Medicare Coverage of Hearing Examinations

What It Is

Hearing examinations

What's Covered

Medicare Part B doesn't cover routine hearing examination or examinations to determine hearing loss.

In certain cases, Medicare Part B covers a hearing and balance examination to diagnose a condition or disease other than hearing loss.

If you have a Medicare Part C Medicare Advantage plan: Medicare Part C Medicare Advantage plans, also called Medicare Advantage plans, must cover everything that's included in original Medicare Part A and Part B coverage. But sometimes a Part C plan covers more, with extra services or an expanded amount of coverage. (Co-payments for Part C plans may also be different than those for Part A or Part B.) To find out whether your plan provides extra coverage or requires different co-payments for hearing examinations, contact the plan directly.

What Medicare Pays

Medicare pays nothing toward the cost of routine or other hearing loss examinations.

If Medicare part B covers a hearing examination to diagnose a condition other than hearing loss, Medicare Part B pays 80 percent of the Medicare-approved amount for the examination.

Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:

  • The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?

  • The care must be performed or delivered by a healthcare provider who participates in Medicare.

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6 Comments So Far. Add Your Wisdom.

over 2 years ago

There is something named "Central Processing Auditory Disorder" (CAPD) which I have been reading about. It seems to "mimic" hearing loss. I live in a large city with a major medical center and there is only one doctor there who diagnoses and treats it. The problem is that he requires a referral from another doctor. Since I have been treated for OCD and Adult Attention Deficit Disorder for years with little improvement, I thought that CAPD might be a possibility. However, my psychiatrist who treats me for the OCD ann the AADD apparently doesn't want to send the referral to the specialist for some reason. (I gave him the fax 3 months ago.) Has any reader gone to an audiologist for a hearing loss and been diagnosed with CAPD? There is a good article online about the symptoms. Two symptoms that are especially bothersome to me are "Difficulty following directions in a series" and "Memorizes poorly".

over 2 years ago

i have been hard of heaing since the age three.started wearing a hearing aid since age 11. after my first ear surgery. i had a total of six altogether. called hearing repair due to problems accured over the years.iam 55 now and iam on medicare. they recent sent me oct 1 2010. i called medicare and ask about hearing aid.s my quit working 2003.medicad promise me one ever three years never saw it.medicare doesnot covered hearing aids if medically needed.i cant even see a specalist like i used too. i lost my job because i cant hear well. i have made fun of by others since my hearing has quit working. this is so sad. mary

over 2 years ago

Thanks for this. At first read, I can't make out what you're saying but I shall persevere and decipher all the A, B, and C particulars. Again thank you. Shore Captain

over 2 years ago

I have been putting it of to but keep telling myself one of these days??? I know I have a problem, but the mony is not all ways there

over 2 years ago

The biggest problem and current reason I will not see a hearing professional is the financial rip off that occurs.

over 2 years ago

I didn't believe that Medicare covered *anything* related to hearing loss. You've given me hope that I can get some help hearing, which is necessary for my work.


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