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A State-by-State Guide for Hearing Aid Insurance

If you live in the United States, it can be hard to know what insurance options are available to support the cost of hearing aids.

Does insurance cover hearing aids? Can I finance my hearing aids? These are common questions asked by people who are looking to purchase hearing aids.

Hearing Aid Insurance Coverage by State

Hearing aids and cochlear implant insurance coverage varies from state to state. Each state has its own mandates on coverage, but even some insurance plans are exempt from these mandates. No matter what state you live in, it’s advised that you contact your plan administrator to see if your plan incorporates state-mandated hearing aid or cochlear implant insurance benefits.

It’s advised that you contact your plan administrator to see if your plan incorporates state-mandated hearing aid or cochlear implant insurance benefits.

Colorado, Delaware, Georgia, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Missouri, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Tennessee, and Texas all require that insurance health benefits plans pay for hearing aids for children. Wisconsin, on the other hand, necessitates coverage for hearing aids and cochlear implants for children. Arkansas, Connecticut, Illinois, New Hampshire, and Rhode Island require hearing aid coverage for both children and adults.

Requirements differ from one state to another for ages covered, amount of coverage, benefit timeline, and provider qualifications. More specific details on the laws from the aforementioned states are listed below. As always, please remember that laws, policies, and regulations may change, so check with your state for the most recent information.

Arkansas

Insurance companies must offer coverage to employers. If the employer wishes to add this option, the plan must accommodate hearing aid coverage of no less than $1400 per ear every three years for people of all ages.

Colorado

Insurance companies are required to provide hearing aid coverage for children under the age of 18 when medically necessary. Coverage has to include a new hearing aid every five years and when alterations to the existing hearing aid do not meet the needs of the child as well as services and supplies (i.e. initial assessment, fitting, adjustments, and auditory training).

Connecticut

Individual and group health insurance plans must provide hearing aid coverage for children 12 years or younger. Hearing aids are classified as durable medical equipment, and policies are allowed to limit the benefit to only $1000 every two years. Thanks to the Affordable Care Act’s prohibition on discriminatory benefit design based on age, the Connecticut Insurance Department has required that insurance plans issued or renewed after January 1, 2016 remove age limits on hearing aid benefits.

Delaware

Individual and group health insurance contracts are required to provide coverage for hearing aids to children under 24 years old covered as a dependent by the policyholder for up to $1000 per ear, every 3 years.

Georgia

Health benefit policies need to provide coverage up to $3000 per year every 48 months for covered individuals 18 years old and younger.

Illinois

Insurers are required to implement coverage for ALL insured individuals, subject to applicable co-payments, co-insurance, deductibles, and out-of-pocket limits, for hearing aids once every 12 months except when there is a major change in the insured’s hearing condition.

Kentucky

Plans must provide coverage for the complete cost of one hearing aid per ear up to $1400 per aid for 36 months for persons under 18 as needed. Additionally, all related services necessary to assess, select and fit the hearing aid must be covered. The insured individual may choose a higher-priced hearing aid at which point they are responsible for covering the difference in cost. Regardless, the hearing aid must be prescribed by a licensed audiologist and fitted by the audiologist or hearing instrument specialist.

Louisiana

Individual and group companies must cover hearing aids for children under the age of 18 if the hearing aids are fitted and dispensed by a licensed audiologist/hearing aid specialist following medical clearance by a licensed physician and an audiological evaluation appropriate to the age of the child. The insurer is allowed to limit the benefit to $1400 per hearing aid for each ear every 36 months. Should the insured wish to pay for a hearing aid priced higher than the benefit coverage, they are welcome to pay the difference to the hearing aid provider directly.

Similar rules apply to those 18 and over. The insured is allowed the option to choose a hearing aid priced higher than the benefit payable, and he or she must cover the difference.

Maine

Policies are required to include coverage for hearing aids for children up to 18 years of age. Coverage may be restricted to $1400 per hearing aid every 36 months.

Maryland

Insurance companies are required to provide coverage for hearing aids to a minor child as long as they are prescribed, fitted, and dispensed by a licensed audiologist. Coverage may be restricted to $1400 per aid per ear every 36 months. The insured may choose a hearing aid that costs more than $1400 and pay the difference.

Massachusetts

Specific health coverage plans are required to provide coverage for the full cost up to $2000 for one hearing aid per ear to anyone 21 and under every 36 months, contingent on a written declaration from the minor’s treating physician stating that hearing aids are medically needed. The insured is allowed to pick a hearing aid of a higher cost and pay the difference without a financial or contractual penalty. (Mass. Gen. Laws: ch. 32A § 23, ch. 175 § 47U, ch. 176A, § 8U , ch. 176B, § 4U, ch. 176G, § 4N)

Minnesota

Insurance plans must cover hearing aids for children under 18 when hearing loss is not correctable by other covered procedures. This is limited to one hearing aid per ear every three years.

Missouri

Health insurance and Medicaid are required to provide coverage for infant hearing screening, re-screening when necessary, audiological assessment and follow-up, and initial amplification (including hearing aids).

New Hampshire

As of January 1, 2011, insurers must cover the cost of no less than $1500 per hearing aid every 60 months. The insured may choose a higher-priced hearing aid if they wish and pay the difference.

New Jersey

Health insurers, State Health Benefits Program and NJ FamilyCare are required to provide coverage for medically necessary expenses related to the purchase of hearing aids for insured children 15 and under. This includes $1000 per hearing aid per ear every two years when medically prescribed and necessary or advised by a licensed physician or audiologist. He or she may choose a higher-priced hearing aid and cover the difference. (New Jersey Stat. Ann. § 17:48-6gg; § 17:48A-7dd; § 17:48E-35.31; § 17B:26-2.1aa; § 17B:27-46.1gg; § 17B:27A-7.14; § 17B:27a-19.18; § 26:2J-4.32; § 52:14-17.29n; § 30:4J-12.2)

New Mexico

Individual and group insurance plans are required to cover $2200 per hearing aid every three years to children under 18 or under 21 if still attending high school. Fitting and dispensing services, including providing properly fitted ear molds, given by a licensed audiologist, hearing aid dispenser or physician are included in the coverage. Should the insured choose a higher-priced hearing aid, he or she may do so and pay the difference in cost. (New Mexico Stat. Ann.§ 13-7-10; § 59A-22-34.5; § 59A-23-7.8; § 59A-46-38.5; § 59A-47-37.1)

North Carolina

As of January 1, 2011, health plans have been required to provide coverage for one hearing aid per ear up to $2500 every 36 months for covered persons under the age of 22.

Oklahoma

Any group health insurance or benefit plan must provide coverage for children up to 18 years of age. Coverage includes audiological services and hearing aids as prescribed and dispensed by a licensed audiologist. Hearing aid benefit has no dollar limit and is allowable every 48 months. (Oklahoma Stat. tit. 36 § 6060.7)

Oregon

Health benefits plans are required to cover one hearing aid per ear for those covered under 18 or those 18 or older if deemed eligible as a dependent under then plan and presently enrolled in an accredited educational institution. The hearing aids must be prescribed, fitted, and dispensed by a licensed audiologist with the approval of a licensed physician. $4000 every four years is the maximum benefit amount, however, the insured may choose a higher-priced aid and cover the difference. (Oregon Rev. Stat. § 743A.141)

Rhode Island

Individual and group insurance companies must provide coverage up to $1500 per hearing aid every three years to children under 19 and $700 per hearing aid for those over 19. (Rhode Island Gen. Laws § 27-18-60)

Tennessee

Each policy renewed on or after January 1, 2012, has been required to cover $1000 per hearing aid per ear every three years for those insured under the age of 18 whether as a dependent or policyholder. The insured is allowed to purchase a hearing aid priced higher than the benefit limit and pay the difference. (Tennessee Code Ann. § 56-7-2368)

Texas

A health benefit plan must provide coverage for the cost of a medically necessary hearing aid or cochlear implant and associated services and supplies for covered individuals 18 or younger. Coverage is restricted to one hearing aid in each ear every three years and one cochlear implant in each ear with internal replacement as medically or audiologically needed. (Tex. Ins. Code Ann. § 1367.251) [as created by H.B. 490 (2017)]

Wisconsin

Health insurance plans and policies must pay for cochlear implants, hearing aids and related services as prescribed by a physician or audiologist for children under 18. This includes the cost of one hearing aid per ear every three years. (Wisconsin Stat. § 609.86§ 632.895 (16))

Medicaid

Under the EPSDT program, states must provide hearing screening and appropriate diagnostic and treatment services to Medicaid beneficiaries under the age of 21. Such services include hearing aids, hearing aid accessories and related services and must be provided periodically in intervals that meet reasonable medical practice standards.

Medicaid coverage of hearing aids for adults 21 and over varies by state. Luckily, more than half of the 50 states offer some coverage for hearing aids and/or other services such as hearing tests, hearing aid repairs, batteries and accessories.

For a comprehensive state by state breakdown, read more here.

Medicare

By law, Medicare does not include funding for hearing aids or associated services such as hearing exams, fitting of hearing aids, or any other audiological rendered services as incorporated in the Medicare Act. Medicare Part B does, however, cover diagnostic hearing and balance tests when mandated by your doctor.

Hearing aid coverage may be available through a Medicare Advantage plan provided by private insurance companies, depending on the plan selected.

Private Health Insurance

Many private insurance plans specifically exclude the coverage of hearing aids, or coverage may be sold as an optional rider unless mandated by the state. (Andrews, 2012Calderone, 2017b)

For instance, Aetna excludes the coverage of hearing aids from a majority of its benefits plans. These exclusions apply to “air conduction hearing aids, implantable hearing aids and semi-implantable hearing aids”, and covered individuals must meet the criteria for medical necessity under inclusive plans. (Aetna, 2016a)

On the other hand, the Tufts Health Plan list in their policies that “medically necessary audiology evaluations and related services for hearing disorders” and hearing aids are covered for those 21 and younger in Massachusetts and those over 21 in New Hampshire and Rhode Island in accordance with state requirements. (Tufts, 2017a)

Aetna, United Healthcare and some other private insurers do offer lower-cost hearing aids or discounts on hearing aids through partnerships with outside companies.

Hearing aids and veteran affairs

If you are a veteran in the United States, there are options to receive hearing aids. If you are a veteran with the Veteran Health Administration (VHA) benefits, then you are eligible to receive hearing health care. According to the Office of Rehabilitation Services, this can include, visiting an audiologist, hearing screenings, diagnostic hearing evaluations, hearing aid fittings, and aural rehabilitation.

Read more: Phonak Hearing aids for Veterans 

What is the process to get a hearing aid through VA? 

To receive hearing technology from the VA, you have to qualify for VA Health Benefits. After you qualify and enroll, you can receive access to hearing health care benefits, and you will receive a hearing evaluation by a VA audiologist. It is not guaranteed that every veteran will receive hearing aids. You are more likely to receive hearing aids based on other medical conditions and military history, which you can learn more about here.

If you do not qualify, then you may be eligible for disability compensation. You can learn more about eligibility here.

Hearing aids financial assistance

 If insurance isn’t an option for you, there are other financial resources to look into to help with the cost of your hearing aids.

Financing/ Credit

There are a few credit options that can help you pay off your hearing aid costs over a longer period of time. Some options don’t start interest until after 12 months of payments.

Care Credit

 An example of a credit option is Care Credit.

According to Connect Hearing, the CareCredit credit card allows you to pay off your hearing aids in monthly payments. If you pay off your purchase of $200 or more made with a CareCredit credit card within 12 months you won’t be charged any interest.

Wells Fargo

Wells Fargo also has a credit card that allows you to pay over your hearing aids over time. Through their Wells Fargo Health Advantage credit card program, you can pay no interest if you pay in full within six, 12 or 18 months, but this depends on the cost of the purchase.

TruHearing

Truhearing is a company that partners with insurance companies to make hearing aids more affordable for people. They work with your health plan and hearing care professionals find a solution that may help with the cost of hearing aids.

Phonak Freedom Program

Ask your audiologist if they are a part of the Phonak Inner Circle Community. If they are, they may be a part of the Phonak Freedom Program. The Phonak Freedom Program is a subscription program that allows hearing aid users to pay a monthly fixed payment that includes follow up services, a full warranty, loss, stolen and damage coverage. You also are able to upgrade to new hearing aids every three years.

Saving account for healthcare

As you would save money in your bank account, there are special accounts for healthcare savings. A flex spending account (FSA) is set up by an employer and allows an employee to use the money in the account for certain healthcare costs. You don’t pay taxes on the money put into this account and your employer may make a contribution to the account.

You could also put money into a health savings account (HSA). This account allows an individual to save untaxed money that can be used for certain healthcare costs. An employer is not needed to set up this account.

Hearing aid banks and local agencies

Local agencies and companies may receive donations or funds to provide hearing aids to others or sell hearing aids at a reduced rate. You can find a list of resources created by the ASHA here.

What is the cost of untreated hearing loss?

The cost of hearing aids may seem very expensive, but it is also important to recognize the cost of untreated hearing loss. According to a study published in the Hearing Review in 2019, untreated hearing loss costs the United States 133 billion dollars per year. Per individual, this amounts to $9,100 per person with hearing loss.

Not only are there monetary costs, but also negative personal effects from hearing loss. According to ASHA, “hearing loss has been linked to feelings of depression, anxiety, frustration, social isolation, and fatigue.”

Studies show that these effects can be helped by wearing hearing aids. Therefore, hearing aids can be a life-changing investment.

Financial assistance for hearing aid accessories

In addition to financial assistance for hearing aids, many of the same sources might be used for hearing aid accessories as well. If you are a child in school or a student in university, there are more options for hearing aid accessories.

Children with hearing loss

If your child has an Individualized Education Program (IEP) that specifies they need hearing aid accessories, they can receive the accessories at no cost. This is a right protected by the Individuals with Disabilities Education Act (IDEA).

If you are in university you also have a right to the hearing technology that you need. According to the The Americans with Disabilities Act of 1990 – Section 504 of Rehabilitation Act of 1973, “all students with an impairment that limits “one or more major life activities,” is applicable for “appropriate educational services designed to meet the individual needs of such students to the same extent as the needs of students without disabilities are met.”

Read more: This is how to get FREE hearing technology at your university

 

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The HearingLikeMe editorial team includes Jill von Bueren, Kirsten Brackett and Lisa Goldstein.
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The HearingLikeMe editorial team includes Jill von Bueren, Kirsten Brackett and Lisa Goldstein.