are certain eligibility requirements. 

For example, you must:

• Have hearing test scores of greater than 40% and less than or equal to 60% when participating in an FDA and CMS approved clinical trial.
• Have moderate to profound sensorineural hearing loss in both ears that doesn’t improve with regular hearing aids.
• Have the cognitive ability to understand what you hear.
• Be willing and able to participate in extensive post-surgical rehabilitation therapy.
• Have an otherwise healthy cochlea that can handle a surgical implant.
• Not have a middle ear infection or other health issue—like a tumor—that affects your auditory nerve or other parts of your central nervous system involved with hearing.
• Be healthy enough for surgery.
• Use the cochlear implant as intended by the FDA for hearing loss.

If you’re enrolled in Medicare and meet these requirements, cochlear implants will cost significantly less than the $51,072 quoted above. According to Medicare.gov’s Procedure Price Lookup tool, most patients will pay an average of $1,911 for the procedure in a hospital outpatient setting. But additional fees may apply.

What about Medicare Advantage? By law, these privately-administered plans must provide the same coverage as original Medicare does. This includes hospital stays, short-term (fewer than 100 days) skilled nursing facility stays, doctor’s visits, and laboratory and diagnostic services.

Still, advised Ryan Ramsey, NCOA’s Associate Director of Health Coverage and Benefits, your coverage may vary. “Always, always read your policy documents and ask your insurance broker whether any service—especially one as expensive as cochlear implants—qualifies for coverage, whether you have satisfied all requirements for coverage, and what your out-of-pocket costs might be,” he said.

This is true for original Medicare, too. If you have any questions about cochlear implants that you or your doctor can’t answer, you can contact your State Health Insurance Assistance Program (SHIP) for free, unbiased assistance.

Do other types of insurance cover cochlear implants?

Yes, many of them do.

According to the American Cochlear Implant Alliance, as many as 90% of employer-provided health insurance plans and managed care organizations provide cochlear implant coverage.⁶

Other options include:⁶

• VA benefits: Veterans Health Administration health care benefits provide broad coverage for preventive services, inpatient care, diagnostic and ancillary services, prescriptions, and more. This likely includes cochlear implants for hearing loss. An accredited Veterans Service Officer (VSO) can help you understand your coverage if you need assistance.
• Health Insurance Marketplace: Many insurance plans offered through the exchange provide at least partial coverage for cochlear implants. It’s important to contact your insurance company up front for pre-approval. And the American Cochlear Implant Alliance advises asking about other coverage—for prosthetics, for example—if your initial request is denied.
• Medicaid: Cochlear implant coverage for adults is optional and depends on where you live. Some states include it; others don’t. If you’re enrolled in Medicaid and/or are dual-eligible, your state Medicaid office can help answer questions about your policy and whether it includes cochlear implants.

Who is a good candidate for cochlear implants?

Infants, children, and adults of all ages can benefit from cochlear implants.

Among adults, the most suitable candidates generally are people with moderate to profound hearing loss that no longer responds well to correction. If you previously have bought hearing aids, successfully adjusted to wearing them, and now regularly struggle to understand and communicate with others, you might benefit from evaluation. An audiologist or ear, nose, and throat (ENT) doctor can help determine whether a cochlear implant is right for you.

Hearing aids vs. cochlear implants

All cochlear implants are hearing aids. But not all hearing aids are cochlear implants. And there are important differences between the two. 

How hearing aids work

Standard hearing aids work by making sounds louder. They use a microphone to pick up the sounds; an amplifier to turn up their volume; and a speaker to broadcast the louder sounds into your ear.

Thanks to advances in technology and design, standard hearing aids no longer resemble the clunky, tan-colored, hard-to-hide models of the past. Today, even some of the best affordable hearing aids fit discreetly behind or in your ear.

What else should I know about cochlear implants vs. hearing aids?

The biggest point is this: cochlear hearing aids are surgically implanted devices while standard hearing aids are not.

Other points to consider:

• Cost: On average, standard hearing aids cost $2,500 compared to the much heftier price tag for cochlear implants.
• Effectiveness: Standard hearing aids work best for people who have mild to moderate hearing loss versus severe to profound.
• Availability: Nearly anyone with mild to moderate hearing loss can buy an OTC hearing aid; cochlear implants have extensive eligibility and evaluation requirements.

Should I get a cochlear implant? Or a hearing aid?

Depending on the type of hearing loss you have, you may find that one of the best hearing aids can improve your hearing without surgery.

If and when your hearing loss gets worse—and hearing aids no longer work for you—you may want to think about cochlear implants and the improved quality of life they can provide.

“This is a very personal decision that no one else can make for you,” NCOA’s Tanbonliong said. “Whether or not you go this route depends on your overall health, your feelings about surgery, your insurance coverage, and of course what your doctor has to say about it."

FAQ

Do cochlear implants for hearing loss work for everyone?
No. People who have conductive hearing loss will not benefit from or qualify for cochlear implants. The best candidates are people with severe to profound sensorineural hearing loss for whom standard hearing aids no longer work.

Can you get a cochlear implant in one ear?
Yes. You can have a “unilateral” (on one side) or a “bilateral” (on both sides) implant. Often, people who need bilateral implants start with one ear first. Keep in mind, though: Medicare only covers cochlear implants for people with bilateral hearing loss.

How long do cochlear implants last?
It depends. In most cases, the internal parts (receiver and electrodes) last your lifetime. The external parts (microphone, processor, and transmitter) may last up to 10 years before needing replacement.

Are cochlear implants waterproof?
No. You will need to remove the external unit(s) whenever you bathe, shower, or go swimming.

Sources

1. Megan Cheslock et al. Presbycusis. StatPearls. August 23, 2023. Found on the internet at https://www.ncbi.nlm.nih.gov/books/NBK559220/

2. Frank R. Lin et al. Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomized controlled trial. Lancet. Sept. 2, 2023. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/37478886/

3. Johns Hopkins Cochlear Center for Hearing and Public Health. ACHIEVE Healthy Aging. Found on the internet at https://www.achievestudy.org/

4. Susan Paretts. Cochlear Implants Cost and Procedure Guide. WellU. Aug. 8, 2025. Found on the internet at https://www.carecredit.com/well-u/health-wellness/understanding-cochlear-implants/

5. CMS.gov. Cochlear Implantation. Sept. 10, 2024. Found on the internet at https://www.cms.gov/medicare/coverage/evidence/cochlear

6. Donna Sorkin, MA et al. Cochlear Implantation: Health Insurance And Other Possible Ways of Gaining Coverage. American Cochlear Implant Alliance. Found on the internet at https://www.acialliance.org/page/HealthIns

7. U.S. Food and Drug Administration. Benefits and Risks of Cochlear Implants. Feb. 9, 2021. Found on the internet at https://www.fda.gov/medical-devices/cochlear-implants/benefits-and-risks-cochlear-implants