Insurance and Financial Assistance for Hearing Aids
Contributed by Paul Dybala, President of Healthy Hearing
If you’re in the market for hearing aids, you will soon discover they are rarely covered by medical insurance or Medicare. There are many avenues for financial assistance with the purchase of hearing aids, but the opportunities can vary according to the individual. It’s important to investigate all options for hearing aid financial assistance, whether it’s from a third-party insurance, The Department of Veterans Affairs or taking advantage of CareCredit.
Finding financial assistance for hearing aids
When you’re ready to purchase hearing aids, you don’t want to waste time finding out if you qualify for monetary assistance. Based on the way most people are provided with financial support, we have put together a prioritized list below to help uncover your options.
Coverage for hearing aids with insurance
To determine if your health insurance covers hearing aids, check with your individual plan. Most plans have a toll-free number for member services listed on the insurance card. Even if you have it, insurance coverage for hearing aids varies in the way it is administered. Here are some real-life benefit types for hearing aids:
|Always be sure to check with your insurance provider to determine if you (or your loved one) qualify for a hearing aid benefit.|
- A health plan may pay a specified amount toward the purchase of aids, like $500 or $1,000. This amount may be allowed toward the entire hearing aid purchase (whether one aid or two aids are purchased), or the amount may be allowed per ear. The benefit may renew after a given number of years, usually 3 to 5 years.
- A health plan may give you an allowance toward hearing aids if you purchase from a contracted provider. An allowance is a specified amount that is subtracted from the total purchase price. For example, if the cost of a pair of instruments is $4,000 and your health plan has a $1,500 allowance, your out-of-pocket cost would be $2,500. This benefit may also renew every few years.
- A health plan may have negotiated discounts with contracted providers. This means that you must purchase from a provider in order to get a specified discount (for example, 20%) off the retail price.
Each health plan is different and hearing aid coverage within a plan may vary according to geographic location. For example, Kaiser Permanente offers a hearing aid benefit with a credit per ear option available every 36 months. This benefit is specifically available in the Colorado service area, but not in Oregon, Washington, Ohio, Georgia, Maryland, Virginia, or Washington DC areas. They state that there is potentially a benefit available in Hawaii and California, but users are encouraged to check on the type of coverage available.
Currently, about 20 states mandate that health insurance companies provide full or partial hearing aid coverage for children. Unfortunately, only three states–Arkansas, New Hampshire and Rhode Island–currently mandate health insurance companies to provide hearing aid coverage for adults. Arkansas and Rhode Island require that health insurance companies provide a benefit that can be used every three years; New Hampshire requires that the benefit be available every five years.
State-mandated health care coverage for hearing aids will vary from state to state and several states have legislation about hearing aid coverage pending. If your state does mandate coverage, you will need to do a little research to find out about the amount covered and how often a claim can be made, as well as any other qualifiers for the coverage. Your hearing care professional can often provide some guidance as you search.
Insurance coverage and discounts are always changing. When you’re considering the purchase of hearing aids, call your insurance provider and ask about your plan. Be sure to ask the following questions:
- What is the health plan benefit for hearing aids?
- Do I have to use specific providers, if so, may I have a list of providers in my area?
- If the health plan has an allowance or benefit, do I have to pay the provider the full amount and then submit paperwork to get reimbursed? Can the provider bill the health plan directly?
- Is the benefit limited to specific hearing aid models or technology? Ask your plan representative to specifically define terms such as “routine” hearing aids.
- Are there any criteria or stipulations for coverage? Some health plans may require that your hearing loss must be a certain degree in order to receive their benefit.
Find out if you’re eligible for the Federal Employee Health Benefit Program through Blue Cross Blue Shield (BC/BS), they will cover up to $2500 for hearing aids every three years.
Always be sure to check with your insurance provider to determine if you or your loved one qualifies for a hearing aid benefit.
If you do not live in one of the mandated states, it does not mean that you do not have insurance coverage for hearing aids, it just means that your state laws do not require it. Check with your employer or benefits coordinator. Often healthcare systems, teacher retirement groups, city and state government employee groups and any other large employer or group will sometimes coordinate with a network of preferred providers to offer some level of discount or service. The AARP organization offers a hearing care program for their members that provides “savings on hearing aids and hearing healthcare products.” Be sure to check with these types of organizations if you are a member to see if there is a benefit.
How people get hearing aid coverage
In his study of trends in the hearing care industry, Kochkin surveyed 3,174 hearing aid users. As part of his survey, he asked about financial assistance for purchasing hearing aids. His results showed that third-party funding for hearing aids through insurance has increased from 24 percent in 1989 to 40 percent in 2008. While encouraging, this still means that a majority of individuals who purchase hearing aids have to pay them out of pocket.
Out of those who do have a third-party that will help pay for hearing aids, Kochkin determined that the largest proportion of assistance comes from benefits through the Veterans Administration and the second largest source comes from health insurance. Hearing aid wearers cited many other potential sources of assistance, including Medicare, Medicaid, HMOs, charities, work unions and family. These sources are summarized in the bar graph below. Overall, the average amount of payment coverage by a third party is about 85% of the total price.
It is not entirely encouraging to find out that in most cases, hearing aids are not covered by insurance or other sources and when it is covered, it is usually not 100%. The good news is that the bar graph below provides you with a simple list of places that you should check to determine if you qualify for financial assistance to purchase hearing aids.
- The Department of Veterans Affairs (VA)
The VA is the single largest purchaser and provider of hearing aids in the United States. If you are a veteran or have a service connection, check with your local VA to see whether you qualify for hearing-related services, including the provision of hearing aids.
- Medicare and Medicaid coverage of hearing aids
Medicare does not usually cover annual hearing exams or hearing aids. You may have some options depending on the type of hearing loss and if you have a Medicare Advantage Plan.
Medicaid coverage for hearing aids varies by state and eligibility is subject to change. To determine if you are qualified for Medicaid coverage for hearing aid(s) and/or cochlear implants in your state, contact your hearing care provider. You can also contact your state’s Medicaid program or visit http://medicaid.gov for more information.
- Charitable and other assistance programs
There are many charitable groups that will provide new or used hearing aids at a discount if you meet the financial criteria. We have provided a list of national programs below, but this is not an exhaustive list of organizations. You may find other local and state programs online by searching for the name of your city or state and terms such as
- hearing aid funding
- hearing aid financial assistance
- hearing aid charity
- hearing aid charitable
- hearing aid assistance
- State Vocational Rehabilitation Programs
If hearing aids are required for employment, your state vocational rehabilitation office may offer assistance to pay for hearing aids or educational opportunities to improve your skillset. Search online for “[your state] vocational rehabilitation program” to find what you need.
- AUDIENT Program
Telephone: 1-866-956-5400 x2
Audient is an affiliate of the Northwest Lions Foundation for Sight and Hearing and it’s administered by EPIC Hearing Healthcare. They provide hearing aids at partial cost to low income individuals across the U.S.
- Gift of Hearing Foundation
The Gift of Hearing Foundation is a nonprofit corporation initially dedicated to increasing access to cochlear implant surgery and services for those who have been identified as candidates for this technology.
- The Starkey Hearing Foundation
Hear Now Program
Hear Now is a national non-profit program committed to assisting permanent U.S. residents who are deaf or hard-of-hearing and have limited financial resources. Eligibility requirements, program details, and applications can be found on their website.
- Lions Sight and Hearing Foundation of Southern California
LSH helps people who meet our guidelines to obtain critically needed hearing aids. If the applicant meets the guidelines, LSH will fund or share in the cost of providing hearing aids to the applicant, dispensed through a local hearing aid dispensary. In some cases, LSH may also cover copay costs for those with insurance.
- Easter Seals
Over 400 local service centers with varying services; some assist low-income adults and children with hearing aids and other rehabilitative devices. Visit their website and find your local office to get contact information.
- Travelers Protective Association of America Scholarship Trust for the Hearing Impaired
3755 Lindell Boulevard, St. Louis, MO 63108
The TPA Scholarship Trust for the Hearing Impaired provides financial aid to children and adults with hearing impairment who need assistance obtaining devices, medical treatment or specialized education or services. There are no age restrictions or requirements for degree of hearing loss; grants are based solely on financial need.
There are many national groups that have programs administered at the level of the local chapter. Not every local chapter participates in these hearing assistance projects, so you’ll have to contact the one in your area to determine if they can help. Some of the groups to consider are the Knights of Columbus, Lion’s Club, Rotary Club and Sertoma. If you’re not sure if you have a local group for any of these organizations, your hearing care professional can help you find these and other sources for financial assistance.
- Hearing aid financing
If you are unable to get a 3rd party to help pay for your hearing aids, you can consider programs that provide short term loans. Check with your hearing care provider for more details or consult with the following programs.
Assistive Technology Loan Programs
Many states have assistive technology financial loan programs through RESNA Alternative Financing and Telework Technical Assistance Project (AFTAP), a grant activity funded by Rehabilitation Services Administration, U.S. Department of Education. The details of these programs vary by state and not all states have a program. In general, they help state residents with disabilities purchase assistive technology, including hearing aids and cochlear implants, by offering very affordable loans.
CareCredit is a patient finance program. CareCredit works like a credit card but is exclusive for healthcare services. It is accepted by over 75,000 providers in a wide range of services including hearing care, vision care, veterinary medicine, dentistry, cosmetic surgery and more. They offer monthly payment options, no up-front costs to patients, no prepayment penalties and no annual fees. Short-term, no-interest plans are available as well as longer term plans with fixed interest rates.
Help with amplified telephones
Many states have telecommunication distribution programs for people with hearing loss who require special equipment to use the telephone. These programs loan or provide Text Telephones (TTYs), amplified telephones and other equipment free of charge to residents with hearing loss or other disabilities that require it. A listing of programs by state can be found at www.tedpa.org and using the “State Directory” link. Contact your state program for more information about what equipment is provided, who is eligible for it and how to obtain it.
Find a provider for more help
The information you find online about hearing aid insurance and funding can get you pointed in the right direction for finding hearing aid payment assistance. However, the best help for navigating your particular financial situation and your best resource for hearing aid funding sources will come from a local hearing care professional. Don’t wait any longer–contact a hearing health professional in your area today!
- MarkeTrak VIII: 25-year trends in the hearing health market, Better Hearing Institute, http://www.betterhearing.org/hearingpedia/marketrak-publications/marketrak-viii-25-year-trends-hearing-health-market
- Aetna Discounts, http://www.aetna.com/individuals-families-health-insurance/plans-benefits/wellness-programs-discounts/discounts.html
- Blue Cross Blue Shield 2013 Benefits and Rates, http://www.fepblue.org/news/benefitsandservices/2013-benefits-rates.jsp
- Kaiser Permanente, https://healthy.kaiserpermanente.org/html/kaiser/index.shtml
- State Insurance Mandates for Hearing Aids, ASHA, http://www.asha.org/advocacy/state/issues/ha_reimbursement/
- Should you change to a lower-cost plan when you sign up for Medicare (Part 3), http://fedretire.net/should-you-change-to-a-lower-cost-fehb-plan-when-you-sign-up-or-medicare-part-3/