Does Medicaid cover hearing aids for seniors?
Hearing loss in seniors is a common health problem. Medicaid coverage for hearing aids for adults in the United States varies from state to state. The good news is that more than half of states offer some level of coverage for hearing aids or cover other services, such as hearing tests and exams, hearing aid repairs and replacements, and other items, such as batteries and accessories. Reading this article will help you understand which benefits apply to you.
How Medicaid Works
Medicaid is a joint federal and state program that helps pay for medical expenses for individuals with limited income and other financial resources. The program provides health insurance to eligible adults and children, including pregnant women and people with disabilities. It also provides some long-term care benefits, such as coverage for skilled nursing home facility services.
While the federal government has general rules that all states must follow, each state has its own Medicaid program. Therefore, the benefits offered and eligibility requirements may vary from state to state.
The Cost of Hearing Aids
The average cost of a pair of hearing aids in the United States in 2024 is **$4,672**. Depending on the type and brand, prices can range from under **$1,000** to over **$8,000**.
For retirees living on a fixed income, the need for hearing aids can present a significant financial challenge. This is especially true for those with limited assets and resources. However, eligible seniors can find some financial relief through Medicaid.
When Does Medicaid Cover Hearing Aids?
According to the Hearing Loss Association of America (HLAA), Medicaid coverage of hearing aids varies by state. For example, in some states, such as Alabama, Arizona, Georgia, Louisiana, and Arkansas, Medicaid does not cover hearing aids at all.
In other states, such as Alaska, Medicaid covers hearing aids (including approved accessories and supplies) and hearing item repairs. However, to qualify for this coverage, "these services must be determined to be medically necessary and prescribed by a physician or other trained licensed health care practitioner who performs hearing assessments and evaluations within the scope of their license."
Minnesota also offers extensive coverage for hearing aids through Medicaid, such as:
1.Ear impressions.
2.Ear molds.
3.Hearing aid exams.
4.Parts and accessories.
5.Repairs.
6.Re-shelling, remanufacturing, and shell modifications.
Likewise, hearing aids are covered by Medicaid in California, including hearing aid repairs and hearing aid part replacements (except batteries). Hearing aids must be provided by a hearing aid dealer on a prescription from an otolaryngologist or the individual's primary physician.
In many states, hearing aid-related items that are not typically covered by Medicaid include:
1.Routine maintenance.
2.Hearing aid batteries.
3.Replacing electrical cords.
4.Cleaning.
5.Repairs while the manufacturer's warranty is in effect.
6.Repairs not covered by the hearing aid manufacturer's warranty.
With this in mind, it's important to understand what your state's Medicaid program does and doesn't cover when it comes to hearing aids so you have a better idea of what to expect and can plan any out-of-pocket expenses accordingly.
How to Get Hearing Aid Insurance Through Medicaid
Before you can get hearing aid insurance through Medicaid, you must first qualify for your state's Medicaid program itself. This typically requires you to meet certain low-income and asset thresholds. These thresholds may also vary from state to state.
Next, you must determine if you can get hearing aid insurance through your state's Medicaid program. If you live in a state where Medicaid covers hearing aids for seniors, you may need to take several steps to get those benefits. Depending on your state, those steps typically include the following:
1.Get a hearing evaluation and assessment.
2.Get a prescription and order from a qualified physician or other licensed healthcare professional.
3.Get hearing aids from a specific pharmacist or supplier.
4.Request prior approval for hearing aid repair and/or replacement.
Some covered services may have time limits. For example, in some states, Medicaid will not reimburse for hearing aid repair more than once every 12 months.
The best place to start is with your state's Medicaid agency, where you can see if you qualify for Medicaid, apply for coverage, find a health care provider, and check the status of your application and claims. You can also verify whether Medicaid covers hearing aids and any limitations on this coverage.
Learn More About Whether Medicaid Covers Hearing Aids in Your State
For more information about Medicaid coverage for hearing aids in each state (as well as limitations and eligibility parameters), visit HLAA's page that details Medicaid coverage for hearing aids.
Before proceeding with any type of Medicaid application, it is recommended that you speak with a professional familiar with the program who can provide you with the right guidance for your specific situation.
References