Does insurance cover hearing aids?
48 million Americans (20% of the adult U.S. population) are living with some form of hearing loss. However, according to the National Institute on Deafness and Other Communication Disorders (NIDCD), one in five people with a hearing loss actually wear hearing aids. So what is preventing people from getting the help they need? The price of hearing aids.
This is understandable, considering hearing aid prices range from $799 for a basic model to $3,100 for a premium device. This in mind, one is left asking: Does health insurance cover hearing aids? This is not an easy question to answer. As you may already know, navigating through the fine-print details of our current health insurance plans is not easy. 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 of the issues associated with health insurance and hearing aids is the lack of private insurance coverage. Currently, 22 states require insurance companies to provide full or partial hearing aid coverage for children. Only three states – Arkansas, New Hampshire, and Rhode Island – require coverage for adults. Insurance plans might cover the costs of hearing screenings, hearing tests, and hearing aids, but this all depends on your individual plan and your respective state’s healthcare policies. For instance, a plan might pay anywhere from $200 to the full amount toward the entire purchase of a pair (or just one) 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 provider to determine if you qualify for a hearing aid benefit.
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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 covers a portion the costs 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 people who are 21 and younger. However, this coverage is no longer applicable for individuals who are over the age of 21.
Unfortunately, Medicare does not cover the costs of hearing aids and most hearing tests. However, if you have a Medicare Advantage Plan, other options might be available to you.
Affordable Care Act (ACA)
According to the Hearing Loss Association of America (HLAA), “Twenty-two states include some coverage for hearing aids and related services, of which 18 are included as state required benefits. The ‘benchmark plans’ for each state covering hearing aids specify the minimum requirements for the qualified health plans that might be offered on the exchange in that state.” Moreover, “‘Hearing aids’ are listed as standard health benefit number 36 on HHS’s [Department of Health and Human Services] benchmark plan format for each state.
HHS appears to recognize that coverage for hearing aids should be considered a standard component of health insurance plans.” In other words, under the ACA’s (or Obamacare) essential health benefits provision, you might qualify for some coverage on hearing loss, appointment fees, hearing tests, and hearing aids, but it depends on your respective state’s benchmark plans.
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Alternative hearing aid coverage options
There are other hearing aid coverage options available if you do not qualify for a hearing aid benefit through your private or public insurance provider. Some of these options include:
- The Department of Veterans Affair
- Federal Employee Benefit Health Program
- Workers Unions
Does your health insurance cover hearing aids?
For most of us, health insurance is a lifeline, and without it, medical assistance may sometimes be out of the question. To make matters worse, finding out if your plan provides coverage for hearing aids can sometimes be confusing. However, at hear.com, we have experienced hearing aid consultants who can help you with all of your health insurance-related questions. Prior to scheduling your appointment with a local audiologist, we will contact your insurance provider to check if you have a hearing aid benefit.
It would only take 10 minutes or less to check your benefits. Once your insurance provider informs us of your benefits, we will pass this information along to you and discuss what your next step should be. If you do not have insurance coverage for hearing aids – whether private or public – we will discuss with you different financing options that can help you pay for your hearing aids.