Why don’t health insurance companies pay for hearing aids? Author:    Posted under: Health InsuranceHealth Insurance questions answered


Consider the statistics:

About 2 to 3 out of every 1,000 children in the United States are born deaf or hard-of-hearing. Nine out of every 10 children who are born deaf are born to parents who can hear.

There is a strong relationship between age and reported hearing loss: 18 percent of American adults 45-64 years old, 30 percent of adults 65-74 years old, and 47 percent of adults 75 years old or older have a hearing impairment.

Staggering figures, are they not? Well, how about this one?

Only 1 out of 5 people who could benefit from a hearing aid actually wears one.

By and large, health insurance companies have refused to pay for hearing aids. While the general public will never really know the exact reasoning behind this, it doesn’t necessarily keep ordinary citizens like you and me from speculating.

One such popular assumption is in direct relation with how insurance companies work. The prevalence rates are so high, as evidenced by the above-mentioned statistics for both adults and children either born with hearing loss or deteriorating sense of hearing, making it such a risk that insurance companies aren’t willing to take on.

Putting it plainly, this is how insurance companies work: It spreads the cost of an uncommon but known ‘insurable risk’ from a small group of people to many. These people are also known as members who have purchased insurance policies from an insurance company. In this way, everyone is paying for a relatively manageable amount instead of having just one person shoulder a heavy financial burden. That’s what your premiums are for; add to that the administrative fees and other costs in order for the insurance company to make a profit.

There are other dynamics to it but that is how insurance works in a nutshell. The chances of a healthy individual getting struck with a serious illness are rather slim, making it an insurable risk. On the other hand that is why for so long, it has been such a great difficulty for people with pre-existing conditions to obtain health insurance coverage without paying for sky-high premiums, if they are able to get any at all. The likelihood that they will file for a claim in the very near future is inevitable, and in some instances their benefits may far outweigh the premiums they have paid making it a near-impossibility for insurance companies to get decent financial returns from them.

Moreover, although hearing aid costs have actually decreased somewhat over time when compared to inflation rates, the price range is still approximately $1,000 to $4,000 each depending on the technology. Many lament how expensive these are, without considering the factors that contribute to the cost such as research and development costs, customization to fit the needs of the user, manufacturing costs, as well as fitting, programming, adjusting and servicing of the instruments. The average lifetime of a pair of hearing aids is only roughly 3-5 years or more. Therefore, it has become public opinion that since insurance companies won’t be generating much revenue, on the contrary, stand to lose a lot of money by paying for hearing aids, they refuse to pay for the instruments for those who need them to improve their quality of life.

Over the years, a few states have passed laws requiring some insurance companies to cover the cost of hearing aids for minors due to the lobbying efforts of families affected with this disability. The first state to pass this law was Maryland, with insurance companies covering the cost of hearing aids up to $1,400 every three years. As it turns out though, there were a lot of exceptions that rendered it absolutely inapplicable to a majority of the children who should benefit from it. For instance, the law would not apply if the child’s insurance coverage was obtained through a parent’s employer. Another such exception was for insurance companies that were headquartered outside of Maryland.

Another loophole in this is that in the event that an insurance company does pay for hearing aids, they are only paying for the very basic ones, effectively making it difficult for people who need the more advanced technology to obtain hearing aids at all.

So what are the deaf and hard of hearing to do if they really could not afford to pay for hearing aids out of their own pockets?

  • People from low-income brackets can qualify for hearing aid assistance through Medicaid in some states.
  • Check the government section of your phone book and call Social Services to determine whether you are eligible or not.
  • Veterans of military service may also check for their eligibility for assistance with hearing aids.
  • Another option may be for you to contact your local Lions Club chapter to see if they have any ongoing programs that provide assistance for those in need of hearing aid.
  • Medicare members should also check the type of coverage they carry to see if it will cover the expenses of hearing aids.

One thing is for sure, families can continue to advocate for the government and the insurance companies to make changes that are desperately needed.

Source:
http://www.nidcd.nih.gov/health/statistics/quick.htm

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