A covered hearing exam does not necessarily mean a hearing aid is covered. Original Medicare excludes hearing aids and exams for fitting them. Some Medicare Advantage plans add hearing benefits, but the device choices and member costs vary.
Diagnostic services
Part B can cover qualifying diagnostic hearing and balance exams. An order is generally needed; a limited direct-access audiology provision applies to certain non-acute services once every 12 months. Ask the audiologist which rule applies to your appointment and whether you will owe a deductible, coinsurance or facility charge.
If your plan advertises hearing benefits
- Ask whether the benefit is insurance coverage, a discount or an allowance.
- Check the participating provider and approved device list.
- Ask how often a replacement is allowed and whether there is a cost per ear.
- Confirm fitting visits, adjustments, batteries and follow-up services separately.
- Get the return period, warranty and final expected cost in writing.
Before paying a deposit
Give the provider your exact plan name and member information through its secure process. Request written confirmation for the model and services you are considering. A brand name, television advertisement or another person's benefit is not proof of your coverage.
If the answer is unclear
Call member services using your insurance card and keep the reference number. If you receive a denial, follow the appeal instructions and deadline in the notice. A Licensed Insurance Agent can help identify which insurance document to review, while an audiologist assesses your hearing needs.
Continue with a related question
- How to Find and Verify a Medicare Provider
- A Medicare Medical Claim Was Denied: What to Do Next
- Original Medicare or Medicare Advantage: Medical Benefits