Ultrasonic acoustic power transfer is an efficient mechanism for coupling energy to millimeter and sub-millimeter implants in the body. To date, published ultrasonically powered implants have been encapsulated with thin film polymers that are susceptible to well-documented failure modes in vivo, including water penetration and attack by the body. As with all medical implants, packaging with ceramic or metallic materials can reduce water vapor transmission and improve biostability to provide decadal device lifetime. In this paper, we evaluate methods of coupling ultrasonic energy to the interior of ceramic packages. The classic wave approach and modal expansion are used to obtain analytical expressions for ultrasonic transmission through two different package designs and these approaches are validated experimentally. A candidate package design is demonstrated using alumina packages and titanium lids, designed to be acoustically transparent at ultrasonic frequencies. Bulk modes are shown to be more effective at coupling ultrasonic energy to a piezoelectric receiver than flexural modes. Using bulk modes, packaged motes have an overall link efficiency of roughly 10%, compared to 25% for unpackaged motes. Packaging does not have a significant effect on translational misalignment penalties, but does increase angular misalignment penalties. Passive amplitude-modulated backscatter communication is demonstrated. Thin lids enable the use of ultrasonically coupled devices even with package materials of very different acoustic impedance. This work provides an analysis and method for designing packages that enable ultrasonic coupling with implantable medical devices, which could facilitate clinical translation.