Does Medicare Cover Hearing Tests?

Medicare Part B covers diagnostic hearing and balance tests if your doctor or other health care provider orders them. It does not cover routine hearing exams. However, many Medicare Advantage plans cover routine hearing exams as an additional benefit.

[keytakeaways]

Routine hearing tests check a person’s vision for disease and damage.
Hearing aids may be prescribed during a hearing test if the person’s hearing has been notably damaged.
Medicare Part B will only cover hearing tests if they are part of medically necessary treatments, such as chronic vertigo and/or cochlear implants.
Standard routine hearing tests can cost $60 to $80 without coverage.
Most Medicare Advantage plans have coverage for routine hearing tests.
Medigap policies are available to help with the costs of eye exams when Part B provides coverage for them.

[/keytakeaways]

[bigad]

What Are Hearing Tests?

During a hearing test, you will have several physical examinations of your ears to diagnose any signs of damage or ailments to your hearing. These will include visual examinations of the ear for damage and obstructions and auditory tests to evaluate any hearing loss you may have suffered. If your hearing loss is caused by excessive earwax, your doctor can flush your ears to restore your hearing.[mfn referencenumber=1]mayoclinic.org, “Hearing loss“, Accessed November 11, 2021[/mfn]

Hearing Aids

Your doctor may determine that you require hearing aids for you to hear clearly. They will help you get fitted for hearing aids depending on the strength and size needed, such as:

Completely in the canal (CIC)
In the canal (ITC)
In the ear (ITE)
Behind the ear (BTE)
Receiver in canal (RIC)
Receiver in the ear (RITE)
Open-fit

When receiving a hearing test, the doctor will determine if you need a new hearing aid prescription due to changes in your hearing.[mfn referencenumber=2]mayoclinic.org, “Hearing aids“, Accessed November 11, 2021[/mfn]

How Does Medicare Cover Hearing Tests?

Sadly, Medicare will not cover your routine hearing tests. Medicare will only provide coverage for hearing tests if they are part of medically necessary treatments, such as checking for:[mfn referencenumber=3]Medicare.gov, “Hearing & balance exams“, Accessed November 11, 2021[/mfn]

Eardrum trauma
Inner ear infections
Chronic vertigo
Cochlear Implants

Vertigo

Vertigo, also known as benign paroxysmal positional vertigo (BPPV), is when you experience mild to intense dizziness when shifting the position of your head, such as sitting up or laying down. If you are experiencing chronic vertigo spells, one of the potential causes can be a damaged inner ear, which can cause hearing loss, frequent sudden dizziness, and loss of balance when moving your head.[mfn referencenumber=4]mayoclinic.org, “Vertigo“, Accessed November 11, 2021[/mfn] Hearing and balance exams to diagnose vertigo are covered by Medicare Part B when ordered by your doctor[mfn referencenumber=3]Medicare.gov, “Hearing & balance exams“, Accessed November 11, 2021[/mfn].

Cochlear Implants

A cochlear implant is a small electronic device that electrically stimulates the ear to treat hearing loss when hearing aids are no longer effective. This incredible tool extends outside the ear to pick up sound waves and transmits them to the internal end of the device, which directly stimulates the cochlear nerve used for hearing.[mfn referencenumber=5]hopkinsmedicine.org, “Cochlear Implant Surgery“, Accessed November 11, 2021[/mfn] Your hearing tests and outpatient surgery for cochlear implants are covered by Medicare Part B when ordered by your doctor[mfn referencenumber=6]Medicare.gov, “Prosthetic devices“, Accessed November 11, 2021[/mfn].

How Much Do Hearing Tests Cost?

Hearing test costs can vary depending on the area and what is done during the tests, ranging from $60 to $80 for standard hearing tests[mfn referencenumber=7]soundrelief.com, “ARE AUDIOLOGISTS COVERED BY YOUR HEALTH INSURANCE POLICY?“, Accessed November 11, 2021[/mfn]. If you require hearing aids, these costs can shoot up dramatically to a range of $1,000 to $6,000, averaging about $2,500 per pair[mfn referencenumber=8]medicalnewstoday.com, “Cost of hearing aids: What to know“, Accessed November 11, 2021[/mfn].

Medicare Part B will provide coverage for a hearing test if it is ordered by a doctor. However, it’s important to remember that Part B only pays 80 percent of the Medicare-approved amount for the covered service. If your doctor charges Excess Charges, you will pay those out-of-pocket unless you have a Medicare Advantage plan or a Medigap policy that covers Part B Excess Charges.

Medicare Advantage

In addition to covering the same services as Medicare Part A and Part B, Medicare Advantage plans can also provide you with expanded services that can include hearing care. However, your out-of-pocket costs with a Medicare Advantage plan may be different than those with Original Medicare. You will also be required to use in-network providers for all services, supplies, and durable medical equipment, which will not give you much room for choices.[mfn referencenumber=9]Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 11, 2021[/mfn]

Medicare Supplements

People with Original Medicare can purchase Medicare supplement insurance to help cover their Medicare out-of-pocket costs. Medigap, as it is also known, is available through private insurance companies. While Medigap policies will not provide you with any expanded hearing coverage with Orginal Medicare, they will help with the out-of-pocket costs for the few necessary hearing services Medicare does cover. These costs include:[mfn referencenumber=10]Medicare.gov, “What’s Medicare Supplement Insurance (Medigap)?“, Accessed November 11, 2021[/mfn]

Deductibles
Coinsurance
Copayments