Why don’t insurance companies cover hearing aids?

This is a question that we as audiologists hear every day, and as approximately 37 million people suffer some form of hearing loss, insurance coverage - or the lack of - is something that has a tremendous impact on the communication ability of so many.  

We know that hearing loss can have profound effects such as isolation, depression, safety issues, social anxiety, reduced job performance, and can contribute to Alzheimer's and dementia.   We also know that the use of amplification can help people become more engaged, active, and involved with friends and loved ones.   However, to most insurance companies, hearing aids are considered an “elective” procedure, much like liposuction or plastic surgery.  Most of us could live with a little pouch on our stomach or thighs, but how many feel that any one of our 5 senses in less important or expendable?

Currently, 20 states require health insurance cover hearing aids - but this is mostly for children.  New Hampshire, Arkansas, Connecticut, and Rhode Island allow for some coverage for adults.  We don’t know for sure why insurance companies don’t cover the cost of hearing aids, but since there are almost 40 million people with hearing loss, we can guess that it’s a financial reason.  Currently, insurance companies have 35 mandated benefits they are required to cover.  Since hearing loss is a “likely risk” - more than 50% of people over age 75 will have hearing loss - the companies feel there is too high of a possibility that a large number of people will make a claim, therefore increasing costs and reducing profit. Hearing loss is then considered uninsurable.

Many people are surprised to find out that Medicare does not cover hearing aids at all.  They also won’t cover a hearing test unless it’s ordered by a physician.  If you choose to go to an audiologist for a hearing test, expect to pay out of pocket unless your physician sends an order - otherwise Medicare feels the testing is not “medically necessary” and will make you responsible for payment.  However, at this time there is a bill before Congress, H.R. 1518 - the Medicare Hearing Aid Coverage Act of 2019 - that looks to amend title XVIII of the Social Security Act by removing the exclusion of hearing aid coverage and examinations for them.  You can voice your support for this act by writing your congressman and tell them to please vote positively for this!

However, some employers’ insurance companies do offer hearing aid benefits, at least in Missouri and Kansas.   BCBS, UHC, Aetna and Cigna, and some of the new Medicare Advantage plans can help pay for hearing aids.  These same companies may also offer a discount program in place of a payable hearing aid benefit; these “third party” programs have negotiated a discount for the price you pay for the hearing aids.  Sometimes these discounts can be as much as 40% off, but your options for hearing aids and services may also be more limited.  

Because this is such a hot topic among our patients, and coverage and benefits vary among plans, we help our patients navigate the complexities of their insurance benefit.  Please let us know what we can do to help you or a family member with this process.