Does Medicare Cover Hearing Tests?

Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare... covers diagnostic hearing and balance tests if your doctor or other health care providerA person or organization that’s licensed to give health care. Doctors, nurses, and hospitals are examples of health care providers.... orders them. It does not cover routine hearing exams. However, many Medicare Advantage plans cover routine hearing exams as an additional benefit.

Key Takeaways

Routine hearing tests are used to 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 necessaryServices or supplies that are needed for the diagnosis or treatment of your medical condition and meet accepted standards of medical practice.... treatments, such as for chronic vertigo and/or cochlear implants.
Standard routine hearing tests can cost $60 to $80 without coverage.
Most Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B).... have coverage for routine hearing tests.
MedigapMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage.... policies are available to help with the costs of eye exams when Part B provides coverage for them.

What Are Hearing Tests?

During a hearing test, you will have several physical examinations of your ears to diagnosis any signs of damage or ailments to your hearing. These will include visual examinations of the ear for damage and obstructions, as well as auditory tests to evaluate any hearing loss you may have suffered. If your hearing loss is being caused by excessive earwax plugging up your ear canal, your doctor can flush or vacuum out the earwax to restore your hearing.¹

Hearing Aids

Your doctor may determine that you require hearing aids in order 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.²

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:³

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.⁴ Hearing and balance exams to diagnose vertigo are covered by Medicare Part B when ordered by your doctor³.

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.⁵ Your hearing tests and outpatient surgery for cochlear implants are covered by Medicare Part B when ordered by your doctor⁶.

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 tests⁷. 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 pair⁸.

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 amountA Medicare-approved amount is what Medicare will pay for a covered service. Healthcare providers that agree to Medicare assignment accept the approved amount without excess charges. What Does Medicare-Approved Amount Mean? A Medicare-approved amount is... for the covered service. If your doctor charges Excess ChargesA Medicare Part B excess charge is the difference between a health care provider’s actual charge and Medicare’s approved amount for payment...., 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 AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care.... and Part B, Medicare Advantage plans can also provide you with expanded services that can include hearing care. However, your out-of-pocket costsOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments.... with a Medicare Advantage plan may be different than those with Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage..... You will also be required to use in-networkDoctors, hospitals, pharmacies, and other healthcare providers that agree to health plan members' services and supplies at a set price are in-network providers. With some health plans, your care is only covered if you get... providers for all services, supplies, and durable medical equipmentDurable medical equipment (DME) is equipment that is designed to last and can be used repeatedly. It is suitable for home use and includes wheelchairs, oxygen equipment, and hospital beds...., which will not give you much room for choices.⁹

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:¹⁰

DeductiblesA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share....
CoinsuranceCoinsurance is a percentage of the total you are required to pay for a medical service. ...
CopaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service....

Summary

Unfortunately, Medicare will not cover hearing tests unless you need a surgical implant or you are wobbling all over the place with frequent spells of vertigo. If you are experiencing severe hearing and/or balance conditions, consult with your doctor to get your ears checked. If you want your routine hearing tests to be covered by Medicare, you will need to check out Medicare Advantage plans with hearing care services in your area.

Citations

1
mayoclinic.org, “Hearing loss“, Accessed November 11, 2021
2
mayoclinic.org, “Hearing aids“, Accessed November 11, 2021
3
Medicare.gov, “Hearing & balance exams“, Accessed November 11, 2021
4
mayoclinic.org, “Vertigo“, Accessed November 11, 2021
5
hopkinsmedicine.org, “Cochlear Implant Surgery“, Accessed November 11, 2021
6
Medicare.gov, “Prosthetic devices“, Accessed November 11, 2021
7
soundrelief.com, “ARE AUDIOLOGISTS COVERED BY YOUR HEALTH INSURANCE POLICY?“, Accessed November 11, 2021
8
medicalnewstoday.com, “Cost of hearing aids: What to know“, Accessed November 11, 2021
9
Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 11, 2021
10
Medicare.gov, “What’s Medicare Supplement Insurance (Medigap)?“, Accessed November 11, 2021