Original Medicare does not cover hearing aids or routine hearing exams, but it does cover diagnostic hearing tests ordered by a doctor to determine if you need medical treatment. This exclusion has been part of the Medicare statute since the program launched in 1965, and it remains one of the most significant gaps in coverage for older adults. The good news: there are several ways to get at least partial coverage depending on your situation.
What Original Medicare Actually Covers
Medicare Part B covers diagnostic hearing and balance exams when a doctor orders them to figure out whether you need medical treatment. The key word is “diagnostic.” If your doctor suspects your hearing loss is caused by an infection, a tumor, nerve damage, or another medical condition, the exam to investigate that is covered. After meeting your Part B deductible, you pay 20% of the Medicare-approved amount. If the test happens in a hospital outpatient setting, you’ll also owe a copayment to the hospital.
Once every 12 months, you can also see an audiologist directly for certain diagnostic tests without a doctor’s order. This applies to non-acute hearing conditions but doesn’t include tests for balance or dizziness problems.
Medicare also covers cochlear implants for people who meet specific criteria: a diagnosis of bilateral moderate-to-profound sensorineural hearing loss, limited benefit from hearing aids, no active middle ear infection, and no contraindications to surgery. The implant candidate also needs the cognitive ability to participate in an extended rehabilitation program. These are surgical devices, not hearing aids, so they fall under a different coverage category.
The Hearing Aid Exclusion
The Medicare statute explicitly prohibits payment for “hearing aids or examination for the purpose of prescribing, fitting, or changing hearing aids.” That means Original Medicare won’t pay for hearing aids themselves, and it also won’t cover the exam you’d need to get fitted for one. This is a statutory exclusion written into the law, not a policy choice that CMS can change on its own.
This distinction between “diagnostic” and “routine” exams is where many people get confused. If your doctor orders a hearing test because they suspect a medical problem, Medicare pays. If the purpose of that same test is to prescribe or fit a hearing aid, Medicare doesn’t. The coverage depends on why the test was ordered, not the test itself.
Medicare Advantage Hearing Benefits
Medicare Advantage plans (Part C) are the main workaround. In 2025, 97% of individual Medicare Advantage plans offer some form of hearing benefit, covering exams, hearing aids, or both. This has been consistent for several years. Special Needs Plans come in slightly lower at 94%.
The catch is that “some form of hearing benefit” varies enormously from plan to plan. One plan might cover a basic hearing exam and offer a modest allowance toward hearing aids every few years. Another might provide a more generous benefit with higher dollar caps. Before enrolling in or switching to a Medicare Advantage plan for hearing coverage, check the specific benefit details: what’s the dollar limit, how often can you use it, and which providers are in network.
What Medigap Plans Don’t Do
Medigap (Medicare Supplement) plans help cover out-of-pocket costs for services Original Medicare already pays for, like your 20% coinsurance on a diagnostic hearing exam. They do not add new benefits. Since Original Medicare excludes hearing aids and routine hearing exams, Medigap plans won’t cover those either. If a diagnostic hearing test is covered by Part B, your Medigap plan can help with the coinsurance. That’s the extent of it.
Over-the-Counter Hearing Aids
Since 2022, the FDA has allowed over-the-counter hearing aids to be sold directly to consumers without a prescription. These devices are designed for adults with mild to moderate hearing loss and typically cost between $200 and $1,000 per pair, far less than prescription hearing aids that can run $2,000 to $7,000. Medicare does not reimburse for OTC hearing aids, and no Medicare reimbursement pathway for them currently exists. But the lower price point makes them accessible without insurance coverage for many people.
Legislative Efforts to Close the Gap
Bills to expand Medicare hearing coverage have been introduced repeatedly in Congress. The most recent, the Medicare Hearing Aid Coverage Act of 2025, was introduced in the House in January 2025. It would allow Medicare to cover hearing aids and related exams. Similar bills have been introduced in prior sessions without becoming law. As of now, the statutory exclusion remains in place, and any change would require an act of Congress.
Practical Steps for Coverage
If you’re on Original Medicare and concerned about hearing loss, start by asking your primary care doctor to order a diagnostic hearing evaluation. If there’s a medical reason to investigate your hearing, Part B will cover the test, and you’ll pay 20% after your deductible. That at least gives you a baseline and a professional assessment.
If you need hearing aids, your realistic options are: enrolling in a Medicare Advantage plan with a hearing benefit during open enrollment (October 15 through December 7 each year), purchasing OTC hearing aids out of pocket for mild to moderate loss, or checking whether your state Medicaid program covers hearing aids if you’re dual-eligible. Some charitable organizations and manufacturers also offer assistance programs for people who can’t afford devices.