When Does Medicare Cover Ear Cleaning?

Earwax is essential to the health of your ears. By lubricating the ear canal, wax makes it less likely that dirt will become trapped in your ear and inhibits the growth of bacteria that give rise to infections. When you bathe, you wash away small amounts of earwax, but sometimes, routine cleaning isn't enough to control buildup. Accumulated wax can become impacted, triggering unpleasant symptoms and hearing problems. A doctor can usually safely remove earwax during a simple in-office procedure. Medicare may cover earwax removal under certain circumstances.

When Does Medicare Cover Ear Cleaning?

Medicare plans generally don't cover routine ear cleaning. However, if earwax buildup becomes severe, plans may help pay for removal.

Does Medicare Cover Ear Wax Removal?

In many cases, Medicare will pay for ear wax removal procedures. To be eligible for coverage, the following statements must be true:

• You're experiencing pain, pressure or hearing problems due to earwax impaction.
• Your doctor can't use ear drops, cotton swabs or a removal tool called a cerumen spoon to remove the impacted wax.
• You receive treatment from a doctor or other highly trained medical professional who accepts Medicare.
• You've satisfied your plan’s deductible.
• You're up to date on your monthly premium payments.

In addition, Medicare may pay for earwax removal if:

• Your doctor needs to remove the wax to examine your ear to diagnose an illness or disease.
• An audiologist must remove earwax to administer a hearing test.

How Do Medical Professionals Clean Your Ears?

Doctors can choose from a variety of ear-cleaning methods, such as:

• Ear drops work by softening wax. Because ear drops are simple to use and noninvasive, doctors often choose drops as the first treatment for earwax impaction. Your doctor may also administer ear drops before performing another ear cleaning method to simplify wax removal.
• Irrigation involves flushing your ear canal with water delivered by a pump. The pressurized liquid helps to loosen and rinse out wax buildup.
• Vacuum extraction is a procedure that involves suctioning out wax using a small vacuum device.
• Lancet or spoon extraction is manual earwax removal. To perform the procedure, your doctor uses a small metal tool to gently remove earwax. Sometimes, medical professionals use a lancet or spoon to remove any wax that remains after irrigation or vacuum extraction.

All four procedures are generally performed in a doctor's office. After ear cleaning, you may be given prescription ear drops to use daily to minimize future buildup.

What Part of Medicare Covers Ear Cleaning?

Coverage for ear cleaning varies based on the type of Medicare Plan you have.

• Medicare Part B only covers ear irrigation for earwax removal. If your doctor believes another ear-cleaning technique is a better option, the service is unlikely to be covered. Under Medicare Part B, your plan pays for 80% of the cost of covered services and you're responsible for paying the remaining 20%.
• Medicare Part C or a Medicare Advantage Plan must cover at least as much as Original Medicare, meaning that ear irrigation is likely to be covered by your plan. Depending on the terms of your plan, your insurance provider may also help pay for other ear cleaning techniques not covered by Medicare Part B. With Medicare Part C, you'll usually pay a copay or coinsurance for ear cleaning.
• Medicare Part D may cover prescription ear drops used for ear cleaning. In addition, your plan may help pay for the cost of ear drops prescribed following an ear-cleaning procedure. Some plans also provide coverage for certain over-the-counter medications. If your plan includes this benefit, you may be able to get reimbursed for the cost of at-home ear-cleaning drops. You'll usually have to pay a copay or coinsurance for covered drugs under Medicare Part D.
• Medigap or a Medicare Supplement plan may help to pay for all or some of the 20% coinsurance that you're responsible for under Medicare Part B.

What Should I Look for in a Medicare Plan
If I Need Frequent Ear Cleaning?

If you frequently need ear cleaning, a Medicare Advantage Plan may be better for your needs than Original Medicare. Choosing a Medicare Part C plan that covers more than one ear-cleaning service will give your doctor the flexibility to choose the procedure that is the right fit for your specific needs.

When shopping for Medicare Part D, look for plans that include over-the-counter drug coverage and confirm that the prescription ear drops your doctor recommends are covered under the insurers' formularies.

How Much Does It Cost to Have My Ears Cleaned?

For 2024, the Medicare Physician Fee Schedule allows medical practitioners to bill Medicare approximately $12 to $23 for earwax removal. Under Medicare Part B, you would expect to pay roughly $10 to $19 out of pocket. The actual cost of ear cleaning depends on where you live and how complicated the irrigation process is.

Under Medicare Part C, the cost of ear cleaning depends on your plan's copay and coinsurance policy.

How Do You Know When You Need Earwax Removal?

Signs of earwax impaction include:

• Balance problems
• Coughing
• Diminished hearing
• Dizziness
• Ear pain
• Persistent itching
• Ringing in your ears
• Sensation of pressure or fullness in your ears
• Spots of blood in your earwax

Other medical conditions can cause similar symptoms, making it important that you see a doctor for a diagnosis.

Why Is Ear Cleaning Important?

Unpleasant symptoms aren't the only danger of earwax impaction. Left untreated, earwax buildup can make you more prone to ear infections. Severe impaction may also result in damage to the structure of your ear.

Can I Safely Clean My Ears at Home?

Experts caution not to try and clean your own ears with your fingers, cotton swabs and manual wax removal tools. When performed incorrectly, manual earwax removal could result in wax moving further up into the ear canal. This worsens blockages rather than addressing them. Plus, manual wax removal could cause injury to your eardrum or ear canal.

Ear candles are also considered dangerous because they pose a risk for burns and might irritate your ear canal.

Over-the-counter ear drops are a safe option for at-home ear cleaning. Your doctor may also recommend that you flush your ears with one of the following:

• A solution of baking soda and water
• Hydrogen peroxide 3%
• Oils like baby oil, glycerin or mineral oil
• Warm water