Medicare's coverage of hearing exams
Original Medicare (Part A and Part B) does not pay for routine hearing exams or hearing tests done to fit you for a hearing aid. Medicare will only cover a hearing test if your doctor orders it as part of diagnosing or treating a medical condition — for example, if you have sudden hearing loss, dizziness, or an ear infection. Even then, the test must be done in a hospital outpatient department or a doctor's office, not at a hearing aid store.
If you have a Medicare Advantage plan (Part C), coverage varies by plan. Some plans cover routine hearing exams, and some do not. You will need to check your plan's coverage details or call the plan directly to know what you are covered for.
Medicare does not pay for hearing aids themselves, regardless of which type of Medicare you have. This is a significant gap for many seniors, since hearing aids can cost hundreds to thousands of dollars.
Key Takeaways
- Original Medicare covers hearing tests only when ordered by a doctor to diagnose or treat a medical condition, not for routine hearing checks or hearing aid fitting.
- The hearing test must take place in a hospital outpatient setting or doctor's office to be covered by Original Medicare.
- Medicare Advantage plans may cover routine hearing exams, but coverage differs by plan and you should contact your plan to confirm.
- Neither Original Medicare nor Medicare Advantage covers the cost of hearing aids.
- Some state Medicaid programs and other information programs may help pay for hearing aids if you meet income requirements.
When Medicare will cover a hearing test
Your doctor can order a hearing test if you report symptoms that suggest a hearing or ear problem. These include sudden hearing loss in one or both ears, tinnitus (ringing in the ears), vertigo or dizziness, ear pain, or drainage from the ear. The test helps your doctor figure out what is causing the symptom and what treatment you might need.
The test must be performed by an audiologist or other may have access to professional in a medical setting — a hospital outpatient department, a doctor's office, or a clinic. Tests done at a hearing aid store or a retail location do not may have access to for Medicare coverage, even if a doctor referred you there.
If the test is covered, Medicare Part B pays 80 percent of the approved amount after you have met your Part B deductible. You pay the remaining 20 percent. If you have a Medigap or Medicaid supplement plan, it may cover some or all of your share.
What Medicare does not cover
Medicare does not pay for hearing aids, ear molds, batteries, or repairs. It also does not cover routine hearing exams done to check your hearing or to fit you for a hearing aid, even if you are having trouble hearing. This means if you want to get your hearing tested just to see how well you hear, or if you want to explore hearing aid options, you will pay the full cost yourself.
Some hearing aid retailers offer free or low-cost hearing tests as part of their sales process. These tests are not covered by Medicare, but they also do not cost you anything — the retailer uses them to help sell you a device. Be aware that these tests are sales tools, not medical evaluations, and the results may not be the same as a test ordered by your doctor.
Medicare Advantage and hearing coverage
Medicare Advantage plans are required to cover everything that Original Medicare covers, but they can also offer extra benefits that Original Medicare does not. Some Medicare Advantage plans include coverage for routine hearing exams and even partial coverage for hearing aids. A few plans cover hearing aids up to a certain dollar amount per year.
If you have a Medicare Advantage plan, you should review your plan documents or call your plan's customer service line to find out exactly what hearing services are covered. Coverage can change from year to year, so it is worth checking even if you have had the same plan for several years. Your plan's Summary of Benefits and Coverage document lists what is and is not covered.
Other ways to pay for hearing exams and aids
If you do not have coverage through Medicare or a Medicare Advantage plan, several other options may help. Some state Medicaid programs cover hearing aids for seniors who meet income and asset limits. You can contact your state Medicaid office to learn what your state covers.
The Hearing Loss Association of America maintains a list of programs and resources that help pay for hearing aids, including state-specific programs, nonprofit organizations, and manufacturer information programs. Some hearing aid manufacturers offer discounts or payment plans if you buy directly from them or through their network of providers.
Veterans may have hearing coverage through the VA. If you are a veteran, contact your local VA medical center to ask about hearing services. Some employers offer hearing benefits through retiree health plans, so if you have retiree coverage, check what it includes.
What to ask your doctor
If you think you are having hearing problems, start by talking to your primary care doctor. You can ask whether your symptoms warrant a hearing test, whether Medicare would cover it, and where you should go to have it done. Your doctor can also rule out other conditions that might cause hearing loss, such as earwax buildup, infection, or medication side effects.
If your doctor does order a hearing test, ask where it will be performed and whether it will be covered by Medicare. Ask your doctor to explain the results and what they mean for your hearing and your health. If your doctor recommends a hearing aid, ask about the cost and whether there are any information programs you might be able to use.
When to seek care for hearing loss
Sudden hearing loss — loss that happens over hours or a few days — is a medical emergency. If you wake up and cannot hear out of one ear, or if your hearing drops suddenly, contact your doctor or go to an urgent care clinic the same day. Sudden hearing loss can sometimes be treated if you seek care quickly.
If you are experiencing hearing loss that has developed over weeks or months, or if you have tinnitus, ear pain, or dizziness along with hearing changes, schedule an appointment with your doctor. These symptoms warrant medical evaluation even if they are not emergencies.
Frequently Asked Questions
Will Medicare pay for a hearing test at a hearing aid store?
No. Medicare only covers hearing tests done in a medical setting such as a hospital outpatient department or a doctor's office. Tests at a hearing aid store are not covered, even if your doctor referred you there. However, many hearing aid stores offer free hearing tests as part of their sales process.
Does my Medicare Advantage plan cover hearing aids?
Some Medicare Advantage plans do cover hearing aids, but not all. Coverage varies widely by plan. You should contact your plan directly or review your Summary of Benefits and Coverage document to find out what hearing services your specific plan covers.
What should I do if I cannot afford a hearing aid?
Several options may help. Contact your state Medicaid office to see if your state covers hearing aids. The Hearing Loss Association of America has a list of nonprofit programs and manufacturer information programs. If you are a veteran, the VA may cover hearing aids. Some employers offer hearing benefits through retiree plans.
Can I get a hearing test covered if I have no symptoms?
No. Medicare covers hearing tests only when a doctor orders one to diagnose or treat a specific medical condition. Routine screening tests are not covered. If you want to have your hearing checked without symptoms, you will pay out of pocket.
What if my hearing loss is caused by my medication?
If you suspect a medication is affecting your hearing, tell your doctor. Your doctor can order a hearing test to document the loss and may be able to switch you to a different medication. The hearing test would be covered by Medicare if your doctor orders it as part of evaluating your symptoms.