How Can I Get My Insurance to Cover Hearing Aids?

Health insurance companies can be difficult to deal with when trying to get medical costs covered. If you are hearing impaired, you may be wondering how to get an insurance company to cover your hearing aids. Unfortunately, your insurance company might try to deny a claim, stating that hearing aids aren’t covered or not medically necessary. However, certain strategies can help you get your insurance company to cover hearing devices.

Eligibility

• Carefully review what your health insurance company covers before receiving medical treatment. Ask questions about what is and is not covered for hearing aids and make sure it matches what’s stated in your insurance documentation. If hearing aids aren’t specifically listed in the policy documents, you may have a loophole to get the insurance company to pay for them. If it does not cover any hearing-related costs, get a supplemental policy or upgrade your existing policy to cover hearing devices, audiologists and related expenses.

Necessity

• If your insurance company denies that the hearing aid is medically necessary, make sure your physician has sent in all necessary documentation explaining the level of your hearing loss. Your physician may need to justify hearing aids as a necessary intervention, deeming their use an appropriate treatment method that meets evidence-based care standards. If your physician has sent in the necessary documentation and the insurer still deems hearing aids not medically necessary, file a complaint with your insurance company, explaining your situation, limitations and other pertinent information. The company may reverse the decision about covering your hearing aids.

Appeal

• Write a letter to appeal the decision of your insurance company within the appeal period specified by your state and insurance company. Typically, you have 180 days, but the time frame varies. You can appeal the insurance company decision or your physician’s office can, depending on the reason stated.

Advocate

• Work with a patient advocate or insurance ombudsman in your area. Such advocates often have knowledge of how specific insurance companies work and may be able to help you in appealing your case by serving as an intermediary between you and the insurance company.

ADA

• Arm yourself with information. The Americans with Disabilities Act (ADA) is a civil rights law protecting people with disabilities from discrimination, which can also relate to access to services. Title V of the American Disability Act states that health plans can make disability related distinctions when offering benefits. However, insurance companies must first provide data stating that hearing devices would be so costly that the plan would become financially insolvent or increase premiums. They also must show clinical evidence demonstrating no medical benefit to hearing aids. If you are disabled, include civil rights laws to strengthen your argument.