Are Hearing Aids Covered by Insurance, Medicaid, or FSAs?
Although the Hearing Loss Association of America (HLAA) reports that 48 million people across the nation experience hearing loss, hearing aids are rarely covered by private insurance companies. Devices that are essential for your daily life are put into the same category as plastic surgery and other "elective" services. It's even harder to get coverage as an adult with hearing loss, as most plans are geared towards those who have lost hearing at a young age.
Hearing aid insurance coverage
There are, however, three states with required hearing aid insurance coverage for adults — New Hampshire, Rhode Island, and Arkansas. While better than nothing, these states still don't offer adequate hearing aid insurance — often with so many restrictions that purchasers are unable to receive the hearing aids they want and the functions they need. The minimum requirements are only $1,500 per hearing aid once every five years in New Hampshire, only $1,400 per hearing aid every three years in Arkansas, and sadly only $700 per hearing aid every three years in Rhode Island. This coverage doesn't go a long way when you consider that the average cost for a hearing aid is $2500 per ear. The coverage also doesn't include direct-to-consumer hearing aids like Lively and completely excludes the additional costs that come with getting a hearing aid, including doctor's visits and audiologist consultations.
This situation was stagnant for many years, as only six companies dominated the hearing aid market. Those who needed hearing aids didn't have many options — either pay out-of-pocket or live with limited hearing.
Hearing aids and medicaid
In the United States, there are a few other options for financial assistance with hearing aids. The first option is Medicaid, the government insurance program people with limited income and resources. It's accessible to both lower income and higher income people through the "medically needy program" administered by the county social service agencies, reports the HLAA. States with Medicaid coverage for hearing aids include: include Alaska, California, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Massachusetts, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Dakota, Ohio, Oregon, Rhode Island, South Dakota, Texas, Vermont, Wisconsin, and Wyoming. There's a wide range of criteria and limitations for hearing aids, all of which can be found on HLAA's website.
Unfortunately, this coverage doesn't extend to direct-to-consumer hearing aids and leaves many with hearing aids that lack the dynamic sound, and popular features like Bluetooth connectivity, that make hearing aids a joy to wear and a path to living an active life.
Hearing aids and health care flexible spending accounts (FSA)
The good news is that most contributions to Flexible Spending Accounts (FSA) and Health Saving Accounts (HSA) can be applied to hearing aids. With your FSA, you can set aside pre-tax earnings to pay for eligible health care expenses that are not covered by your workplace insurance. If you're not working, however, you won't be able to open a FSA. With your FSA, you'll avoid Federal Income Tax or Federal Insurance Contributions Act (FICA) tax, but it's important to note that these dollars can't be accumulated because they don't roll over to the next year — it's a "use it or lose it" situation.
If you're enrolled in a High Deductible Health Plan (HDHP), you can set up a HSA with money that earns interest similar to a savings account and will not be taxed upon withdrawal for qualified medical expenses. Unlike a FSA, your balance will roll over year-to-year. The money in the account is available when you need it to lower health-related costs. Reimbursements usually require a copy of the receipt, so hold onto your paperwork.
Unfortunately, a Limited Care FSA and Dependent Care FSA (DCFSA) are not eligible for hearing aids.
Other ways to lower the cost of hearing aids
Depending on your eligibility (i.e. which demographic you fit into), there are several programs that help lower the cost of hearing aids or cover the cost completely. State vocational rehabilitation agencies, for example, offer financial assistance to college-aged people and those concerned about losing their job due to hearing loss. Military veterans qualify through the U.S. Department of Veterans Affairs. Federal employees also receive insurance benefits that often cover hearing aids.
Because of the tremendous impact of hearing loss, there are also many local civic organizations that offer financial assistance for hearing aids. Kiwanis or Lions Clubs close to you might have funds available for a device. For example, the Georgia Lions Lighthouse Foundation provides approximately 1,000 low-income Georgia residents with hearing aid assistance every year.
There are also now hearing aid companies selling high-quality devices directly to consumer, which can significantly lower costs. Lively, for instance, offers a pair of professionally programmed hearing aids are available for one payment of $1,195 or $39/month (with no interest financing), significantly less than many other companies charge for a single comparable device. A Lively hearing aid also includes many features that aren't standard features with other hearing aids, such as follow-up care with an audiologist as well as a simple and seamless mobile app. This ultimately makes hearing aids more accessible for anyone with hearing loss, but who doesn't have hearing aid insurance.
As policies change, there's a good chance insurance companies and government agencies will show a greater understanding of the need for hearing aid insurance that anyone, anywhere can access. It might take a bit of digging, but hopefully there are many resources available.
No matter the cost, treating your hearing loss with a hearing aid is a health decision you should prioritize. At Lively, we're proud to keep costs low, and the quality of our devices and our services high — so that you can be happy with your purchase no matter your insurance situation.