Insurance coverage for hearing aids
Does insurance cover hearing aids?
48 million Americans live with some form of hearing loss. However, according to the National Institute on Deafness and Other Communication Disorders (NIDCD), only 1 in 5 people with hearing loss wear hearing aids. What prevents people with hearing loss from getting the help they need? Unfortunately, it typically comes down to price.
This is understandable, considering hearing aid prices range from $1,599 for a pair of basic devices to $6,499 for a pair of premium hearing aids. Because of this, we get asked one question constantly: does health insurance cover hearing aids? This is not an easy question to answer, as coverage varies by an individual’s insurance plan. Nonetheless, this highly important topic deserves careful attention. Therefore, this page covers some of the most relevant topics related to hearing aids and health insurance.
Private health insurance and hearing aids
One issue associated with health insurance and hearing aids is the lack of private insurance coverage for them. Currently, only 22 states require insurance companies to provide full or partial hearing aid coverage for children. And only five states – Arkansas, Connecticut, Illinois, New Hampshire, and Rhode Island – require hearing aid coverage for adults. Insurance may cover the costs of hearing screenings, tests, and hearing aids, but that all depends on your individual plan and your respective state’s healthcare policies. For example, your plan might pay anywhere from $200 to the full amount toward the entire purchase of a pair of hearing aids.
Another option some health insurance providers offer is an allowance, which is a specified amount that is deducted from the total price of the hearing aids. Some plans also offer negotiated discounts with contracted providers. In general, some private health insurance companies might cover some of the costs of hearing aids, but you should always check with your healthcare provider to determine if your plan qualifies you for these benefits.
Public health insurance and hearing aids
Government health care programs might provide some coverage for hearing aids. However, government assistance for hearing loss is very limited, and coverage for appointments, hearing tests, and hearing aids varies from state to state. You may be responsible for additional fees or copays under certain plans. The three most relevant insurance programs are Medicaid, Medicare, and the Affordable Care Act (ACA).
Medicaid often provides coverage for a portion of the cost of hearing aids, but this coverage varies from state to state. Medicaid is required to pay for hearing screenings and other hearing related tests for those who are 21 and younger. However, this coverage is no longer applicable for individuals who are over the age of 21.
Medicare does not cover the costs of hearing aids, however, if a PCP Referral is provided to the audiologist, Medicare will cover the cost of your hearing tests. Additionally, if you have a Medicare Advantage Plan, other options might be available to you.