Roughly 29 million adults in the U.S. could benefit from hearing aids.  Yet many health insurance plans don’t cover hearing aids. Medicare doesn’t cover them either. Hearing aids aren’t among the essential health benefits required by the Affordable Care Act, so there’s no federal requirement for insurance companies to cover even a portion of the costs. But a growing number of states have taken matters into their own hands.
On March 31, Washington pushed to become the latest state to require insurance companies to cover hearing aids, sending a bill to Governor Jay Inslee’s desk that would require insurance companies to provide up to $3,000 of coverage per hearing aid every 36 months.
Jill Bujnevicie has been pushing for the bill for five years, after her son Hugo, then 3, first got hearing aids.
“I pretty much immediately started working on this when he was diagnosed,” says Bujnevicie, a physician assistant. “I can’t keep my mouth shut when something is wrong, so I just kept asking questions and making phone calls and one thing just kept leading to the next.”
Now 8, the bill has been a big part of Hugo’s life, with Bujnevicie staying up late many nights sending emails and making calls to lobby for it.
Hugo is now old enough to have spoken out in favor of the bill in legislative hearings as well.
“He knows (his hearing aids) are his lifeline and that other kids go without them is just heartbreaking,” Bujnevicie says.
The bill also found champions in the state legislature, including former Rep. Emily Wicks, who was born deaf in her right ear. 
Washington’s Medicaid program had already covered hearing aids since 2019.  If Inslee signs the bill into law, it will take effect Jan. 1, 2024 and cover most group health plans. The cost of hearing aids and related services won’t count against a health insurance plan’s deductible, except for some plans with health savings accounts.
“I think Washington’s entry point of $3,000 is a really nice starting place,” says Doug Sladen, an associate professor and chair of the Department for Communication Sciences and Disorders at Western Washington University, who testified in support of the bill.
Hearing aids can cost up to $7,000 per pair and need to be replaced every few years.  Other state coverage requirements range from $700 to $4,000 per hearing aid.
The impact of hearing aids
Hearing aids have more than just a medical benefit, Sladen says. Restoring even partial hearing loss can have benefits in many other aspects of life.
“Hearing is required for spoken word development, which cascades into quality of life, academics, reading, learning, job prospects,” he says.
Studies have identified hearing loss as one of the top risk factors for dementia, and hearing aids appear to reduce that risk.  And they’re more effective the sooner you get them, says Lindsay Creed, an audiologist and associate director of audiology practices for the American Speech-Language-Hearing Association.
Coverage for hearing aids across the country
Virginia and Montana have also recently laws in the past few years requiring insurance companies to cover hearing aids. About half the states require at least some coverage of hearing aids, and about a dozen more have legislation in the works, says Eileen Crowe, director of state association relations for ASHA.
“There’s a lot of legislation being introduced and passed out there,” Crowe says.
The absence of a federal requirement means that many people who get health insurance from “self-funded” or “self-insured” plans don’t benefit from these state laws. In self-funded plans, companies — often large corporations — pay for health bills on their own rather than paying premiums to insurance companies. These plans are regulated by the federal government, not states.
Getting a requirement through Congress has proved tougher than the states.
“It would be hard to federally mandate a lot of this,” says Neela Swanson, director of health care and education policy at ASHA.
The recent introduction of over-the-counter hearing aids may help lower prices, Sladen says, but they’re not available for children yet.
For people whose employers don’t cover hearing aids, Swanson suggested talking directly to your human resources department.
“ASHA has some resources on our website for people in employer-based plans that they can use to talk to their employers about getting better access to audiology services,” she says.
Insurance coverage may only represent one obstacle for people needing access to these services.
In some places, there aren’t enough audiologists. While telehealth is becoming a more common option, not everyone may have internet access.
“It’s not just a geographical challenge, it’s not just having enough practitioners,” Crowe says.
Bujnevicie says she’s aware of how lucky she is to have the resources available where she lives in the Seattle area. The bill should give more kids like Hugo access to hearing aids. Once it becomes a law, she’s not sure what she’ll do with her nights.
“It will be amazing to not have this hanging over me all the time,” she says. “It takes a really driven, emotionally charged parent to be so motivated to do this. But it felt like a slap in the face to Hugo to not have it acknowledged as a necessary device. So I just wanted to change that for him.”
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