Medicare Hearing Aids and Dialysis in 2027: The “Use It or Lose It” Change California Families Should Check Before December 7

Are you in Merced County or elsewhere in California reviewing Medicare before December 7, 2026, and wondering whether your hearing aid allowance will carry into 2027 or whether dialysis-related costs may change?

You are likely hearing about Medicare hearing benefits, new supplemental-benefit rules, phosphate binders, and plan changes all at once. In simple terms: an unused hearing allowance may not follow you into 2027, and people receiving dialysis should confirm how certain medications will be supplied beginning January 1.

The new hearing-benefit warning: unused money generally does not roll over

Under the CMS Contract Year 2027 Medicare Advantage and Part D final rule, Medicare Advantage plans using supplemental-benefit debit or flex cards must use:

• Real-time point-of-sale verification to confirm that a purchase is eligible.
• Plan-year limits: unused balances cannot roll over into the next plan year.
• Clear information about covered products, vendors, card use, and reimbursement options.

For many members, this means an unused 2026 hearing aid allowance generally expires on December 31, 2026 and starts over on January 1, 2027. Do not wait until the final week. Hearing exams, fittings, ordering, and delivery may take time.

Your allowance could be listed as $500 to $2,500 per ear, but the amount alone does not tell the whole story. Check your Annual Notice of Change (ANOC) and Evidence of Coverage for:

• Whether the benefit is per ear, per year, or available at a different frequency.
• Which hearing aid vendors are approved.
• Whether fittings and exams are included.
• Whether the device must be purchased, delivered, or billed before December 31.
• Whether the 2027 benefit is smaller or structured differently.

The ANOC should arrive by September 30, 2026, so it should be in your hands now. Medicare’s Annual Enrollment Period runs October 15 through December 7, with new coverage generally beginning January 1, 2027.

A local example: why “I thought it carried over” can be expensive

Consider Rosa and Miguel Hernandez of Atwater: a fictional example based on situations families commonly face. Miguel receives dialysis, while Rosa had a $2,000 hearing allowance through her Medicare Advantage plan.

Rosa assumed the unused amount would accumulate. When she checked after December 31, the allowance had expired, and she had to wait for the new plan year before using the benefit. The lesson is clear: a benefit listed in your plan is not necessarily available indefinitely.

Original Medicare still does not cover routine hearing aids or hearing-aid fitting exams. Part B generally covers a physician-ordered diagnostic hearing or balance exam in appropriate circumstances. Although the Medicare Hearing Aid Coverage Act of 2025, H.R. 500, remains stalled in committee as of September 2026, it has not created hearing-aid coverage.

Medicare Advantage is different: about 97% of plans offer some hearing benefit, but vendor and frequency restrictions can apply. Prescription hearing aids may cost roughly $2,500–$6,000 per pair, while over-the-counter devices may range from approximately $200–$2,500 per pair.

Dialysis has a separate 2027 issue: ask about phosphate binders

The hearing allowance rule does not change core dialysis coverage. Under Original Medicare, Part B generally covers outpatient dialysis after the deductible, with approximately 20% coinsurance. However, Original Medicare has no annual out-of-pocket maximum, so a Medigap policy or Medicare Advantage plan can be especially important.

People with End-Stage Renal Disease (ESRD) under age 65 have been able to apply for Medigap since 2021, but carrier rules and pricing vary. In California, timing can also matter because Medigap choices may be affected by the birthday rule.

A separate CY 2027 ESRD Prospective Payment System proposed rule would increase the base dialysis payment from $281.71 to a proposed $299.55 per treatment. More importantly, oral-only phosphate binders would move into the ESRD bundled payment beginning January 1, 2027.

That generally means the dialysis facility, not the Part D pharmacy benefit, will furnish or pay for these medications. Ask your dialysis facility and Part D plan exactly how your phosphate binders will be supplied and billed. Confirm there will be no medication gap.

The proposed rule also includes higher home/self-dialysis training payments and an expanded low-volume payment adjustment. These are proposed changes, so final details may differ.

Do not overlook networks, plan closures, or Medi-Cal help

CMS finalized a 2.48% average increase in federal payments to Medicare Advantage plans for 2027, with a 5.33% effective growth rate. Even so, roughly 1 million enrollees could face plan or product closures, with notices expected around early October.

Your plan may remain available but still change its hearing allowance, vendor list, premiums, networks, or cost-sharing. When comparing plans, remember:

• A PPO generally lets you use out-of-network providers at a higher cost.
• An EPO generally requires in-network providers except for emergencies and other limited situations.

You can also review our related guide on PPO vs. EPO coverage.

If you have Medi-Cal, ask about your share of cost Medi-Cal status. Medi-Cal may not pay the Medicare Part B premium in months when an unmet share of cost remains. Medicare Savings Programs (QMB, SLMB, and QI) can pay the Part B premium regardless of share of cost, so ask your county to screen you for QMB.

Also remember: share of cost resets monthly and is a spend-down, not a premium. Projected 2027 figures circulating online, including a possible $209.50 Part B premium, $292 deductible, approximately $700 Part D deductible, and $2,400 Part D out-of-pocket cap, are not final.

What to do in the next 30 days

• Review your 2027 ANOC and Evidence of Coverage.
• Verify your hearing allowance, approved vendor, and frequency rules.
• Schedule a hearing exam or fitting early enough for delivery before December 31.
• Ask the dialysis facility how phosphate binders will be supplied in 2027.
• Ask the county to screen you for QMB or another Medicare Savings Program.
• Compare your plan before the December 7, 2026 deadline.

Frequently asked questions

1. Does Medicare cover hearing aids in 2027?

Original Medicare generally does not cover routine hearing aids. Some Medicare Advantage plans offer hearing benefits, but the allowance, vendor, frequency, and covered device rules vary.

2. Will my Medicare Advantage hearing allowance roll over?

Generally, no, especially when the allowance is administered through a supplemental-benefit debit or flex card. Unused 2026 funds may expire December 31, 2026. Read your plan documents.

3. Does Medicare cover dialysis?

Yes. Medicare generally covers medically necessary dialysis, but deductibles, coinsurance, networks, and out-of-pocket exposure depend on whether you have Original Medicare, Medigap, or Medicare Advantage.

4. What happens to my phosphate binders in 2027?

Under the proposed ESRD payment changes, oral-only phosphate binders would generally be included in the dialysis facility’s bundled payment. Confirm the exact process with your facility and Part D plan.

Get a personalized Medicare review before December 7

Peace & Grace Insurance Services has served the Life and Health Insurance industry since 2015-more than 10 years. We were the first Covered California storefront in Atwater, serving families throughout Merced County and across California. We are BBB Accredited with an A+ rating, and consultations are free and no-cost.

We can help you compare real 2027 Medicare plans, verify hearing vendors and allowances, review dialysis-related coverage, check networks, and discuss available Medi-Cal or Medicare Savings Program considerations.

Book a free Medicare consultation: https://go.oncehub.com/1PNG
Call: (209) 812-4026

For additional coverage needs:

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We are here to help you make informed decisions with compassion, clarity, and care.