Most adults should have their hearing screened at least once every ten years through age 50, then every three years after that. But several situations call for testing sooner, including noisy work environments, certain medications, chronic conditions like diabetes, and everyday signs you might already be noticing, like turning the TV up louder than you used to. Here’s a full breakdown of when testing makes sense at every stage of life.
Routine Screening Schedule for Adults
The American Speech-Language-Hearing Association recommends adults get a hearing screening at least every decade through age 50, then switch to every three years. If you have risk factors like regular noise exposure, certain medications, or a family history of hearing loss, more frequent testing is appropriate.
One thing many people skip is a baseline hearing test. Johns Hopkins Medicine recommends getting at least one audiogram between ages 21 and 60, even if your hearing seems fine. That baseline gives an audiologist a reference point. If your hearing changes years later, they can compare the new results to your original test and get a clearer picture of how much loss has occurred and how to treat it. Without a baseline, it’s harder to gauge severity.
Signs You Should Get Tested Now
You don’t need to wait for a scheduled screening if you’re already experiencing changes. The Mayo Clinic identifies several common early signs of hearing loss:
- Trouble understanding words in noisy or crowded places
- Difficulty hearing consonant sounds (letters like S, F, and T)
- Frequently asking people to speak more slowly or loudly
- Needing to turn up the volume on your TV or phone higher than others prefer
- Avoiding social situations because following conversation feels exhausting
- Ringing in the ears (tinnitus)
- Finding background noise unusually bothersome
Any one of these is reason enough to schedule a hearing evaluation. You don’t need to check multiple boxes. People often wait years after first noticing these signs, partly because hearing loss tends to creep in gradually. But earlier detection leads to better outcomes, especially since untreated hearing loss is linked to cognitive decline, social isolation, and depression.
Tinnitus and Balance Problems
Persistent ringing, buzzing, or pulsing sounds in your ears warrant an audiological evaluation, not just a quick office visit. A full workup typically includes an ear exam, a hearing test, and a review of your medical history and medications. The results help determine whether imaging or further testing is needed. Tinnitus often accompanies some degree of hearing loss that you may not have noticed on your own.
Balance problems, vertigo, or a sensation of fullness in the ear also call for a combined hearing and balance exam. These symptoms can point to inner ear conditions that are easier to manage when caught early.
Noise Exposure at Work or in Daily Life
If you work in a loud environment, your employer may already be required to provide hearing tests. The CDC’s National Institute for Occupational Safety and Health considers repeated exposure at or above 85 decibels hazardous. That’s roughly the noise level of heavy city traffic or a loud restaurant. For every 3-decibel increase above that threshold, the safe exposure time is cut in half.
NIOSH recommends a baseline hearing test within 30 days of starting work in a noisy setting, followed by annual testing for as long as exposure continues. Annual tests should ideally happen near the end of a shift, so any temporary noise effects show up in the results.
You don’t need to work in construction or manufacturing to be at risk. Musicians, bartenders, fitness instructors, and people who regularly use power tools or attend concerts all face significant noise exposure. If loud environments are a regular part of your life, annual hearing checks are a reasonable precaution even without an employer mandate.
Diabetes and Cardiovascular Conditions
Diabetes roughly doubles the risk of hearing loss. High blood sugar damages small blood vessels throughout the body, including the delicate vessels in the inner ear. The CDC recommends getting your hearing tested when you’re first diagnosed with diabetes and then every year after that, treating it as a routine part of diabetes care alongside eye exams and foot checks.
Cardiovascular disease, high blood pressure, and other conditions that affect blood flow can also impair hearing over time. If you have any of these, bring up hearing with your doctor even if you haven’t noticed obvious changes. The inner ear is especially sensitive to circulation problems, and subtle losses can go undetected without formal testing.
Medications That Can Affect Hearing
Certain medications are known to damage hearing, sometimes permanently. The highest-risk categories include platinum-based chemotherapy drugs and a class of antibiotics called aminoglycosides, both of which can cause permanent hearing loss. Loop diuretics (used for heart failure and high blood pressure), some antimalarial drugs, and high-dose aspirin can also affect hearing, though the damage is often reversible once the medication is stopped.
If you’re starting treatment with any of these, you should have a hearing test before your first dose to establish a baseline. During treatment, monitoring schedules vary. Chemotherapy patients may need testing before every infusion or every few infusions, while patients on aminoglycoside antibiotics are typically tested weekly or biweekly. After treatment ends, follow-up testing is recommended within a month and then every three months for the first year, since some hearing damage can appear or worsen after the last dose.
Hearing Checks for Babies and Children
About 98% of newborns in the U.S. now have their hearing screened before leaving the hospital. If your baby wasn’t tested, the screening should happen before they’re one month old. Babies who don’t pass the initial screening need a follow-up evaluation with a pediatric audiologist by two to three months of age. If hearing loss is confirmed, intervention should begin between three and six months, a window that’s critical for language development.
Even after a baby passes the newborn screening, hearing can change during childhood. Ear infections, certain genetic conditions, and illnesses like meningitis can all cause hearing loss after birth. If your child seems unresponsive to sounds, is slow to develop speech, or has risk factors for childhood hearing loss, ask their pediatrician for a referral to an audiologist rather than waiting for school-based screenings.
What Medicare Covers
Medicare Part B covers diagnostic hearing exams when a doctor orders them to determine whether you need medical treatment. If you have symptoms like hearing loss, tinnitus, or balance problems, a diagnostic exam is generally covered. You can also visit an audiologist once every 12 months without a referral for non-acute hearing conditions or for diagnostic services related to hearing loss treated with surgically implanted devices.
Original Medicare does not cover routine hearing screenings, hearing aids, or exams specifically for fitting hearing aids. Some Medicare Advantage plans offer broader hearing benefits, so it’s worth checking your specific plan if you’re considering a test and aren’t sure about costs.