Medicare's coverage of hearing tests depends on whether you need the test for diagnosis or just for a hearing aid fitting
Medicare Part B covers a hearing test (called an audiological exam) only when a doctor orders it to diagnose a medical condition — such as sudden hearing loss, dizziness, or ear infection. If your doctor writes an order saying the test is medically necessary, Medicare pays 80 percent of the approved amount after you meet your Part B deductible. You pay the remaining 20 percent.
Medicare does not cover hearing tests done solely to fit a hearing aid, even if you have never had one before. This is the most common reason people get hearing tests, and it is not covered. If you want a hearing test to see whether you need a hearing aid, you pay the full cost out of pocket — typically $50 to $200 per test, depending on where you go.
There is no annual limit on how many diagnostic hearing tests Medicare will cover if your doctor orders them. However, in practice, most people do not need more than one or two per year unless they have an ongoing ear condition.
Key Takeaways
- Medicare covers hearing tests only when ordered by a doctor for diagnosis of a medical problem, not for hearing aid fitting.
- When Medicare covers a test, you pay 20 percent of the approved amount after meeting your Part B deductible; Medicare pays 80 percent.
- Hearing tests done to determine whether you need a hearing aid are never covered by Medicare and cost $50 to $200 out of pocket.
- Your primary care doctor or ear, nose, and throat (ENT) specialist can order a diagnostic hearing test if they believe one is medically necessary.
- Some Medigap and Medicare Advantage plans may cover hearing aid fittings or hearing aids themselves, even though Original Medicare does not.
How to tell whether your hearing test will be covered
The key question is why your doctor is ordering the test. If the order says the test is for diagnosis — because you reported sudden hearing loss, ringing in your ears, balance problems, or another symptom — then Medicare will likely cover it. The doctor's order must state a medical reason, not just "patient wants to know if they need a hearing aid."
If you go to an audiologist or hearing aid store and ask for a hearing test without a doctor's order, that test is not covered. Even if you later show the results to your doctor, the test was not ordered for diagnosis, so Medicare will not pay for it retroactively.
Before you schedule a hearing test, ask your doctor whether they will order it as a diagnostic test. If they say yes, ask them to write the order and send it to the testing facility. This protects you from being billed for a test Medicare should have covered.
What happens after a diagnostic hearing test
Once you have a covered diagnostic hearing test, the results may show that you have hearing loss. At that point, your doctor might recommend a hearing aid. Medicare does not cover the cost of hearing aids themselves, and it does not cover the fitting appointment where an audiologist programs the device for you.
If you decide to get a hearing aid, you will pay the full cost out of pocket. Hearing aids range from $1,000 to $6,000 per device, depending on the type and features. Some people buy one hearing aid; others buy two (one for each ear).
The fitting appointment — where the audiologist takes ear impressions, programs the device, and teaches you how to use it — is also not covered by Medicare. This typically costs $200 to $500 and is separate from the cost of the device itself.
Medicare Advantage and Medigap coverage for hearing
Original Medicare (Part A and Part B) does not cover hearing aids or hearing aid fittings. However, some Medicare Advantage plans (Part C) do offer hearing benefits. These vary widely: some plans cover one hearing aid per year, others cover two, and some cover the full cost while others require you to pay a copay.
If you have a Medicare Advantage plan, check your plan documents or call the plan's customer service line to ask what hearing benefits are included. The answer depends entirely on which plan you chose.
Medigap (supplemental insurance) plans do not cover hearing aids or hearing tests either. Medigap covers the gaps in Original Medicare — copays, coinsurance, and deductibles — but it does not add new benefits that Original Medicare does not already have.
Where to get a diagnostic hearing test
You can get a diagnostic hearing test from an audiologist, an ear, nose, and throat (ENT) specialist, or sometimes from your primary care doctor's office if they have the equipment. The location does not matter for coverage purposes — what matters is that your doctor ordered it for a medical reason.
If you do not have a regular doctor, you can schedule an appointment with a primary care physician or an ENT. Tell them you have noticed hearing changes and ask whether they think a hearing test is necessary. If they do, they can order one.
Some hearing aid stores also employ audiologists who can perform diagnostic tests. If you go to a hearing aid store, be clear that you want a diagnostic test ordered by your doctor, not a fitting test. Ask the store to contact your doctor to get the order before you come in.
Common mistakes that lead to unpaid bills
The biggest mistake is getting a hearing test at a hearing aid store without a doctor's order. Hearing aid stores are businesses that sell hearing aids, and their hearing tests are designed to fit you for a device, not to diagnose a medical condition. These tests are never covered by Medicare, no matter how good your hearing loss turns out to be.
Another mistake is assuming that because you have hearing loss, Medicare will cover a hearing aid. It will not. Medicare covers the diagnostic test that finds the hearing loss, but not the device or the fitting that follows.
A third mistake is not asking your doctor to put the medical reason in writing on the order. If the order just says "hearing test" with no reason, the testing facility may bill you as if it were a fitting test rather than a diagnostic one. Always ask your doctor to note why the test is medically necessary.
What to do if you are billed for a covered hearing test
If you had a hearing test ordered by your doctor for a medical reason and you received a bill for the full cost, contact the testing facility and ask why they did not bill Medicare. Provide them with a copy of your doctor's order showing the medical reason for the test.
If the facility says they never received the order, ask your doctor's office to send it again. Once the facility has the order, they should resubmit the claim to Medicare.
If the facility refuses to bill Medicare or says the test was not medically necessary, contact Medicare directly at 1-800-MEDICARE (1-800-633-4227) and explain what happened. Medicare can review the claim and determine whether it should have been covered.
Frequently Asked Questions
Does Medicare cover hearing aids?
No. Original Medicare does not cover hearing aids or the cost of fitting them. Some Medicare Advantage plans do offer hearing benefits, so check your plan documents. Hearing aids typically cost $1,000 to $6,000 per device.
Can I get a free hearing test through Medicare?
Only if your doctor orders it for diagnosis of a medical condition. If the test is ordered for that reason, Medicare covers 80 percent after your deductible. Tests done to fit a hearing aid are not covered and cost $50 to $200 out of pocket.
What if my doctor says a hearing test is not medically necessary?
Then Medicare will not cover it. You can still get a hearing test at a hearing aid store or audiologist's office and pay out of pocket. Many people do this to find out whether they need a hearing aid, even though Medicare does not cover it.
How do I know if my Medicare Advantage plan covers hearing aids?
Call your plan's customer service number (on the back of your insurance card) and ask what hearing benefits are included. Coverage varies by plan — some cover one hearing aid per year, others cover two, and some cover the full cost while others charge a copay.
Can I appeal if Medicare denies a hearing test claim?
Yes. If Medicare denies a claim for a hearing test your doctor ordered, you can file an appeal. Call 1-800-MEDICARE and ask for help with the appeal process. Bring a copy of your doctor's order showing the medical reason for the test.