Hearing loss is an incredibly common health problem. According to the Centers for Disease Control and Prevention, around 37 million people suffer from hearing loss, and that number is only rising as the population ages. Hearing loss is a frustrating and expensive condition, leading many individuals to spend thousands of dollars on treatment and devices like hearing aids. However, according to many private medical insurance providers, moderate hearing loss isn’t technically considered a disability. That’s just one of the reasons why having hearing aids covered by insurance can be a challenge.
Hearing Aid Coverage
According to the American Speech-Language-Hearing Association (ASHA), 20 states currently require health insurance companies to cover hearing aids for children. Those requirements don’t apply when it comes to adult hearing aid coverage. In some states, private insurance does cover hearing exams, but it typically does not cover hearing aids.
Currently, there are only five states that require insurance companies to provide coverage for hearing aids for both children and adults.
These are seen below:
- New Hampshire
- Rhode Island
So why don’t most insurance providers include coverage for hearing aids? They’re not considered essential medical devices. Instead, they’re deemed “elective” – chosen, rather than urgently necessary.
The Trouble with “Elective” Coverage for Hearing Aids
More than 50 percent of people over the age of 75 suffer from hearing loss, and for these individuals, hearing aids are far from elective. Hearing aids are a lifeline, helping people with hearing loss communicate with loved ones, stay sharp on the job, stay safe in everyday situations, and stave off depression and cognitive issues as they age. They can improve a person’s quality of life, affecting nearly every aspect of their day-to-day routine.
When you consider how dramatically hearing aids can influence a person’s health and happiness, it’s difficult to understand how insurers could say that they’re inessential and not worthy of insurance coverage. Unsurprisingly, the issue extends beyond whether hearing aids are necessary or elective. It’s also about risk vs. reward.
Coverage – Risk vs Reward
Insurance companies work by spreading the cost of health services over a large group of people so that members can pay a reasonable amount and still receive coverage. The insurer profits when individuals pay for coverage without filing claims. Unfortunately, that makes individuals with hearing loss a serious risk for insurance companies. Individuals with hearing loss are very likely to file insurance claims to help pay for hearing aids, which can cost thousands of dollars. Hearing aids also require replacement every five years, which is an additional expense for the insurance provider.
Simply put, insurance companies are less likely to make a profit on high-risk individuals like those with hearing loss. That’s a major reason why they’re less likely to offer coverage for hearing aids. Even if insurance companies do eventually provide coverage for hearing devices, they will have a major impact on the pricing of hearing devices and services, setting lower allowed contractual amounts for what can be billed.
Medicare and Medicaid Coverage for Hearing Aids
We’ve discussed the fact that it’s rare to find hearing aids covered by insurance provided by private lenders, but what about Medicare and Medicaid? In most cases, hearing aids aren’t covered by Medicare, the government health program for individuals ages 65 and up. That’s because Medicare typically covers services, not devices. There are a few Medicare Advantage plans that include hearing aid coverage; however, traditional Medicare doesn’t include any hearing aid coverage whatsoever. In addition, tinnitus (which can sometimes be treated using hearing aids) is not recognized by Medicare as “medically necessary” to treat. It is also a non-covered diagnosis for devices with major insurance companies.
Medicaid, on the other hand, often covers hearing aids, with different standards for each state. Unfortunately, this coverage typically only includes young people. For example, the Medicaid programs in Colorado and Arizona only cover hearing aids for individuals under the ages of 20 and 21, respectively. Curious about Medicaid and Medicare coverage in your state? You can find more information about coverage by state through the Department of Health and Human Services.
Do you have more questions about getting your hearing aids covered by insurance? Reach out to Sound Relief Hearing Center in Colorado or Arizona, and our friendly team members will help you understand your options. You can also visit our Insurance and Financing page to learn more.
We are independently owned, so we always have the patient’s best interests at heart. Plus, our state-of-the-art technology ensures that our patients receive the best treatment available. With our unparalleled excellence in the hearing industry, our dedication to patient care, and our commitment to helping people control and conquer their hearing issues, you can count on Sound Relief Hearing Center. To learn more about us, please browse our website, visit our YouTube channel, or give us a call at 720-344-7600. You can also schedule an appointment online to meet with one of our audiologists. We look forward to hearing from you!
At Sound Relief Hearing Center, we provide hope and help to those living with tinnitus and other hearing health issues. Our patients are at the center of everything we do, and we strive to guide them to overcome their challenges by delivering innovative and compassionate healthcare.
Dr. Julie Prutsman, owner of this family-owned practice, has expanded to 8 locations across Colorado and Arizona. In 2012, she founded Sound Relief in her hometown of Highlands Ranch, Colorado and continues to foster their mission through mentorship of the brightest minds in the field of Audiology.