Why aren't hearing aids covered by insurance?

If you have recently been diagnosed with hearing loss, you may be considering hearing aids. For many people, hearing aids can be a lifeline. They enable people to not just communicate and understand speech, but also feel confident, engaged, stay connected, and maintain a steady income, while also helping to prevent cognitive decline.

However, with the average cost of hearing aids ranging from $1,500 to $6,000, you may be wondering: are hearing aids covered by insurance?

While there are around 20 states in the US that require health insurance companies to provide hearing-aid insurance coverage for children, according to the American Speech-Language-Hearing Association, just five require hearing aid insurance coverage to be available for hearing aids for adults. These are:

• Arkansas
• Connecticut
• Illinois
• New Hampshire
• Rhode Island

The type of hearing-aid insurance coverage does vary considerably across these states. For instance, in New Hampshire, insurance providers must provide coverage for a minimum of $1,500 per hearing aid every five years. Insurance providers in Rhode Island must provide $700 per individual hearing aid once every three years for people over 19 years old. Meanwhile, in Arkansas, insurance providers are required to offer coverage to employers. If an employer takes this up, the insurance plan must cover a minimum of $1,400 per hearing aid, every three years.

Outside of these five states, it’s essentially down to individual insurance companies as to whether they provide hearing-aid insurance coverage. Hearing aids are classified as ‘elective’ and are thereby considered to be something that’s chosen rather than necessary – although the 37 million people with hearing loss may strongly disagree with that. Despite the enormous benefits of wearing hearing aids, they are not considered essential medical devices. Your ability to get hearing-aid insurance will largely depend on where you live and the insurance plan you have with your provider.

Insurance providers generally work by taking the cost of an uncommon but still feasible risk and spread it over a large group of people. This helps to ensure members pay a reasonable price and still receive insurance coverage. The insurer, meanwhile, profits when a person pays for their coverage without filing a claim.

People with a hearing loss, however, are often considered a serious risk by an insurance company. If you have hearing loss, you are more likely to make an insurance claim to help pay for your hearing aids. This could total thousands of dollars.

Hearing aids also generally need replacing every five years, therefore resulting in further expense for your insurance provider. To put it simply, your insurance provider will have less chance to make a profit, which is often a key reason why hearing aids are not covered by insurance.

In most cases, hearing aids aren’t covered by the government’s health program, Medicare, as it generally only covers services. It does not cover devices or tinnitus (ringing in the ears) which is not considered to be medically necessary to receive treatment. However, the majority of Medicare Advantage plans do cover hearing aids. Medicaid provides different standards of cover for each state. This coverage does generally only cover young people, though.

Whether or not your insurance provider covers your hearing aids or you have to pay all the costs yourself, you shouldn’t delay in getting hearing aids. To find the best hearing aid for your hearing loss, schedule a hearing evaluation with a hearing care professional.