Hearing Loss After 50: Signs, Testing, Hearing Aids and What Medicare Covers

Do people seem to mumble more than they used to? Is the TV volume a running debate in your home? Hearing changes are very common, and they usually happen so slowly that we’re the last to notice.

The good news is that help is easier to get than ever. This guide walks through the signs, getting tested, your hearing aid choices and what Medicare covers.

How Common Is Hearing Loss?

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), part of the National Institutes of Health:

About 1 in 3 people ages 65 to 74 has hearing loss.
Nearly half of people over 75 have trouble hearing.

Age-related hearing loss usually affects both ears and comes on gradually. That’s why many people don’t realize how much they’re missing.

Why It’s Worth Paying Attention To

Hearing well helps you stay safe and catch what your doctor tells you. NIDCD notes that when it’s hard to enjoy talking with family and friends, hearing loss can lead to feelings of isolation. Taking care of your hearing helps you stay connected and involved.

Signs You Might Have Hearing Loss

NIDCD offers a short self-check. It asks whether a hearing problem:

Makes it hard to listen to the TV or radio
Makes parties or visits with friends, relatives or neighbors harder
Leaves you frustrated when talking with family
Makes you feel left out in a group, or leads you to avoid groups
Makes you visit people less often than you’d like
Limits your personal or social life

NIDCD says that answering “yes” to two or more of its questions, or “sometimes” to three or more, is a reason to get your hearing checked. Family members often notice first, so it’s worth listening if they mention it.

What Causes It?

NIDCD lists several causes and risk factors, including:

Natural changes in the inner ear, middle ear and nerve pathways as we age
Years of exposure to loud noise
Health conditions such as high blood pressure and diabetes
Certain medicines that can harm the ear’s sensory cells
Genes that make some people more likely to lose hearing as they age

Scientists don’t yet know how to prevent age-related hearing loss, but you can protect against noise damage. Turn the volume down, limit time around loud sounds and wear earplugs or earmuffs when using loud tools like lawn mowers or leaf blowers.

Getting Your Hearing Checked

Your first stop can be your primary care doctor. NIDCD lists three kinds of hearing professionals:

Primary care doctor: can do a basic check and refer you
Otolaryngologist (ENT): a doctor who specializes in ear, nose and throat conditions
Audiologist: a hearing specialist who tests hearing and helps with hearing aids and other devices

See a Doctor First If You Have These Warning Signs

The Food and Drug Administration (FDA) says to see a doctor, preferably an ENT, before trying an over-the-counter hearing aid if you have:

Ear pain or discomfort
Fluid or blood coming from your ear in the past 6 months
A sudden change in your hearing in the past 6 months
Dizziness or vertigo
Ringing or buzzing in only one ear

Your Hearing Aid Options

Over-the-Counter (OTC) Hearing Aids

In 2022, the FDA created a category of hearing aids you can buy without a prescription or exam. According to the FDA:

They’re for adults 18 and older with “perceived mild to moderate” hearing loss. In plain terms, you notice some trouble hearing, but you can still follow most conversations.
You can buy them in stores or online.
The outside of the box must say “OTC” and “hearing aid,” show whether the device is new or used and say whether you need a phone or remote to control it.
The FDA doesn’t require a warranty, so check the return or warranty period before you buy. That gives you time to try the hearing aids at home, in a restaurant and on the phone.

Prescription Hearing Aids

If your hearing loss is more serious, if OTC hearing aids don’t help or if loud sounds bother you, NIDCD suggests seeing a hearing professional. They can test your hearing, recommend and fit prescription hearing aids and adjust them over time.

Other Helpful Tools

NIDCD also mentions:

Assistive listening devices: such as phone amplifiers, smartphone or tablet apps and “hearing loop” systems in some theaters and places of worship
Cochlear implants: surgically implanted devices for people with severe hearing loss or profound deafness

Your smartphone may help too. Both iPhone and Android phones have built-in settings for hearing aids, captions and sound. A family member or a library tech class can help you find them.

What Medicare Covers (and Doesn’t)

As of October 2026, here’s what Medicare.gov says:

Hearing aids: Original Medicare doesn’t cover hearing aids or the exams to fit them. You pay all costs.
Diagnostic hearing and balance exams: Medicare Part B covers these when your doctor or other health care provider orders them. After you meet the Part B deductible, you generally pay 20% of the Medicare-approved amount.
Audiologist visits: You can see an audiologist once every 12 months without a doctor’s order for certain non-urgent hearing problems, such as gradual hearing loss.
Medicare Advantage: Some Medicare Advantage (Part C) plans offer extra hearing benefits that Original Medicare doesn’t. Contact the plan to find out what it covers.

Medicare Open Enrollment runs October 15 to December 7. If hearing coverage matters to you, it’s a good time to compare plans. A free SHIP counselor (find yours at shiphelp.org) can help you compare without a sales pitch.

A word of caution: be wary of unexpected calls or mailers offering “free” hearing aids in exchange for your Medicare number. Only share your Medicare number with doctors, pharmacies and plans you trust.

Tips for Easier Conversations

NIDCD suggests a few simple habits that help, whether or not you wear hearing aids:

Let friends and family know which situations are hard for you.
Ask people to face you, speak clearly and slow down a little.
Ask them to speak a bit louder, but not to shout.
Turn off the TV or radio when you’re talking.
In restaurants, ask for a quiet table, such as a booth away from the kitchen or music.

If You’re Helping a Loved One

Hearing can be a touchy subject. A gentle approach usually goes further than pointing out every missed word.

Pick a quiet, relaxed moment to bring it up, not the middle of a frustrating conversation.
Talk about what you’ve both noticed, such as phone calls getting harder, rather than labeling the problem.
Offer to go along to the appointment or to help compare hearing aid return policies.
Be patient with new hearing aids. It can take time to get used to them and to have them adjusted.

Simple Next Steps

Take the self-check above, or ask a family member what they’ve noticed.
Mention your hearing at your next checkup and ask whether a hearing test makes sense.
If you have any of the FDA warning signs, see a doctor before buying a hearing aid.
If you choose OTC hearing aids, check the return period and test them in your everyday life.
During Open Enrollment, check what hearing benefits your plan options offer.

This article is general information, not medical advice. Talk to your doctor or pharmacist about your own health.