Yes. Medicare covers exams to diagnose hearing problems, balance disorders and ringing in the ears if your doctor or other health care provider orders them to decide if treatment is necessary. But Medicare doesn’t cover routine hearing tests, hearing aids and exams for fitting hearing aids.
Rest assured. You may get some hearing-care coverage from other sources, such as Medicaid, if you’re eligible financially; a private Medicare Advantage plan; retiree health insurance; or U.S. Department of Veterans Affairs (VA) health care.
What hearing-related tests does Medicare cover?
Medicare covers diagnostic exams with an audiologist when a physician, clinical nurse specialist, nurse practitioner, physician’s assistant or other eligible provider refers you to determine appropriate medical or surgical treatment of hearing loss or a hearing-related problem.
Medicare Part B covers eligible hearing tests once you’ve paid your annual Part B deductible for doctor’s services and outpatient care, which is $226 in 2023. You’ll pay 20 percent of the Medicare-approved amount for doctor’s visit and tests. But if you have Medicare supplemental insurance, better known as Medigap, that policy may cover the 20 percent copayment.
Do Medicare Advantage plans cover hearing tests?
If you choose to get coverage from a private Medicare Advantage plan, rather than traditional Medicare, you may have some coverage for hearing tests and hearing aids.
Different from original Medicare. Medicare Advantage plans generally cover one hearing test a year. They may also cover a hearing aid-fitting exam. Most plans don’t charge copayments or any other cost sharing for the annual hearing exam, but you may have to use an audiologist or other qualified provider in the plan’s network.
Medicare Advantage plans also provide some coverage for hearing aids, often with a copayment or annual coverage limit. But some plans limit their purchase to once every two or three years.
How to check out plans. To find a list of Medicare Advantage hearing-care plans in your area, go to the Medicare Plan Finder, type in your zip code and click Medicare Advantage Plan in the Plan Type drop-down menu. Click Start, and then answer questions about whether you receive financial aid and if you want to see drug costs when you compare plans. Next you will see a list of all of the Medicare Advantage plans in your area, with Hearing in the Plan Benefits list noted with a green check mark.
For more information about the plan’s hearing coverage, click Plan Details and scroll down to Extra Benefits. You’ll see copayments for hearing aids, exams, hearing aid-fitting/evaluation services and other hearing benefits.