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Does Health Insurance Cover Hearing Aids?

March 12, 2016 By Rob Schwab Leave a Comment

No one is left untouched by the effects of aging. In this era of scientific progress, we’ve found many ways to stave off the ravages of age. Most people know that preventive options like wearing sunblock, eating right, and exercising can keep us looking and feeling young and healthy much longer.

In addition, modern medicine provides us with cures (or at least treatments) for common side effects of aging. If all else fails we can laser our eyes, replace failing joints and internal organs, and get cosmetic lifts and tucks. Plus, people are living longer than ever before.

The only negative, of course, is the cost of caring for ourselves as we exceed life expectancy and thrive into our 80s, 90s, and 100s. One common complaint is hearing loss as we age, and while there is a solution thanks to hearing aids, these products do not come cheap.

So you may want to know: does health insurance cover hearing aids? As is often the case when it comes to the wide range of health plans available, the answer is maybe.

Obamacare
The Affordable Care Act (ACA), or Obamacare, has a set of rules relating to minimum essential coverage. The Department of Health and Human Services (HHS), under which Obamacare operates, created a benchmark plan format for state exchanges that included hearing aids and related services (audiologist visits, hearing tests, etc.) as part of minimum requirements.

In 2013, 22 states elected to include some coverage for hearing services, including hearing aids, while 18 of those states made hearing aids and hearing related services part of their minimum required benefits. As it currently stands, only three states mandate full or partial coverage of hearing aids for adults (while 22 provide services for children) as part of mandatory essential coverage. New Hampshire requires benefits every five years while Arkansas and Rhode Island take the cake with benefits every three years for adults who need hearing aids.

2016 is the year when HHS is supposed to reconsider the benchmark plan and potentially expand minimum essential coverage requirements for all states, possibly including hearing aids and related services in all future policies.

Medicare and Medicaid
Incredibly, most Medicare policies do not include coverage for hearing aids and related services. With hearing loss a common problem for people over the age of 65, it seems odd that this coverage is excluded, but it turns out that only certain plans provide coverage for hearing aids and related services.

Medicare Part B provides coverage only for diagnostic and hearing balance exams ordered by a doctor. It does not cover standard hearing exams or hearing aids. If you have the Medicare Advantage Plan (Medicare Part C) it is possible that you could gain additional benefits.

As for coverage under Medicaid, it will depend on your state of residence. Coverage for hearing aids and related services varies by state. The Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program in Medicaid provides coverage for children up to the age of 21 and includes hearing related screening, diagnosis, and treatment, as well as hearing aids and accessories.

Other Options
Private insurance policies may or may not cover hearing aids and related services, so you’ll have to do some research if you want a policy that provides such benefits. Insurance through Kaiser Permanente, for example, includes some hearing aid benefits. Qualifying parties may also seek assistance through Veterans Affairs.

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