Does Medicare Cover Ear Wax Removal? 

Earwax may not be the most pleasant thing to deal with in life, but it is actually a vital part of keeping your ears healthy. Cerumen is the medical terminology used for the waxy substance produced in the ear canal. Everyone’s ears produce cerumen, and along with hair follicles in the ear canal, cerumen helps to trap and remove debris that ends up in the ear.

In most cases, ear wax is produced at low enough rates that it is hard to notice. Although many people use cotton swabs to try to remove ear wax, this is usually unnecessary and can even be harmful. Impacted ear wax can end up blocking the ear canal and even lead to the potential for infection. If an ear becomes blocked with wax, medical removal may be necessary.

How is ear wax removed?

Medical removal of ear wax is usually accomplished in one of three ways. First, your doctor may use medical instruments to manually remove the ear wax. Small hand tools with curved ends can safely get into the ear canal to pull excess wax out. Next, suction tools may be used to gently loosen and remove excess ear wax. Finally, liquids and syringes may be used to dissolve or flush out excess ear wax.

Some people also rely on ear candling. This is a procedure that involves inserting a cone-shaped candle into the ear canal. The end of the cone that sticks out is lit on fire, and this is supposed to create gentle suction. While some people swear by this method, the science on the subject is dubious at best.

Over-the-counter products are also available to treat ear wax. These include suction products as well as chemicals designed to loosen ear wax.

How does Medicare cover ear wax removal?

In terms of Medicare coverage for ear wax removal, Medicare will cover the cost of medical treatment as long as the treatment is deemed medically necessary. Medicare benefits can only be used for treatments and prescriptions that are ordered by a Medicare-participating physician.

As long as your doctor or specialist believes that treating your ear wax is medically necessary, Medicare benefits will usually apply. In general, Medicare benefits do not apply toward the cost of a routine ear cleaning and will only be considered valid if there is a medical reason to remove excess wax.

Medical ear wax removal in a hospital

For ear wax removal that takes place in a doctor’s office or clinical setting, Medicare Part B usually supplies benefits. This is the outpatient portion of Original Medicare. Ear wax treatment and removal that takes place while Medicare recipients are admitted to a hospital or skilled nursing facility is usually covered by Medicare Part A.

Part A is inpatient coverage, and it can be used for up to 60 days in a benefit period. After 60 days, Medicare recipients can continue to receive a portion of the regular coverage, meaning you will pay a per-day fee instead of receiving 100% coverage. From day 90 onward, lifetime reserve days can be utilized to continue coverage.

Does Medicare cover over-the-counter ear wax removal products?

If you purchase over-the-counter (OTC) ear wax removal products, Medicare coverage does not apply. Although your Original Medicare coverage may pay for prescription medications to aid in ear wax issues through Medicare Part D, the prescription drug benefit, the program does not cover OTC products. However, a Medicare Advantage plan may provide additional benefits toward the purchase of select OTC products. If you’re enrolled in Medicare Advantage, check your plan for more details.