Hearing aids and health insurance: are you covered?
Probably not. Most health insurance does not cover hearing aids- not even for children
WASHINGTON DC, February 27, 2013 – Even though as many as one in five Americans over the age of 12 suffers from some form of hearing loss in one or both ears, the cost of hearing aids is rarely covered by either Medicare or private health insurance. Even when an insurance policy covers hearing, this usually means insurance will pay for a doctor’s examination or contribute a fraction of the cost for hearing aids. Only 20 states require some form of coverage for children. Three states require some form of coverage for adults.
Why? Because hearing impairment is not officially recognized as a disability by the insurance industry. If hearing loss were considered a disability, it would be the largest disability class in the U.S.
Many of us would be surprised to learn that hearing impairment does not qualify as a disability for insurance purposes. Medicare does cover the cost of hearing aids, but only if hearing loss is due to a specific disease or injury. Medicare Part B covers the cost of a diagnostic exam, but only if ordered by a doctor.
In general, however, Medicare and private insurance classify hearing aids as “elective,” on the same level as plastic surgery and teeth whitening. Ironic, considering Viagra for ED is covered by most insurance plans. Extremely unjust, considering that due to the high cost of hearing aids — $1,000 to $6,000 per ear, plus periodic adjustment and replacement—without the help of their insurance, few families can afford something so essential. Hearing problems can lead to isolation, depression, and even dementia in adults.
I have a personal connection to this story, as my stepfather is hearing impaired. I have witnessed his struggle with progressive hearing loss and – what seems more unfair- his struggle with his insurance company to get hearing aids. A formerly a gregarious, hungry for life, world traveler, he has slowly withdrawn and isolated himself, mostly because of his hearing loss and inability to get his hearing aids (which he paid for without help from insurance) adjusted and replaced every three to five years as recommended.
While an adults’ struggle with hearing loss and the costs involved seems unfair, the situation is even more irritating when it comes to hearing aids for children. Hearing is essential for a child’s development of speech, language, and social skills. Children can feel even more isolated and depressed if their hearing loss goes unaided or unaddressed. While generally as expensive as adult hearing aids, children’s hearing aids may require more adjustment and replacement as they grow and develop. This only makes the price higher and places hearing aids further out of reach for more families.
Currently in the U.S., 16 states require private health care plans to pay for all or some of the costs related to hearing aids for children, three states require coverage for both children and adults, and Wisconsin requires plans that cover both hearing aids and cochlear implants for children. However, state requirements vary in terms of ages covered, extent of coverage, and provider qualifications. For example, Colorado requires coverage for children under 18; Connecticut only requires coverage up to the age of 12.
There are bill initiatives in several states to mandate hearing aid coverage for children. There are very few initiatives aimed at obtaining coverage for adults, especially when the insurance industry invariably threatens higher premiums.
It makes no sense for insurance not to cover the cost of hearing aids. It also makes no sense to classify getting a hearing aid- whether for a child or an adult- at the same level as getting liposuction or a butt lift. It does not make sense to declare that being able to hear clearly is not a necessity, especially for a child, just to save some money and satisfy corporate greed.
Angry yet? The problem is bound to get worse and affect many more people as baby boomers age and experience hearing loss. Chances are that most people reading this do not know whether or to what extent their insurance plan covers hearing loss. Chances are you are not covered. Chances are also that a portion of people reading this has some form of hearing loss already.