Original Medicare Parts A and B do not cover hearing aids or routine hearing exams. However, Medicare Part B may cover diagnostic hearing and balance exams when medically necessary and ordered by a physician. Medicare Advantage (Part C) plans often include hearing aid benefits — coverage varies by plan. We check your specific plan before your appointment.

A pre-authorization (pre-auth) is your insurance carrier's approval for a service before it's performed. For hearing aids, most commercial carriers require pre-auth using HCPCS codes V5011–V5267. Our team submits the request with supporting clinical documentation. 94% of requests are approved within 48 hours — we track every submission and escalate delays.

Same-day appeal. Our billing team reviews the denial reason code, prepares a clinical appeal letter, and resubmits with additional documentation. Common denial reasons — missing prior auth, wrong modifier, out-of-network — are each handled with a specific resolution protocol. You'll receive a plain-language update within 24 hours.

The AB modifier tells Medicare that an audiologist is performing a service that would otherwise require a physician order, under direct-access rules. Using the wrong modifier — or omitting it — is the #1 cause of Medicare audiology claim denials. Our billing team applies the correct modifier on every claim.

Generally, no. OTC hearing aids (FDA-regulated since 2022, averaging $200–$1,000) are not covered by most insurance plans. Prescription hearing aids fitted by a licensed audiologist are more likely to qualify for insurance benefits. We'll tell you exactly what your plan covers before you commit to anything.

Yes. Veterans who qualify for VA healthcare may receive hearing aids at no cost through the VA system — this is separate from any private insurance. We work with VA-eligible patients and can help coordinate with your VA provider. Please mention your veteran status when you fill out the coverage check form.