By Sueanne Phan
Recent changes to hearing aid legislation have expanded to include complete insurance coverage for children in Idaho and low-income adults in Maryland. Hearing aid costs have historically served as a barrier to hearing healthcare access. As such, these changes may set the stage for additional coverage expansion in other states.
This is a potentially very exciting time in terms of increasing access to audiological services and audiologists" says Dr. Catherine Palmer, President-Elect of the American Academy of Audiology. "Patient groups need to make sure that this access includes the essential services that customize the device to the individual's hearing and communication needs.
On January 10, the state of Idaho passed a law that now requires insurance companies to cover the purchase cost of hearing aids for all children. The law will also includes coverage for supportive services such as speech therapy. This update comes as a relief for approximately 1,000 Idaho families with deaf or hard of hearing children, who will no longer need to pay out-of-pocket for the financially costly but much needed devices. Prior to this change, Idaho insurance companies were not required to provide any amount of coverage for hearing aids. Instead, families needed to finance the cost themselves or qualify for Medicaid, which could at times prove to be an arduous process.
Following months of negotiations, a meeting was held at the Idaho Statehouse, which garnered almost 50 community members present to voice their support for the bill. The Idaho House Business Committee listened as healthcare professionals, parents, and their children shared their own personal experiences with hearing loss. The Committee later voted unanimously to pass the law.
Most noteworthy to this change was the role of community members and healthcare professionals, namely audiologists, who advocated for the revision and exact terms. Insurance companies in Idaho are now updating their current policies to accommodate the change for implementation in 2020.
Dr. Palmer explained that "[t]he key to legislation is for audiologists to be part of shaping the language so we ensure that the patients we serve have access to appropriate care and that audiologists are reimbursed in a manner that allows them to continue to serve these patients."
Another notable change to hearing aid coverage in the country is the inclusion of adults to Maryland's Medicaid program. Specifically, coverage for hearing aid devices costs that was previously exclusive to children with Medicaid is now available for adult members. In addition to "medically necessary" hearing aids, Maryland Medicaid coverage for adults now includes cochlear implants and auditory osseointegrated devices. Maryland residents seeking such coverage must be referred to an audiologist for an evaluation by their primary care physician. The new law went into effect at the beginning of the year and was formally introduced to the public on January 9.
Maryland's move to extend Medicaid hearing aid coverage to adults marks a growing trend towards increasing access to hearing care through government assistance. This is particularly crucial as hearing loss has become noted as a public health issue. Currently, 28 states provide Medicaid coverage to adults, which is defined as individuals aged 21 years and older. To further compound the challenge in navigating coverage terms by state, there is also wide variation in eligibility requirements (e.g., degree of hearing loss) and extent of coverage.
"We will be seeing legislation at the state and federal level that will be approaching hearing aid coverage in the coming year" noted Dr. Palmer. "We will continue to see changes in Medicaid initially but there is every reason to believe there will be proposals beyond Medicaid coverage."
These two changes in hearing aid coverage law highlight the need for states to reevaluate their own policies to address a significant public health issue. Taken together, expansion of insurance coverage for both pediatric and adult populations could pave the way for more universal hearing aid funding legislative across the country.
Consumers and audiologists need to ensure that legislators understand that the services that audiologists provide are critical to success with amplification" emphasized Dr. Palmer. "We need to continue to talk about "hearing health care coverage" as opposed to "hearing aid coverage."
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