Medicare covers the cost of a hearing evaluation if your doctor refers you for one, but only under specific circumstances
Medicare Part B covers a diagnostic hearing evaluation when your primary care doctor or another physician believes you may have hearing loss that needs medical attention. The evaluation must be ordered by a doctor — you cannot schedule one on your own and have Medicare pay for it. Medicare will cover the test itself, but not hearing aids or fittings that may follow.
The key difference is between a diagnostic test (which Medicare may cover) and a hearing aid fitting or routine hearing check (which it does not). A diagnostic evaluation is meant to identify whether you have hearing loss and what type it is. Once that diagnosis is made, any follow-up care related to purchasing or fitting hearing aids falls outside Medicare's coverage.
Key Takeaways
- Your doctor must order the hearing evaluation for Medicare to cover it — self-referral to an audiologist does not may have access to.
- Medicare Part B covers the diagnostic test itself, but not hearing aids, fittings, adjustments, or routine hearing checks.
- You pay your Part B deductible and coinsurance (typically 20 percent of the cost) even when the test is covered.
- Some Medicare Advantage plans offer additional hearing coverage beyond Original Medicare, so check your plan documents.
- Medicaid and some state programs may cover hearing aids or evaluations if you meet income limits, even when Medicare does not.
When Medicare Part B will cover a hearing evaluation
Medicare Part B covers a diagnostic hearing evaluation when a physician orders it to investigate a medical concern. This typically happens when you report hearing problems to your doctor during a visit, or when your doctor suspects hearing loss may be contributing to another health issue — for example, balance problems, falls, or cognitive changes.
The evaluation must be performed by an audiologist or other may have access to professional and must be ordered in writing by your doctor. The test itself — which may include pure-tone audiometry, speech discrimination testing, or other diagnostic procedures — is what Medicare covers. The location matters less than the referral: the evaluation can take place in a hospital, clinic, or private audiology office, as long as the provider is enrolled in Medicare.
If you straightforward want a routine hearing check because you think your hearing is getting worse, or if you go directly to an audiologist without a doctor's order, Medicare will not cover the cost. This is an important distinction: the test must be diagnostic (ordered to investigate a medical problem) rather than preventive or routine.
What you pay out of pocket
Even when Medicare covers the hearing evaluation, you are responsible for your Part B deductible and coinsurance. For 2024, the Part B deductible is $240 per year. Once you meet that deductible, you typically pay 20 percent of the Medicare-approved amount for the evaluation, and Medicare pays the remaining 80 percent.
The actual cost of a hearing evaluation varies by location and provider. Medicare's approved amount (called the "allowed amount") is usually lower than what a private audiologist might charge. If your provider charges more than the Medicare-approved amount, you may owe the difference on top of your coinsurance — this is called balance billing.
To avoid surprise bills, ask your audiologist's office before the appointment whether they accept Medicare assignment, which means they agree to accept Medicare's approved amount as full payment (plus your deductible and coinsurance). If they do not, you may want to find a different provider or understand exactly what you will owe.
What Medicare does not cover related to hearing
Medicare Part B does not cover hearing aids themselves, regardless of whether you have had a diagnostic evaluation. This includes the cost of the device, fitting, programming, adjustments, repairs, batteries, or replacement. Even if your evaluation clearly shows you need a hearing aid, Medicare will not pay for it.
Medicare also does not cover routine hearing checks or screenings done for general wellness — only diagnostic evaluations ordered by a doctor for a medical reason. Hearing aid fittings, follow-up appointments with an audiologist to adjust your hearing aid, or counseling on how to use hearing aids are also not covered.
Some services related to hearing loss treatment, such as cochlear implant surgery, may be covered under different circumstances, but this is separate from routine hearing evaluation and aid coverage. If you think you might need a cochlear implant, discuss this with your doctor, as the rules and coverage are different.
Medicare Advantage plans and hearing coverage
Original Medicare (Part A and Part B) does not cover hearing aids, but some Medicare Advantage plans (Part C) offer additional hearing coverage as a supplemental benefit. This varies widely by plan and by year. Some plans may cover a certain dollar amount toward hearing aids each year, cover routine hearing evaluations, or offer discounts through partner audiologists.
If you are enrolled in a Medicare Advantage plan, check your plan's Summary of Benefits or call the plan directly to ask what hearing services are covered. The coverage can change from year to year, and it differs from plan to plan, so you cannot assume that because one plan covers hearing aids, yours does too.
If you are considering switching to a Medicare Advantage plan partly for hearing coverage, review the plan's hearing benefits carefully during the annual open enrollment period (October 15 to December 7). Some plans require you to use specific audiologists or networks, and some have limits on how often you can receive services.
Other sources of help paying for hearing aids
Because Medicare does not cover hearing aids, many older adults turn to other programs. Medicaid, which is jointly funded by federal and state governments, covers hearing aids in some states for people who meet income and asset limits. Coverage varies significantly by state, so contact your state Medicaid office to learn what is available where you live.
Some nonprofit organizations, such as the Hearing Loss Association of America and local Lions Clubs, offer financial information or discounted hearing aids to people with limited income. Veterans may be covered through the Department of Veterans Affairs. Some audiologists also offer payment plans or discounts for uninsured or out-of-pocket patients.
If cost is a barrier, talk to your doctor about your concerns. Your doctor may be able to refer you to resources in your community, or help you understand whether a hearing aid is truly necessary right now or whether other strategies (like hearing loops in your home or captioning services) might help in the meantime.
How to get a hearing evaluation through Medicare
Start by mentioning hearing concerns to your primary care doctor at your next visit. Describe what you are noticing — difficulty hearing conversations, trouble with phone calls, needing the television louder, or trouble hearing in noisy places. Your doctor will decide whether a diagnostic evaluation is warranted.
If your doctor agrees, they will write an order for the evaluation and may recommend a specific audiologist or facility, or you may be able to choose one. Make sure the provider is enrolled in Medicare before you schedule. When you call to book the appointment, tell the office that you have a doctor's order and that you want to confirm they accept Medicare assignment.
Bring your Medicare card and any other insurance information to the appointment. After the evaluation, the audiologist will send the results to your doctor. If hearing aids are recommended, your doctor can discuss options with you, but Medicare will not cover the cost of the aids themselves.
Frequently Asked Questions
Can I get a hearing evaluation without a doctor's order?
You can schedule a hearing evaluation with an audiologist on your own, but Medicare will not cover it. You would pay the full cost out of pocket. If you want Medicare to cover the evaluation, you need a doctor's written order first.
Does Medicare cover hearing aid batteries or repairs?
No. Medicare does not cover hearing aids, batteries, repairs, adjustments, or any related services. If you own a hearing aid, you pay for all maintenance and supplies yourself, unless you have coverage through Medicaid, a Medicare Advantage plan, or another program.
What if my audiologist charges more than Medicare allows?
If your audiologist accepts Medicare assignment, they agree to charge only the Medicare-approved amount, and you pay your deductible and coinsurance. If they do not accept assignment, you may owe the difference. Always ask before your appointment whether the provider accepts Medicare assignment.
Will my Medicare Advantage plan cover hearing aids?
Some Medicare Advantage plans offer hearing aid coverage, but it varies by plan and year. Check your plan's Summary of Benefits or call the plan to ask. Coverage limits, network requirements, and what is covered differ from plan to plan.
Can I use my HSA or FSA to pay for a hearing evaluation?
Yes, if you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you can typically use those funds to pay for a hearing evaluation and hearing aids. Check your account rules, as some have specific requirements about what qualifies as a medical expense.