Hearing Aid Insurance

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).

May 2002 – Maryland Requires Insurers to Pay for Babies’ Hearing Aids

More on this and related topics

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Mothers push Georgia lawmakers for hearing aid coverage

March 2013

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.  Full Story

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Hawaii Includes Hearing Aids as an Essential Health Benefit!

December 2012

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.  Full Story

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Massachusetts Requires Insurance Coverage for Hearing Aids

August 2012

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.”  Full Story

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Tennessee Enacts $1,000 Hearing Aid Insurance Coverage Mandate for Children

January 2012

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.  Full Story

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States Expand Emphasis on HA Insurance Coverage Mandates

September 2011

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.   Full Story

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New Hampshire Requires Insurers to Cover Hearing Aids

January 2011

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

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Governor Vetoes Children’s Hearing Aid Bill

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 (sigh).

The following story is reprinted with permission from the Los Angeles Daily News, September 24, 2004

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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 is introduced.

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Virginia Considers Hearing Aid Legislation

January 2004

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 proposed bill.

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.

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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.

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Maryland Requires Insurers to Pay for Babies’ Hearing Aids

May 2002

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.