Does Medicare Cover Hearing Exams?

Hearing loss can occur due to hereditary factors, aging, illness or injury. If you suspect you may be suffering from hearing loss, it’s important to inform your physician so that they can help you determine the appropriate exam, diagnosis, and course of treatment. Depending on the circumstances, there may be Medicare coverage options available to you.

When to Test Your Hearing

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), the following circumstances may indicate the need to examine your hearing:

• You struggle to understand others in conversation. Whether it’s at home, in the car or at the restaurant, if you find it difficult to follow a conversation with friends and family, then you may be experiencing hearing loss.
• You argue with others about volume. A common sign of hearing loss is compensating for it by turning up the volume on that radio, television or mobile devices. If others around you complain it’s too loud, or if you find you can’t hear well at a concert or in a movie theater, it’s possible you need a hearing exam.
• You experience limitations in lifestyle due to hearing issues. Many people who begin to experience hearing loss may find they’re avoiding certain activities due to the embarrassment of asking others to repeat themselves or the fact that they’re missing out on certain details.

You should discuss any changes to your daily habits or usual activities with your doctor. Additionally, any underlying medical conditions that might be common in your family or that you have experienced personally can help your healthcare professionals assess the likelihood of hearing loss.

Certain infections and trauma to the head can also cause hearing loss, which may be permanent or temporary. Your doctor may suggest hearing exams as a way to monitor your recovery from these conditions.

Types of Hearing Exams

The American Speech-Language-Hearing Association (ASHA) notes that more than one exam may be administered in order to determine hearing loss conclusively.

• Pure-Tone Testing. Headphones or speakers in a sound booth are used to emit sounds at different pitches and frequencies.
• Speech Testing. This exam tests how well you can listen to and repeat the words you hear while wearing headphones that transmit what an audiologist says. The volume may fluctuate and the test may be conducted in a quiet or noisy place.
• Middle Ear Tests. These tests use different instruments to measure the reaction of your eardrum to sound, certain small muscle reflexes, or how much air or fluid might be impacting your hearing.
• Auditory Brainstem Response (ABR). Through the use of electrodes placed on your head, brain wave activity is monitored for response to sounds you hear through earphones.
• Otoacoustic Emissions (OAEs). The inner ear’s vibrations in response to sound are measured with the placement of a small probe that emits a sound and monitors feedback.

These tests do not require sedation and are not known to cause discomfort, pain or side effects. If you’re concerned about any potential issues during a hearing exam, your healthcare professional can help you understand the process and what to expect with each test.

Medicare Coverage for Hearing Exams

Routine hearing exams that do not arise out of a qualifying medical condition, injury or illness are not likely to be covered through Original Medicare insurance. If your doctor suspects you are experiencing hearing loss and determines diagnostic testing to be medically necessary in order to treat it, then Medicare Part B may cover part of the costs of your exam. You would still be responsible for applicable deductibles and coinsurance payments in addition to the monthly Part B premium.

Certain Medicare Part C plans, also known as Medicare Advantage plans, can offer extra benefits in addition to the Original Medicare coverage they provide. This may include routine or medically necessary hearing exams. Check each plan’s details to confirm coverage requirements.