Hearing and vision checks after 50 and 65

If you notice a change in your hearing or eyesight, these statements do not apply to you. Tell your doctor. For eye pain, an eye injury, an eye infection, or sudden floaters or flashes of light, the American Academy of Ophthalmology says to call an ophthalmologist. (USPSTF, 2021) (USPSTF, 2022) (AAO)

Hearing and vision checks by age

Hearing and vision checks by age: USPSTF, American Academy of Ophthalmology and Medicare
Check	USPSTF	Other advice	Medicare
Hearing, 50 and older	I (2021)	ASHA: consider regular checks, especially with noise exposure or new concerns	Diagnostic exam if your doctor orders it; no hearing aids
Vision, under 40 with healthy eyes	No statement	AAO: a complete eye exam every 5 to 10 years	Routine eye exams not covered
Vision, 65 and older	I (2022)	AAO: every year or two	Simple vision test in the Welcome visit; routine eye exams not covered
Glaucoma, 40 and older	I (2022)	AAO: checked at eye exams every year or two from 65	Every 12 months if at high risk
Diabetes	Outside these statements	AAO: ask your ophthalmologist how often	Diabetic eye exam every year

Sources: (USPSTF, 2021) (USPSTF, 2022) (USPSTF, 2022) (ASHA) (AAO) (Medicare.gov) (Medicare.gov) (Medicare.gov) (Medicare.gov) (Medicare.gov)

Hearing: what the USPSTF found

The statement covers adults 50 and older with age-related hearing loss who have not noticed any problem. It does not cover sudden hearing loss, hearing loss from recent noise, hearing loss present from birth, or anyone with signs of hearing loss. (USPSTF, 2021)

Checks a clinician can use include a single question ("Do you have difficulty with your hearing?"), a short questionnaire, the whispered voice test, or a handheld screening device; a hearing test by audiometry confirms a positive result. The USPSTF says the harms of screening are likely small, but early hearing aid use for mild loss has not been shown to help, and many people offered hearing aids do not use them. (USPSTF, 2021)

ASHA describes a full hearing evaluation by an audiologist as a more in-depth test that finds whether you have hearing loss, what type, and what may cause it. (ASHA)

Vision: what the USPSTF found

The statement covers adults 65 and older seen in primary care who have no known vision problem and are not seeking care for one. It does not cover vision loss from another condition, such as diabetic eye disease. (USPSTF, 2022)

Common causes of poor eyesight with age are refractive errors (needing glasses), cataracts and age-related macular degeneration. Glasses and cataract surgery work well once a problem is found. The USPSTF found that the quick eye-chart tests used in primary care miss many problems compared with a complete eye exam, and that screening questions were not accurate. (USPSTF, 2022)

Glaucoma has its own statement: for adults 40 and older, the evidence is also insufficient (I, 2022). (USPSTF, 2022)

Where eye doctors differ

The American Academy of Ophthalmology advises a complete eye exam every 5 to 10 years under 40 if your eyes are healthy, every year or two from 65, and an earlier exam for people with diabetes, high blood pressure or a family history of eye disease. Wearing contact lenses calls for a yearly visit. (AAO)

The USPSTF statement is about a quick check by a primary care clinician, not about seeing an eye doctor. Ask your doctor or eye doctor which schedule fits you. (USPSTF, 2022)

What Medicare covers

The one-time "Welcome to Medicare" visit, in your first 12 months with Part B, includes a simple vision test. (Medicare.gov)
Routine eye exams for glasses or contact lenses are not covered by Original Medicare. (Medicare.gov)
A diabetic eye exam once a year if you have diabetes, and a glaucoma test every 12 months if you are at high risk (diabetes, a family history of glaucoma, African American and 50 or older, or Hispanic and 65 or older). You pay 20% after the Part B deductible. (Medicare.gov) (Medicare.gov)
Diagnostic hearing and balance exams when your doctor orders them; you pay 20% after the deductible. Hearing aids and fitting exams are not covered. (Medicare.gov) (Medicare.gov)
Some Medicare Advantage plans offer extra vision and hearing benefits; ask the plan. (Medicare.gov) (Medicare.gov)

Questions people ask

At what age should you get your hearing checked?

The USPSTF sets no age for adults who have not noticed a problem. In 2021 it found the evidence insufficient to weigh screening adults 50 and older (I statement). ASHA suggests adults consider regular hearing checks, especially with loud noise exposure, new hearing concerns or health conditions linked to hearing loss. If you notice trouble hearing, tell your doctor. (USPSTF, 2021) (ASHA)

How often should you have an eye exam after 60?

The American Academy of Ophthalmology advises an eye check every year or two from 65, and sooner for people with diabetes, high blood pressure or a family history of eye disease. The USPSTF found the evidence insufficient on vision screening in primary care at 65 and older; that is about a quick check at the doctor's office, not about seeing an eye doctor. (AAO) (USPSTF, 2022)

Does Medicare pay for a hearing test?

Part B covers a diagnostic hearing and balance exam when your doctor orders it to see if you need medical treatment; you pay 20% after the deductible. Original Medicare does not cover hearing aids or exams for fitting them. Some Medicare Advantage plans offer extra hearing benefits. (Medicare.gov) (Medicare.gov)

Does Medicare cover a yearly eye exam?

Not a routine one for glasses or contacts. Part B covers a yearly eye exam for diabetic retinopathy if you have diabetes, and a glaucoma test every 12 months if you are at high risk. The one-time "Welcome to Medicare" visit includes a simple vision test. (Medicare.gov) (Medicare.gov) (Medicare.gov) (Medicare.gov)

Is an I statement the same as "do not screen"?

No. The USPSTF says an I statement means the evidence is insufficient to weigh benefits and harms. It is neither a recommendation for nor against screening; the decision is up to you and your clinician. (USPSTF grade definitions) (USPSTF, 2021)

Hearing and vision checks for older adults