Hearing aids can greatly enhance your quality of living and independence. Unfortunately, many individuals who have a hearing loss shy away from treatment for a variety of reasons. Among those, I often encounter have to do with the cost of hearing aids and insurance coverage. Are hearing aids covered by insurance? I can offer no simple answer to that question, but I can provide you with some help for navigating through the complicated world of insurance coverage for hearing aids.

Insurance and Coverage Types

One reason that determining whether your insurance covers hearing aids is difficult has to do with the broad range of coverage types. A quick glance at various types of insurance and the coverage they offer will provide some basic insight into what you can expect.

Medicare and Medicaid

Medicare and Medicaid coverage of hearing aids includes a mixture of good and bad news. Presently, Medicare does not cover hearing tests or hearing aids, but in some states, Medicaid does provide some cost benefits. Medicaid complies with mandated Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) for children under the age of 21 in all states, but Medicaid in Alabama does not provide any coverage for adults.

Affordable Care Act

Some states offer coverage for hearing aids and related expenses under the Affordable Care Act. Unfortunately, coverage under ACA follows that of Medicare and Medicaid.

Veteran (VA) Benefits

Veterans fair better when it comes to having hearing aids covered. VA benefits will cover the cost of hearing aids and hearing tests if your symptoms cause severe or direct interference to daily living. Coverage limitations include treatment in VA facilities after meeting specific qualifications.

Federal Employee Assistance

Families of those employed by the federal government receive some coverage for hearing aids. Most federal employee health plans cover the cost of basic hearing aids. You will pay for upgrades and extras, which can be deducted from your pay packet.

Private Insurance

Your chances of hearing aid coverage by private insurance, if you are an adult, are pretty slim. Children under 21 are covered due to the EPSDT mandate. However, without the addition of policy riders, your basic private insurance plan probably won’t provide any financial assistance.

Health Savings Accounts

Recent healthcare coverage shakeups have led to the establishment of various types of health savings accounts, which provide a viable solution to covering the costs of hearing aids. The most common types include:

• Flexible Spending Account (FSA) –you cover the cost, and the FSA account reimburses you.
• Health Savings Account (HSA) – works like an FSA, but with an annual accumulation feature.
• Health Reimbursement Account (HRA) – funded by your employer, who decides whether they cover the costs of your hearing aids.

Ask Your Insurance Provider

Before talking to your insurance provider, it is a good idea to prepare some specific questions to receive clear answers, including:

• What is covered? (both testing and instruments or only testing, but no instruments)
• Who can provide your hearing aids? (coverage limited only to in-network providers and what penalties for seeing a non-network provider)
• How do they bill? (direct billing to the provider or reimbursement after you pay)
• What restrictions and limitations are included? (the financial limit for each hearing aid, special qualifications for coverage, non-network penalties, etc.)

What If Hearing Aids Aren’t Covered by Your Insurance?

It is frustrating to learn that your insurance does not provide coverage, and there is a temptation to walk away from treatment. Keep in mind that leaving your hearing loss untreated is far more costly in the long term, as it contributes to a full range of additional health problems. A 2012 Johns Hopkins study connected a 50 percent increased risk in developing dementia and a 40 percent risk of developing depression in patients with an untreated hearing loss. Recent research adds to this, noting that untreated hearing loss leads to more frequent and longer hospitalizations along with increased admissions and more ER visits.

Besides reducing the added burden on your overall health, treatment for hearing loss contributes to a much more rewarding lifestyle. I strongly encourage my patients to keep looking for resources to cover hearing aid costs. Financial resources are often available from local, state, or nationwide organizations.

Alabama Hearing Associates is here to help. We participate in most insurance plans, and our staff is more than happy to help verify your benefits and lead you through the intimidating world of insurance coverage. Contact us at either of our Northern Alabama locations to schedule a consultation.

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Dr. Jan Liles

Dr. Liles earned her bachelor’s degree from the University of Montevallo and her master’s degree from the University of Alabama. From 1991 to 2001, she worked with two ENT medical practices and initiated one of the first newborn hearing screening programs in the state. In 2002, she was awarded a doctorate in audiology from the University of Florida. Dr. Liles and her longtime best friend, Dr. Sheehy, founded Alabama Hearing Associates in January 2002.
    Basic Hearing Test

    A basic hearing test begins with an air conduction test. You will be seated in a soundproof booth and single-use, foam earphones will be inserted into your ear canals. The Audiologist will ask you to push a button or raise your hand when you barely hear a series of beeps (tones) presented at various frequencies (pitches) to obtain your air conduction thresholds.

    To determine whether your hearing loss is a conductive (mechanical) loss, sensorineural (permanent) loss or combination of the two, we perform a bone conduction test.  

    For this test, a head band is place on the bone behind one of the ears to obtain your bone conduction thresholds. This process provides a different form of sound transmission using vibration, which bypasses the eardrum and the middle ear bones and directly stimulates the auditory nerve. When you hear the beeps/tones, you will push a button or raise your hand.

    If bone conduction thresholds are better than air conduction thresholds (through the foam inserts), you have a conductive hearing loss. This suggests a problem with the mechanical structures (moving parts) of the ears.

    Conductive hearing loss is often a medically treatable condition for which we will provide you with a referral to an Ear, Nose and Throat (ENT) physician. However, if bone and air conduction thresholds match, it indicates a sensorineural hearing loss (permanent), and the treatment will likely involve hearing aids.



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