Did you know that, according to the World Health Organization (WHO), more than 5% of the global population, or 430 million people, require rehabilitation to address a “disabling” hearing loss.
Hearing loss that is more than 35 dB is referred to as debilitating. This is a key reason why hearing tests are so necessary. They are the primary way healthcare providers measure hearing loss.
If you are concerned about your hearing and would like to have a test, you may be wondering, “Does Medicare cover hearing tests?”
In this article, we answer the question in clear, plain English. You will also find the average costs of a hearing screening if you have to pay for it out of pocket.
Does Medicare Cover Hearing Tests?
The short answer is yes. Medicare will cover the cost of hearing and balance screening. But not 100% of the time. As is often the case with Medicare, certain conditions must be met for Medicare to pay for your hearing screening. Below we look at what these are so you know what to expect.
Original Medicare Coverage of Hearing Tests
Original Medicare (Medicare Part A and Part B) provides hearing and balance screening coverage.
This plan provides coverage for your hearing screening if medically necessary. Your healthcare provider must first order the screening for Original Medicare to provide coverage.
When Hearing Tests are Covered by Part A vs. Part B
Coverage for hearing and balance tests is provided by Medicare Part A if it takes place in an inpatient setting. Such places include a hospital or a skilled nursing facility.
Most of the time, coverage for hearing tests is provided by Medicare Part B. However, this part only provides coverage for the tests if your healthcare provider orders it. This ensures it is a test that is considered medically necessary.
However, Medicare Part B does not provide coverage for all hearing tests. Medicare Part B will not provide coverage for hearing tests if it is a part of fitting hearing aids.
Once approved, Medicare Part B covers 80 percent of the costs of medically necessary hearing and balance tests. You will pay for the remaining 20 percent.
Medicare Advantage Coverage of Hearing Tests
Medicare Advantage plans (Medicare Part C) also provide test coverage for hearing and balance. All Advantage plans must cover everything Original Medicare covers. These plans will also offer additional benefits as well. Often this includes hearing-related services.
However, what each Advantage plan covers varies, as does the plan’s cost. So be sure to check with your insurance company to see what additional services, treatments, and more you have coverage for.
What Does Medicare Not Cover?
Original Medicare does not provide coverage for hearing aids. Although hearing aids may seem like they fall under Durable Medical Equipment (DME), Medicare Part B does not provide coverage for hearing aids.
How Much Do Hearing Tests Cost?
The average cost of hearing tests can be as much as $250. The exact costs of hearing tests can be quite different, however, based on various factors such as the clinic and the healthcare provider.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage. Always double-check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
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 TMJ Problems?