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Does Medicare Cover Hearing Exams?
In general, Medicare does not cover routine hearing exams. In some cases, diagnostic hearing exams are covered by Medicare Part B, but this is only when they are ordered by a doctor. If your hearing problem is due to a specific injury or disease—such as removal of a brain tumor or head injury—Medicare may cover the charges. Your doctor or hearing specialist will be able to explain which hearing exams are covered by Medicare, and the conditions for a diagnostic hearing exam.
You pay 100% of charges for routine hearing exams. If you are approved by your physician for a Medicare-covered diagnostic hearing exam, you pay 20% of the charges. You must pay your deductible for any Medicare Part B services and supplies before Medicare begins to pay its share. If a doctor, health care provider or supplier does not accept assignment, the amount you pay may be higher.
If your insurance is original Medicare with a supplemental, it is possible that some supplement plans cover a portion of the hearing exam. You would need to check with your individual policy to determine if hearing loss is covered. If you are in the process of going on original Medicare and need to purchase a supplemental, check with several different supplemental coverages for specifics on hearing loss coverage.
Do I Need A Hearing Exam?
If you feel as though you are suffering from hearing loss, you may want to ask your physician for a hearing exam. If your doctor does not conduct hearing exams, he or she will direct you to a hearing aid professional.
How Do I Get a Hearing Exam?
A hearing exam may be conducted by a hearing aid specialist known as an audiologist, or an otolaryngologist, who is an eye, ear, nose and throat specialist. This specialist can determine if your loss of hearing is due to medical reasons, or simply the result of aging. The otolaryngologist may determine that your condition is medical, and if so, may be covered by Medicare. This is the reason the hearing exam is extremely important, even if it is found to not be medically caused. If that is the case you would be responsible for the cost of the exam. Your primary care physician (PCP) may refer you to the specialist. If so, Medicare may cover the cost of the exam. Ask you PCP about this before going for the exam. If your PCP feels the hearing loss is not medically caused, you may be referred to an audiologist.
What Happens During a Hearing Exam?
During your hearing exam, you will be asked a variety of open-ended questions that help the examiner see how hearing loss impacts your daily life. You want to be specific about when, where, and how you have the most trouble hearing. For example, at home alone you can hear the television fine, but at a noisy coffee shop you have trouble hearing your friends. Explanations such as this help the hearing aid specialist determine the type of hearing aid that fits your lifestyle. The hearing exam will also question medications, ear pain or drainage, surgical history, dizziness or vertigo, and if you experience ringing in your ears.
The hearing exam will also use special equipment to test the type of hearing loss you have. In a sound-controlled booth, you will wear headphones or earphones that make a tone or word. The examiner will ask you to push a button when you hear the sounds. This will test the ability of your ears to recognize speech and tones based on the level of pitch and intensity. Remember that you may have to return to the hearing aid professional's office for further testing, depending on your individual needs and the types of sounds that you can or cannot hear.