Medicare's Coverage of Hearing Tests
Medicare Part B covers a diagnostic hearing test if your doctor orders it to figure out whether you have a medical problem. This is different from a routine hearing test to fit hearing aids. The test must be ordered by your primary care doctor or an ear, nose, and throat specialist (ENT) as part of diagnosing a specific condition — not straightforward because you want to know if you need hearing aids.
You pay 20 percent of the cost after you meet your Part B deductible. The doctor's office or hospital bills Medicare directly, and you receive a bill for your share. If the test happens in a hospital outpatient department, you may also owe a facility fee on top of the test itself.
The key distinction: Medicare covers the test when it serves a diagnostic purpose (ruling out infection, checking for nerve damage, or assessing sudden hearing loss). Medicare does not cover routine hearing tests done solely to determine whether you need hearing aids, even if you pay for them at an audiologist's office.
Key Takeaways
- Medicare Part B covers diagnostic hearing tests ordered by your doctor, but you pay 20 percent after your deductible.
- Routine hearing tests to fit hearing aids are not covered by Medicare, and you pay the full cost out of pocket.
- Medicare does not cover hearing aids themselves, though some Medicare Advantage plans offer limited coverage as an added benefit.
- Your doctor must order the test for a medical reason — not straightforward because you want to check your hearing.
- Some state Medicaid programs and Veterans Affairs cover hearing aids, so check your other coverage before paying full price.
What Medicare Does Not Cover for Hearing
Medicare Part B does not cover hearing aids or the fitting and adjustment of hearing aids. This is a long-standing exclusion that has not changed. If you need hearing aids, you pay the full cost yourself, which typically ranges from a few hundred dollars to several thousand dollars per pair depending on the technology and the provider.
Medicare also does not cover routine hearing tests performed by an audiologist for the purpose of fitting hearing aids. If you walk into an audiologist's office for a hearing test without a doctor's referral for a medical diagnosis, you will be charged for that test out of pocket.
The one exception is Medicare Advantage plans (Part C). Some plans include hearing aid coverage or discounts on hearing aids as an added benefit, though the amount and type of coverage varies widely by plan and by year. You would need to check your specific plan's benefit document or call the plan directly to learn what hearing services it covers.
How to Get a Diagnostic Hearing Test Covered
Start by talking to your primary care doctor about your hearing concerns. Describe what you are noticing — difficulty hearing conversations, ringing in your ears, sudden hearing loss, or hearing loss in only one ear. Your doctor will decide whether a hearing test is medically necessary to diagnose a condition.
If your doctor agrees, they will place an order for the test. The order should specify that it is a diagnostic test, not a routine hearing screening. Your doctor may refer you to an audiologist or an ENT specialist, or the test may be done in your doctor's office or a hospital outpatient department.
When you arrive for the test, tell the provider that Medicare is covering it and that you have a doctor's order. The provider will bill Medicare directly. You will receive a bill for your 20 percent coinsurance after your Part B deductible is met. Keep the order and any documentation from your doctor in case you need to appeal a denial.
Hearing Aid Costs and Where to Find Lower Prices
Hearing aids are expensive. A single hearing aid can cost $1,000 to $3,000 or more, depending on the features and the brand. A pair costs double that. Because Medicare does not cover them, you need to explore other options to reduce the cost.
Check whether you have coverage through another source. If you are a veteran, the Department of Veterans Affairs covers hearing aids and hearing tests. If you are on Medicaid, some state programs cover hearing aids — contact your state Medicaid office to ask. If you have retiree health insurance from a former employer, review the plan documents or call the plan to see whether hearing aids are covered.
If you have a Medicare Advantage plan, call the plan and ask specifically what hearing services and hearing aids it covers. Some plans offer a discount program with participating providers rather than direct coverage. If you do not have other coverage, ask your audiologist or hearing aid provider about payment plans, discounts for buying two aids at once, or whether they offer refurbished or older-model aids at a lower price.
The Difference Between Diagnostic and Routine Hearing Tests
A diagnostic hearing test is ordered by a doctor to investigate a medical problem. Examples include sudden hearing loss, hearing loss in only one ear, ringing or buzzing in the ears, dizziness with hearing changes, or a suspected ear infection. The test helps the doctor figure out what is causing the problem and whether treatment is needed. Medicare covers this test when your doctor orders it.
A routine hearing test is a screening to see whether you might benefit from hearing aids. You might request it because you are having trouble hearing in conversations, or because a family member suggested you get your hearing checked. This test is not ordered to diagnose a medical condition — it is ordered to determine whether you need a device. Medicare does not cover routine hearing tests, and you pay the full cost.
The distinction matters because it determines who pays. If you are unsure whether your doctor's order qualifies as diagnostic, ask your doctor's office directly. They can tell you whether they are billing it as a diagnostic test (which Medicare may cover) or a routine screening (which you will pay for).
Medicare Advantage Plans and Hearing Coverage
Medicare Advantage plans are an alternative to Original Medicare (Part A and Part B). These plans are run by private insurance companies and must cover everything Original Medicare covers, but they can also add extra benefits. Some plans include hearing aid coverage or hearing test coverage as an added benefit.
The coverage varies. Some plans cover one hearing aid per ear per year. Others cover hearing tests but not the aids themselves. Some offer a discount with a network of providers rather than direct coverage. A few plans cover nothing related to hearing. You need to check your specific plan's benefit document or call the plan's customer service line to learn what it covers.
If you are thinking about switching to a Medicare Advantage plan partly because of hearing coverage, ask the plan directly what the coverage includes, what you pay out of pocket, and whether there are limits on how often you can get new aids. Coverage can change from year to year, so even if your current plan covers hearing aids, next year's version might not.
Frequently Asked Questions
Will Medicare cover a hearing test my doctor ordered?
Yes, if your doctor ordered it to diagnose a medical condition. You will pay 20 percent of the cost after you meet your Part B deductible. If your doctor ordered it just to see whether you need hearing aids, Medicare will not cover it.
Can I get a hearing test covered if I do not have a doctor's order?
No. Medicare only covers hearing tests that a doctor orders for a medical reason. If you go to an audiologist on your own for a routine hearing screening, you pay the full cost out of pocket.
Does Medicare Advantage cover hearing aids?
Some plans do, but not all. Coverage varies by plan and by year. Call your plan directly or check your benefit document to see what hearing services and aids your specific plan covers.
What if I am a veteran or on Medicaid?
Veterans Affairs covers hearing aids and hearing tests for may be able to access veterans. Some state Medicaid programs also cover hearing aids. Contact the VA or your state Medicaid office to learn what you may have access to for.
How much do hearing aids cost if I have to pay out of pocket?
A single hearing aid typically costs $1,000 to $3,000 or more, depending on the features. A pair costs roughly double. Ask your provider about payment plans, discounts for buying two aids, or refurbished models at lower prices.