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Does Medicare Cover Audiology?

Does Medicare Cover Audiology?

An audiologist is a healthcare professional that specializes in diagnosing and treating medical conditions that affect the person’s hearing and balance. 

Aside from diagnosis and treatment for hearing and balance medical issues, they also perform hearing exams as well as help with the fitting, maintenance, and issue hearing aids.

If you need to see an audiologist, a very common question you likely have is, “does Medicare cover audiology?” 

In this article, we answer that question in clear, plain English. You will also find the average costs for hearing aids as well as other helpful info.

Does Medicare Cover Audiology?

The short answer is yes; Medicare will cover the cost of audiology services. But this is not the case 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your audiology visit. 

Let’s take a look at what these conditions are so you know what to expect.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for certain services provided by audiologists. It provides coverage for your audiology visit if it is considered medically necessary. The visit must also be first ordered by your healthcare provider for Original Medicare to provide coverage.

Original Medicare Coverage

Coverage for audiology is provided by Medicare Part B as it often takes place in an outpatient setting. However, Medicare Part B only provides coverage for certain audiology services such as diagnostic hearing exams.

For Medicare Part B to provide coverage for your diagnostic hearing exam, it needs to be ordered by your healthcare provider for the reason of detecting and diagnosing a hearing problem. Once approved, Medicare Part B covers 80 percent of the costs of audiologists. You will be responsible for paying the remaining 20 percent of the costs. 

However, Original Medicare (Medicare Part A and Part B) does not provide coverage for hearing aids. 

Although hearing aids may seem like they fall under the category of Durable Medical Equipment, or DME, Medicare Part B does not provide coverage for hearing aids. Medicare Part B provides coverage for DME. 

Next, let’s explore what Part C coverage is like for audiology.

Part C Coverage

Medicare Advantage plans (Medicare Part C) also provide coverage for audiology services. They cover them because these plans must cover everything Original Medicare does. But they also cover things that Original Medicare does not. In some cases, this can include some audiology services and treatments. However, exactly what is covered and what the out-of-pocket costs are will vary depending on the specifics of your plan.

Unlike Medicare Part B, some Medicare Part C plans provide coverage for hearing aids. For example, United Healthcare plans that administer Medicare Advantage plans also provide coverage for hearing aids. 

How Much Do Hearing Aids Cost?

Hearing aids can be somewhat expensive, with their cost ranging from $1,000 to $6,000. One of the reasons why hearing aids can be expensive is due to bundling. 

Bundling may include services such as hearing tests, consultation, follow-up adjustments, and more. Another factor that will affect how much hearing aids cost is the type of hearing aid you purchase.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare Cover Beovu?

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