Medicare Part B covers diagnostic hearing tests ordered by your doctor, but not routine hearing exams or hearing aids
Medicare Part B will pay for a hearing test if your doctor orders it to diagnose a medical problem — for example, if you have sudden hearing loss, dizziness, or an ear infection. The test must be done by an audiologist or physician, and Medicare pays 80 percent of the approved amount after you meet your Part B deductible. You pay the remaining 20 percent.
Medicare does not pay for routine hearing exams done just to check your hearing, even if you notice it getting worse. It also does not cover hearing aids, fitting appointments, or follow-up adjustments. Some Medigap and Medicare Advantage plans offer hearing benefits, but coverage varies widely by plan.
Key Takeaways
- Medicare Part B covers hearing tests when your doctor orders them to diagnose a specific medical condition, not for routine screening.
- You pay 20 percent of the approved cost after meeting your Part B deductible; Medicare pays the other 80 percent.
- Routine hearing exams, hearing aids, and fitting services are not covered by Original Medicare under any circumstance.
- Some Medicare Advantage and Medigap plans include hearing benefits, so check your plan documents or call your plan to ask what is covered.
- If you need a hearing test, ask your primary care doctor for a referral to an audiologist or ear, nose, and throat specialist.
When Medicare Part B pays for a hearing test
Your doctor must order the test as part of diagnosing or treating a medical condition. Common reasons include sudden hearing loss, tinnitus (ringing in the ears), balance problems, ear pain, or suspected infection. The test itself — called an audiogram or audiometric evaluation — measures how well you hear different sounds and pitches.
The test must be performed by a licensed audiologist, an ear, nose, and throat doctor (ENT), or another physician. Tests done at a hearing aid store or by a hearing aid salesman are not covered, even if an audiologist performs them. The key is that your doctor must order it for medical diagnosis, not for you to shop for hearing aids.
What you pay out of pocket
After you meet your Part B deductible for the year, Medicare pays 80 percent of what it considers the approved amount for the test. You are responsible for the remaining 20 percent. The approved amount varies by location and provider, so the exact dollar amount you owe depends on where you live and which provider performs the test.
If you have not met your deductible yet, you pay the full cost of the test until you reach it. Once you reach the deductible, the 80/20 split begins. If you have a Medigap plan, it may cover some or all of your 20 percent coinsurance, depending on which Medigap plan you hold.
Hearing aids and fitting are not covered
Even if Medicare pays for your hearing test and the test shows you need hearing aids, Medicare does not pay for the aids themselves, the fitting appointment, or any adjustments after you receive them. This is true for all types of hearing aids — behind-the-ear, in-the-ear, or any other style.
Hearing aid costs range widely depending on the type and features, but most people spend between $1,000 and $6,000 per pair. Some states offer programs that help low-income seniors pay for hearing aids, and some nonprofit organizations offer discounted or refurbished aids. Your audiologist or local Area Agency on Aging can point you toward these resources.
Medicare Advantage and Medigap hearing benefits
Some Medicare Advantage plans (Part C) include hearing benefits as an extra service. These plans may cover routine hearing exams, hearing aids, or both, though the coverage is usually limited — for example, one exam per year and one pair of aids every two or three years. The amount you pay out of pocket depends on your specific plan.
Medigap plans do not standardly cover hearing aids or exams, but a few plans offer limited hearing benefits. Plan G, Plan M, and Plan N may include some hearing coverage depending on the insurance company offering the plan. Call your Medigap insurer directly to ask whether your plan covers hearing services.
If you are shopping for a new Medicare Advantage plan during open enrollment, check the plan's Summary of Benefits to see what hearing services it covers and what you would pay. Plans change their benefits year to year, so even if your current plan covers hearing, next year's version might not.
How to get a hearing test through Medicare
Start by talking to your primary care doctor about your hearing concerns. Describe what you are noticing — difficulty hearing conversations, trouble with phone calls, or needing the television louder than others do. Your doctor will decide whether a hearing test is medically necessary and write an order for it.
Your doctor can refer you to an audiologist or an ENT specialist. Ask whether the provider is in your Medicare network, because out-of-network providers may charge more and you could owe a larger share of the cost. Once you have the referral, call the audiologist or specialist's office to schedule the appointment and confirm they accept Medicare.
Bring your Medicare card and any referral paperwork to your appointment. The provider's office will handle billing Medicare directly. You will receive a bill for your 20 percent coinsurance after Medicare processes the claim.
Frequently Asked Questions
Does Medicare cover hearing aids at all?
No. Original Medicare (Part A and Part B) does not cover hearing aids, fitting, or adjustments under any circumstance. Some Medicare Advantage plans include hearing aid benefits, but coverage is limited and varies by plan. Check your plan's Summary of Benefits or call your plan to ask.
What if I want a hearing test but my doctor won't order one?
You can request a hearing test from your doctor and explain your concerns. If your doctor believes it is medically necessary, they will order it. If they do not think it is necessary, Medicare will not pay for it even if you pay for it yourself and ask for reimbursement later. A routine exam for hearing loss alone is not covered.
Can I go to a hearing aid store and have them bill Medicare?
No. Hearing tests performed at a hearing aid store or by a hearing aid company are not covered by Medicare, even if a licensed audiologist performs the test. The test must be ordered by your doctor and performed at a medical office, clinic, or hospital for Medicare to pay.
Will my Medigap plan pay for a hearing test?
Most Medigap plans do not cover hearing tests or hearing aids. A few plans (G, M, and N) may offer limited hearing benefits depending on the insurance company, so call your Medigap insurer to ask. If your Medigap plan does cover the test, it typically pays your 20 percent coinsurance after Medicare pays its 80 percent.
How much does a hearing test cost if Medicare doesn't pay?
A hearing test at an audiologist's office typically costs between $0 and $300 depending on the type of test and where you live. If you need a test but Medicare will not pay because your doctor did not order it, you can pay out of pocket. Some audiologists offer reduced rates for uninsured or self-pay patients if you ask.