Does Insurance Pay For Hearing Aids?
Insurance coverage varies from plan to plan, but regardless of which plan you have there are a few states where insurance is required to cover the purchase of hearing aids. There are 25 states currently requiring insurance to cover hearing aids for children, but only five states have this requirement for adults. The five states that require insurance to cover the purchase of hearing aids for adults are:
- Arkansas
- Connecticut
- Illinois
- New Hampshire
- Rhode Island
Although coverage is mandatory in these five states, the exact amount and specific details of coverage required by each state still varies. For example, Arkansas requires insurance companies to offer coverage options to employers, with a minimum required coverage of $1,400 per ear every three years. Plans in New Hampshire are required to offer at least $1,500 of coverage per hearing aid every five years, while insurers in Rhode Island are required to cover at least $700 per hearing aid every three years.
As mentioned above, these five states require coverage for adults. There are currently twenty-four states that require insurers to offer coverage for children, although the particular terms and specific coverage amounts still vary from state to state.
So, what about older adults who don’t live in the five states that require hearing aid coverage for all adults? In these cases, coverage will be harder to come by, but will depend on the individual’s specific insurance plan. If you are an older adult and don’t live in one of these five states, but you do use Medicare, Medicaid, or private insurance, here’s what you need to know:
Medicare
Original Medicare, available to adults age 65 and over, does not offer coverage for hearing aids or hearing aid-related exams. Those with Original Medicare insurance are responsible for 100% of the cost of their hearing aids.
If you have a Medicare Advantage Plan (also called Part C), there may be additional coverage available that applies to hearing aids. Medicare Advantage Plans are bundled plans offered by private insurance companies, and their coverage will vary by company, state, and individual plan.
Some coverage for hearing aids may also be available through Medicare Supplemental Insurance, also called Medigap, which is sold by private insurance companies to supplement your existing Medicare coverage.
Medicaid
Medicaid offers health resources and coverage for low-income families and individuals, and hearing aid coverage will vary depending on what state you reside in. In some states, Medicaid provides full coverage but it may only include low end technology. This coverage typically requires medical necessity as determined by a licensed audiologist.
Private Insurance
Generally speaking, most private insurance companies don’t offer hearing aid coverage in their basic plans because hearing aids are considered elective devices as opposed to medical necessities. In order to determine if you have coverage or not, you’ll need to contact your insurance company to get details for your specific plan. If your plan does not offer hearing coverage, many private insurance companies have options to purchase add-on coverage, which may be worth considering depending on your hearing needs.
Other Ways To Pay For Hearing Aids
Even though most insurance plans don’t offer hearing aid coverage without additional payment or supplemental programs, there are other options for covering the cost of your hearing aids if you’re paying out of pocket. We will discuss a few of these options below.
Health Savings Account (HSA): If you have an insurance plan that qualifies for an HSA, the account allows you to save pre-tax money to cover approved medical expenses. If your health insurance plan is HSA-eligible, the account may be offered either through your health insurance company or your bank. Health savings accounts are approved for use in purchasing hearing aids, batteries, and for help in covering any repairs or maintenance costs for your hearing aids.
Flexible Spending Arrangement (FSA): Like health savings accounts, flexible spending arrangements use pre-tax money to cover eligible medical expenses. FSAs are available to people who have health insurance through their employer, and the employer funds the account with a predetermined amount of pre-tax dollars deducted from your paycheck throughout the year. When you submit documentation of an eligible medical expense to your employer, you can receive reimbursement from the FSA.
Financing: Besides using insurance or a designated medical expense account to purchase your hearing aids, many hearing aid companies and audiology practices may offer financing for the purchase of hearing aids. Hearing aid companies often have financing available through separate financial institutions, which essentially offer you a loan to cover your hearing aids that you repay in monthly payments with interest. Some of these financial institutions offer promotional periods where you don’t have to pay interest if you pay off the balance by the specified date discussed at purchase. This process is often the same with audiology offices, although some also offer financing in-house. Audiologists may also accept Care Credit, which is a credit card used exclusively for healthcare-related services and expenses. Most financing options will have varying terms and are subject to credit approval.
How Much Do Hearing Aids Cost?
The cost of hearing aids ranges widely. Affordable hearing aids are available for as low as $99 per pair, while high-technology hearing aids can cost $5,000 or more per pair. The difference in cost is typically a function of the technology included in the hearing aid, as well as what features are available. It’s typically pricey to purchase hearing aids from an audiologist because these professionals have to cover things like employee salaries and building expenses in addition to the costs of the actual hearing aids.
To offset the cost of getting hearing aids from an audiologist, the FDA recently passed a ruling making over-the-counter (OTC) hearing aids available and regulated. While OTC hearing aids are still available at a wide range of prices, many of the same technologies, brands, and models are now, or will soon be, available OTC at a lower cost than hearing aids purchased from an audiologist.
How to Get Affordable Hearing Aids
OTC: As mentioned above, the 2022 FDA ruling allowing OTC sales of approved and regulated hearing aids will make them available to more people for a more affordable price. Many hearing aid brands, like Jabra Enhance, MDHearing, and Audien, are selling OTC hearing aids online, and national retailers like Walmart and Walgreens are rolling out sales of OTC hearing aids from well-known brands like Lexie.
Even though OTC sales of hearing aids will make hearing aids accessible and affordable to many more people than in the past, there are some drawbacks to skipping the audiologists office altogether. OTC hearing aids are indicated for perceived mild-to-moderate hearing loss, which means that anyone with more advanced or complex hearing loss may not be getting the right hearing aids for them. Also, OTC sale of hearing aids means that a hearing test is no longer required.
While there are plenty of free hearing screenings available online, and many companies offer them to assist in initial setup of their OTC hearing aids, more people are now likely to purchase their hearing aids without doing a test. Skipping the hearing test means that more advanced hearing loss, or other hearing- or ear-related problems, may go undetected. Lastly, purchasing OTC hearing aids means that wearers will not have access to the ongoing support, including adjustments and repairs, that they would have if they purchased through an audiologist or audiologist-overseen program.
Personal sound amplification products (PSAPs): If you’re looking for an inexpensive hearing aid alternative, PSAPs may be an option. Their price point is significantly lower than even the least expensive OTC hearing aids, with prices as low as $20 per pair, but their functionality is also fundamentally different. PSAPs are designed to simply amplify sounds, meaning that the volume of all incoming sounds (regardless of things like tone or frequency) will be increased. PSAPs are designed to be used by people with normal or unaffected hearing who want to hear sounds that may be very quiet, or far away, for example. Even so, some people with very mild hearing impairment may benefit from using PSAPs, especially if they’re looking for a very low-cost option.
Bottom Line
Most insurance companies don’t offer coverage for purchasing hearing aids, but there’s no one-size-fits-all answer for a predicament so many people face. Some plans offer partial coverage, some plans offer supplemental coverage at an additional cost, and some states require hearing aid coverage from insurers regardless of the company or specific plan. For a concrete answer to what specific benefits and allowances you are entitled to, it’s best to contact your insurance company to understand your exact coverage and options. If your insurance doesn’t cover hearing aids, there are still options for saving money, and more good news is that OTC hearing aid sales are making hearing aids more affordable and accessible than ever.
