Hearing Aid Insurance
The issue of hearing aid insurance is heating up, and several states are responding with bills to require coverage of some
hearing aids for some people. It's a long ways from universal coverage,
but it's a start.
March 2013 - Mothers push Georgia
lawmakers for hearing aid coverage
December 2012 - Hawaii Includes Hearing
Aids as an Essential Health Benefit!
August 2012 - Massachusetts Requires
Insurance Coverage for Hearing Aids
January 2012 - Tennessee Enacts $1,000
Hearing Aid Insurance Coverage Mandate for Children
September 2011 - States Expand Emphasis
on HA Insurance Coverage Mandates
January 2011 - New Hampshire Requires
Insurers to Cover Hearing Aids
October 2010 -
HearUSA Reports Expanded
Managed Care Contracts for 2011
January 2009 - NJ Law Requires
Insurance Coverage For Children's Hearing Aids
June 2008 - Delaware Passes Mandatory
Hearing Aid Insurance Coverage for Kids
June 2007 - HEAR Act Introduced to
Eliminate Exclusion of Hearing Aids from Medicare
December 2005 - Medicare has just
decided to cover the Baha Hearing System. It had not previously been
covered by Medicare, because it was classified as a hearing aid. But a
reclassification of the device noe makes it eligible.
October 2004 - California governor
Arnold Schwarzenegger vetoes legislation that would have required
insurance companies to help pay for children's hearing aids!
January 2004 - Virginia is considering
legislation to require insurance to cover hearing aids for kids.
September 2002 - Hearing Aid Insurance Legislation
Update by Randy Kirsch provides a great summary of current hearing
aid insurance legislation (HAIL).
2002 - Maryland Requires Insurers to Pay for Babies'
More on this and related topics
A handful of mothers with deaf children urged
Georgia legislators on Tuesday to require health insurance companies to
provide hearing aids. The women estimated there are fewer than 400
children needing the devices, which can run as much as $6,000 for a pair
every five years. Medicaid, the state's insurance for the poor, already
provides them, but most private insurance companies don't because they
aren't necessary for survival. The mothers, who formed LetGeorgiaHear.org,
argue that spending $40,000 on hearing aids during a child's youth avoids
tenfold costs for special education. "It's going to be hard. It's not a
very popular concept," admits Kelly Jenkins, one of the group's
co-founders and the mother of Sloane, age 3, who was fitted with hearing
aids before she could walk.
HLAA is thrilled to learn that on October 1, the
State of Hawaii published their list of benchmark benefits under the
Affordable Care Act (ACA). Included in those benefits is coverage for
hearing aids. The benefits ensure that people will be able to receive
hearing aids for each ear every 60 months. Also covered is routine hearing
exams, newborn hearing screenings and pediatric hearing screening. Hawaii
appears to be in the forefront of hearing health care benefits under the
ACA, If your state includes hearing aids or other hearing health care
services under ACA, let us know. Hawaii Benchmark Benefits under the PPACA
(Oct 01, 2012) http://hawaii.gov/dcca View the Hawaii Benchmarks Benefits
under the Affordable Care Act (ACA). Below is a preview of the benefits
covering hearing screenings, hearing exams and hearing aids.
The next time her twin sons need to order new
hearing aids-at a cost of roughly $5,000 per kid-they will have help from
their insurance company. The same is true for any other child in
Massachusetts who is hearing impaired, thanks in large part to Adams's
efforts. The effort began when the Newtonville mom and former trial
attorney decided that the thousands of dollars she and her husband had to
pay every three to five years for new hearing aids was too much for most
families to afford. At the same time, Adams realized that hearing aids are
essential for kids success in school and society. With the help of state
Rep. Sean Garballey, D-Arlington, Adams authored House Bill 52 requiring
insurance companies to cover up to $2,000 for hearing aids for children 21
years old and younger every 36 months. In her efforts to gain advocacy for
the legislation, Adams formed the Massachusetts Hearing Aids for Children
Coalition network to provide support for other families of children who
are deaf or hearing impaired. The Legislature passed the bill Thursday and
Gov. Deval Patrick signed House Bill 52 into law Tuesday afternoon. "Our
family is just thrilled that this has finally happened for all the
children in Massachusetts that need hearing aids," Adams said. "We are
just thrilled that Massachusetts has done this."
Tennessee has passed and enacted HB0761, a law
that mandates that group and individual insurance policies reimburse
parents for hearing aids for their insured children. This new law,
effective January 1, 2012, provides coverage of up to $1,000 per
individual hearing aid per ear, every 3 years, for every child covered as
a dependent by the policyholder. This requirement would apply to most
types of health insurance policies, including HMO and individual
self-insured policies. If a licensed audiologist or physician certifies
that the child's hearing loss has become significantly worse during the
3-year period since the child received a hearing aid, coverage must be
provided for a new hearing aid suitable to the child's hearing needs
before the end of the three-year period.
The number of states that mandate some form of
hearing aid insurance coverage has more than doubled in the past three
years, with mandates going into effect in 11 states since January 2009.
Even so, most Americans live in states that do not require insurance
companies to provide coverage for hearing aids, and of the 19 that mandate
a benefit, only New Hampshire and Rhode Island extend that requirement
beyond children to people of all ages. Since children make up only about
2% of the hearing loss population, such coverage mandates have only a
limited impact on the number of people with hearing loss. It is difficult
to analyze the actual impact of these mandates since the New Hampshire
benefit went into effect in January 2011, and Rhode Island offered only a
limited benefit starting in 2002, and has just upgraded it to mandate full
coverage for children and up to $1,500 per hearing aid for adults.
The State of New Hampshire wants its residents to
"live free or die" with insurance coverage for hearing aids. A New
Hampshire law passed in 2010 and effective January 1, 2011, requires all
New Hampshire insurance companies to cover the cost of a hearing aid, for
each ear, up to $1,500, plus the related fitting and dispensing services.
Specifically, the law states that "Each insurer
that issues or renews any policy ... must provide coverage for the
professional services associated with the practice of fitting, dispensing,
servicing, or sale of hearing instruments or hearing aids by a hearing
instrument dispenser or other hearing care professional."
Furthermore, the new law makes hearing benefits on
par with other common medical services. In other words, all hearing
benefits cannot be subject to any deductible or coinsurance or co-pay
that is greater than any other benefits provided by the insurer.
The new law, HB 561-FN, also states that insurers
are required to cover the cost of a hearing aid and related expenses every
60 months. In addition, the insured has the option to choose a higher
price hearing aid and pay the difference in cost.
SOURCE: State of New Hampshire
Editor: Those who have been following the Hearing Aid Insurance
Legislation (HAIL) efforts know that the California legislature passed a
bill requiring health insurance companies to include hearing aid
coverage for children. Sadly, Gov. Arnold Schwarzenegger vetoed the bill
The following story is reprinted with permission from the Los Angeles
Daily News, September 24, 2004
By Alex Dobuzinskis Staff Writer
BURBANK -- Gov. Arnold Schwarzenegger vetoed a bill championed by a
Burbank woman that would have required health insurance companies to
help pay for children's hearing aids.
SB 1158 was introduced by Sen. Jack Scott, D-Pasadena, at the urging
of Susan Grafman, 39. Her medical insurance did not cover the cost of
hearing aids for her two sons and she had to pay $7,600 for the devices.
"While I want children with hearing impairments to have hearing
aids, I am concerned that increasing the cost of health coverage by
mandating benefits, if even by a small amount, would have the far more
serious consequence of leaving some children without (any) health
insurance whatsoever," Schwarzenegger wrote to members of the
Senate in vetoing the bill Wednesday.
Grafman said she was surprised by the veto. The state's Medi-Cal and
Healthy Families programs cover hearing aids and the rich can pay for
them, but the "middle class is left out of the loop struggling to
pay for hearing aids for their children," she said.
Grafman expects to work to support another version of the bill if it
Editor: The Virginia legislature is considering a bill that would
require health insurance to provide hearing aid coverage for children. I
know, I know! We need it for adults, too. But we may need to go slow on
this and take what we can get (I hope) now. Here's a summary of the
By the way, we were hearing a lot about insurance coverage for
hearing aids a while ago, but haven't seen anything for a while. Maybe
I'm just missing the articles. Please do let me know if there's
something going on in your state.
Insurance; mandated healthcare coverage; hearing aids for minors.
Requires health insurers, health maintenance organizations, and
corporations providing health care coverage subscription contracts to
provide coverage for hearing aids and related services for children from
birth to age 18 when a licensed audiologist prescribes such hearing aids
and related services. Such coverage shall include one hearing aid per
hearing-impaired ear, up to a cost of $1,400, every 36 months. The
insured may choose a higher priced hearing aid and pay the difference in
cost above $1,400, with no penalty to the insured or the hearing aid
provider. No co-payment will apply. Hearing aids are not to be
considered durable medical equipment.
We've noted with pleasure the increasing strength of the movement to
get hearing aids covered under health insurance. As things currently
stand, insurance aid coverage is usually optional and is negotiated
between the insurer and the insured. For those covered under a group
plan, the terms of the plan as negotiated by the plan provider determine
the presence or absence of hearing aid coverage.
That is starting to change, as a few states start to require hearing
aid coverage in certain situations. The most recent news is that
effective last October, health insurers in Maryland are required to pay
up to $1400 per ear every 3 years for children's hearing aids.
We have long known that the early use of hearing aids can provide a
lifelong benefit to people born with hearing loss. Because we are able
to most easily learn language as infants, the early years are the most
crucial times to have sound input. Kids who don't get that early input
almost never catch up in terms of language development.
Universal infant screening programs are ensuring that we identify the
children with hearing loss as early as possible. The next step is to be
sure that these kids have immediate access to hearing aids. For many
families, insurance coverage is the best, possibly the only, way to
ensure this access.
As of late 2001, only four states require any kind of insurance
coverage for children's hearing aids. These states are Connecticut,
Maryland, Oklahoma, and Rhode Island. If you live in one of those
states, please spread the word. If not, please spread the word.