Medicare Part B covers a hearing test ordered by your doctor, but only if it is medically necessary — not for routine screening

Medicare Part B will pay for a hearing test (called an audiological exam) when your doctor orders it because you have a medical problem affecting your hearing. The test must be done by a licensed audiologist or physician, and your doctor must document why the test is needed. If you go in for a routine hearing check without a medical reason, Medicare does not cover it.

The key difference is medical necessity. If you notice you cannot hear well and your doctor refers you for testing, that is covered. If you straightforward want to know whether your hearing has changed, that is not. Your doctor decides whether the test meets the medical necessity standard — not you, and not the audiologist.

Key Takeaways

  • Medicare Part B covers a hearing test when your doctor orders it for a medical reason, such as sudden hearing loss or dizziness with hearing changes.
  • The test must be performed by a licensed audiologist or physician and ordered by your doctor before you have the test done.
  • Routine hearing screening — testing when you have no symptoms — is not covered by Medicare.
  • You pay 20 percent of the Medicare-approved amount after you meet your Part B deductible; the audiologist's office can tell you the expected cost before the test.
  • Hearing aids themselves are not covered by Medicare, even if the test shows you need them.

When Medicare Part B will pay for your hearing test

Your doctor can order a hearing test if you report symptoms that suggest a hearing problem. Common reasons include sudden hearing loss in one ear, hearing loss that started after an illness or injury, dizziness or balance problems that may be related to your inner ear, ringing in your ears (tinnitus) that affects your daily life, or difficulty understanding speech even in quiet settings.

The audiologist or physician performing the test will document the medical reason in your chart. Medicare's contractor will review the claim to confirm the reason meets the medical necessity standard. If it does, Medicare pays its share; if it does not, you may receive a notice that the test was not covered and you may owe the full cost.

What you pay out of pocket

After you meet your Part B deductible for the year, you pay 20 percent of the Medicare-approved amount for the hearing test. The remaining 80 percent is covered by Medicare. The actual cost varies depending on where you have the test done and what type of test your doctor orders.

Before you schedule the test, ask the audiologist's office what the Medicare-approved amount is for the specific test your doctor ordered. They can tell you roughly what 20 percent will be. If you have a Medigap or Medicare Advantage plan, your plan may cover some or all of your 20 percent share — check your plan documents or call your plan to confirm.

How to make sure Medicare will cover your test

Start with your primary care doctor or the specialist treating your ear, nose, and throat condition. Tell them about your hearing concerns and ask whether they think a hearing test is medically necessary. If they agree, they will write an order for the test.

When you call to schedule the test, tell the audiologist's office that you have a doctor's order and that you want to confirm Medicare will cover it. Give them your Medicare number. The office can submit the order to Medicare's contractor ahead of time to get a information — this is called a pre-information or pre-authorization. It is not required, but it protects you from an unexpected bill if Medicare later denies the claim.

If the pre-information comes back as "not covered," you have the right to decline the test without owing anything. If you choose to have the test anyway, the audiologist must give you a written notice before the test explaining that Medicare will not cover it and you will owe the full cost.

What Medicare does not cover related to hearing

Medicare does not cover hearing aids, even if your hearing test shows you need them. It also does not cover the fitting, adjustment, or repair of hearing aids. Some Medicare Advantage plans offer hearing aid coverage as an added benefit — if you have a Medicare Advantage plan, check your plan documents or call the plan to see whether hearing aids are included.

Medicare also does not cover routine hearing screening — a test done when you have no symptoms and no medical reason to suspect a problem. Some employers, community health centers, or senior centers offer free or low-cost hearing screenings; those are separate from Medicare coverage.

The difference between a hearing test and a hearing aid fitting

A hearing test (audiological exam) measures how well you hear at different volumes and frequencies. It is diagnostic — it tells your doctor what is wrong. Medicare covers this when medically necessary.

A hearing aid fitting is the process of selecting, programming, and adjusting a hearing aid to match your hearing loss. It is treatment, not diagnosis. Medicare does not cover it. If you need a hearing aid, you will pay out of pocket, though some hearing aid companies offer payment plans or discounts for Medicare beneficiaries.

If your hearing test is denied

If Medicare denies your claim, you will receive a notice called an Explanation of Benefits (EOB). The notice will explain why Medicare said the test was not medically necessary. You have the right to appeal the decision.

To appeal, follow the instructions on the EOB. You can ask your doctor to provide additional documentation explaining why the test was medically necessary — for example, notes about your symptoms or test results that led to the referral. Send this information to Medicare's contractor within the important date shown on the notice. Many denials are overturned on appeal when the doctor provides more detail about the medical reason.

Frequently Asked Questions

Can I get a hearing test at my annual wellness visit?

Medicare covers an annual wellness visit, but a hearing test is not part of it unless your doctor finds a reason during the visit to order one. If your doctor does order a hearing test during the wellness visit, it is a separate service and follows the same rules — it must be medically necessary and you pay 20 percent after your deductible.

What if I have a Medicare Advantage plan instead of Original Medicare?

Medicare Advantage plans must cover at least what Original Medicare covers, so they cover a medically necessary hearing test the same way. However, some Medicare Advantage plans offer additional hearing benefits, such as hearing aid coverage or routine screening. Check your plan documents or call your plan to see what hearing services are included.

Do I need a referral from my doctor to see an audiologist?

You do not need a formal referral to see an audiologist, but your doctor must order the hearing test for Medicare to cover it. You can call an audiologist's office and ask to schedule a test, but tell them you will need a doctor's order. Your doctor can send the order directly to the audiologist, or you can pick it up and bring it yourself.

Will Medicare cover a hearing test if I have sudden hearing loss?

Yes. Sudden hearing loss is a medical emergency and a clear medical reason for a hearing test. If you experience sudden hearing loss in one or both ears, contact your doctor right away. Your doctor can order a hearing test, and Medicare will cover it as medically necessary.

What happens if the audiologist's office says they do not accept Medicare?

Some audiologists do not bill Medicare directly. If the office does not accept Medicare, you can still have the test done, but you will pay the full cost upfront and then submit the bill to Medicare yourself for reimbursement. Ask the office for an itemized receipt showing the test name, date, and cost. Send it to Medicare with a claim form (CMS-1500), which you can get from the office or from Medicare's website.