Medicare Part B covers diagnostic hearing exams, but not routine hearing tests or hearing aids
Medicare Part B pays for a hearing exam only when your doctor refers you for one to diagnose a specific medical problem — such as sudden hearing loss, dizziness, or ear infection. The exam must be ordered by your primary care doctor or an ear, nose, and throat (ENT) specialist and performed by an audiologist or physician. You pay 20% of the approved amount after you meet your Part B deductible.
Medicare does not cover routine hearing tests done to check your hearing as part of a general checkup, even if you notice your hearing is getting worse. It also does not cover hearing aids, fitting fees, or adjustments to hearing aids. Many people assume Medicare covers hearing because it covers so many other medical services — this is one of the most common gaps in coverage for older adults.
If you need a hearing exam for a medical reason, your doctor can order it at no cost to you beyond your normal Part B cost-sharing. If you want a routine hearing test to see if you need hearing aids, you will pay the full cost out of pocket unless you have a supplemental plan or Medicare Advantage plan that includes hearing coverage.
Key Takeaways
- Medicare Part B covers hearing exams only when ordered by a doctor to diagnose a medical condition, not for routine hearing checks.
- You pay 20% of the Medicare-approved amount after meeting your Part B deductible for a covered diagnostic exam.
- Hearing aids, hearing aid fittings, and adjustments are never covered by Original Medicare, regardless of the reason.
- Some Medicare Advantage plans and Medigap policies include hearing coverage, so check your plan documents or call your insurer.
- If you cannot afford a hearing exam out of pocket, community health centers and some nonprofits offer low-cost or sliding-scale hearing tests.
When Medicare Part B pays for a hearing exam
Your doctor must order the exam and document a medical reason for it. Common reasons include sudden hearing loss in one ear, hearing loss paired with dizziness or balance problems, ear pain, discharge from the ear, or a suspected infection. The exam is typically performed by an audiologist in a hospital outpatient department, a clinic, or a private audiology practice that accepts Medicare.
The audiologist will test your ability to hear different frequencies and volumes, measure how sound travels through your ear, and may perform other tests depending on your symptoms. This is different from a hearing aid fitting test, which Medicare does not cover. If the exam shows you need hearing aids, that is where Medicare's coverage stops.
You will receive a bill showing what Medicare approved and what you owe. If the provider is in-network with Medicare, they cannot bill you more than 20% of the approved amount. Always ask the provider before the exam whether they accept Medicare and whether they will bill you directly or send the bill to you.
What Medicare does not cover related to hearing
Original Medicare (Part A and Part B) does not cover hearing aids under any circumstance. This includes the hearing aids themselves, the fitting appointment, the adjustment visits, the molds, batteries, or repairs. Even if your hearing loss is caused by a medical condition that Medicare does cover, the hearing aid is still your responsibility.
Routine hearing tests — exams done to check your hearing when you have no specific medical complaint — are not covered. Many people schedule these annually or when they notice their hearing changing, but Medicare considers this preventive rather than diagnostic. You will pay the full cost out of pocket, which typically ranges from $50 to $200 depending on where you go.
Hearing aid adjustments and follow-up visits after you purchase hearing aids are also not covered. If you buy hearing aids through a private provider, all the follow-up care is your cost. Some hearing aid manufacturers and retailers offer free adjustments for a set period after purchase, but this is their policy, not a Medicare benefit.
Medicare Advantage and Medigap coverage for hearing
Some Medicare Advantage (Part C) plans include hearing coverage as an added benefit. This might mean a yearly hearing exam, a discount on hearing aids, or a set dollar amount toward hearing aids — typically $500 to $2,000 per year. Coverage varies widely by plan and by region, so you need to check your specific plan's benefit document or call the plan directly.
Medigap (supplemental insurance) plans do not standardly cover hearing, but a few insurers offer riders or add-ons that do. These are less common than Advantage plan hearing benefits and usually cost extra per month. If hearing coverage matters to you, ask about it when comparing Medigap plans during your enrollment period.
If you are thinking about switching to a Medicare Advantage plan partly for hearing coverage, remember that these plans often have network restrictions — you may have to use hearing providers in the plan's network. Ask whether the plan covers routine exams, hearing aids, or both, and whether you need a referral from your primary care doctor.
How to find out what your plan covers
The fastest way is to call the customer service number on the back of your insurance card. Tell them you want to know whether your plan covers hearing exams and hearing aids. They can tell you whether a referral is needed, whether you have a deductible or copay, and which providers are in-network.
You can also read your plan's Summary of Benefits and Coverage (SBC) document, which lists what is and is not covered. For Original Medicare, this is in your Medicare & You handbook or on Medicare.gov. For Medicare Advantage or Medigap, your insurer sends this document every year, and you can request it anytime.
If you are enrolled in Original Medicare and want to know whether a specific exam your doctor ordered will be covered, ask your doctor's office to check with Medicare before the appointment. They can submit a query to Medicare and get an answer in writing — this protects you from unexpected bills.
Low-cost hearing exams if you are uninsured or underinsured
Community health centers offer hearing exams on a sliding fee scale based on your income. To find one near you, search the Health Resources and Services Administration (HRSA) database at findahealthcenter.hrsa.gov or call 211 and ask for hearing services in your area.
Some nonprofit organizations, including the Hearing Loss Association of America and local Lions Clubs, sponsor free or low-cost hearing screening events. These are not full diagnostic exams, but they can tell you whether you should see an audiologist. Check their websites or call your local chapter to ask about upcoming events.
Costco, Sam's Club, and some independent audiologists offer hearing exams for $50 to $100 without insurance. If you are considering hearing aids, getting a baseline exam at a lower cost can help you decide whether to pursue treatment before spending more money.
What to do if you need a hearing exam but cannot afford it
Start by talking to your primary care doctor about your hearing concerns. If the doctor thinks a diagnostic exam is medically necessary, they can order it, and Medicare will cover your share. You will still owe 20% of the approved amount, but this is usually less than paying out of pocket for a private exam.
If you do not have a primary care doctor, you can see one through a community health center or urgent care clinic. Explain that you have hearing loss and ask whether they think it warrants a diagnostic exam. Some doctors will order one; others will refer you to an audiologist for a routine test that you pay for privately.
If cost is the main barrier, ask about payment plans. Some audiology practices offer plans that let you pay for an exam over a few months. You can also ask whether a less comprehensive exam (which may cost less) would give you the information you need to decide about hearing aids.
Frequently Asked Questions
Can I get Medicare to cover a hearing exam if I just want to check my hearing?
No. Medicare Part B only covers exams ordered by a doctor for a specific medical reason. If you want a routine hearing check because you think your hearing is declining, you pay the full cost out of pocket. Your doctor can order a covered exam only if you have symptoms like sudden hearing loss, dizziness, or ear pain.
If my doctor orders a hearing exam, will I owe anything?
You will owe 20% of the Medicare-approved amount after you meet your Part B deductible for the year. The exact amount depends on what the exam costs and what Medicare approves. Ask the provider for an estimate before the appointment so you know what to expect.
Does Medicare cover hearing aids if I have a hearing loss diagnosis?
No. Medicare does not cover hearing aids under any circumstance, even if a doctor has diagnosed you with hearing loss. This is true for Original Medicare, and it is also true for most Medicare Advantage plans, though some Advantage plans offer hearing aid discounts as an added benefit.
What if I have a Medicare Advantage plan — does it cover hearing?
Some do and some do not. Coverage varies by plan and region. Check your plan's benefit document or call customer service to ask whether hearing exams and hearing aids are covered, what the limits are, and whether you need a referral.
Where can I get a cheap hearing exam if I cannot afford one?
Community health centers offer exams on a sliding scale based on income. Search findahealthcenter.hrsa.gov or call 211. Some nonprofit organizations and Lions Clubs also sponsor free or low-cost hearing screenings. Costco and Sam's Club offer exams for $50 to $100 without insurance.