Why do most insurance providers exclude coverage for hearing aids?
They’re not considered essential medical devices. Instead, they’re deemed “elective” – chosen, rather than urgently necessary.
“Elective” Coverage for Hearing Aids is a problem
Hearing aids are a lifeline. They help people with hearing loss communicate with loved ones, coworkers, they help stay safe in everyday situations, and are a know preventative measure of cognitive issues like Dementia , Alzheimer’s and Depression as they age. They can improve a person’s quality of life, affecting nearly every aspect of their day-to-day routine. More than 50 percent of people over the age of 75 suffer from hearing loss, and for these individuals, hearing aids are far from elective.
If you would consider how dramatically a hearing loss could influence a person’s health and happiness, it’s difficult to understand how insurers could say that they’re nonessential and not worthy of insurance coverage. Not surprisingly, the issue extends beyond whether hearing aids are necessary or elective. It’s also about insurance companies risk vs. reward.
The Risk vs Reward
An Insurance company works by spreading the cost of health services over a large group of people so that members can pay a reasonable amount and still receive coverage. The insurance company profits when individuals pay for coverage but do not file any claims. Unfortunately, that makes individuals with hearing loss a serious risk for insurance companies. Individuals with hearing loss are very likely to file insurance claims to help pay for hearing aids, which can cost thousands of dollars. Hearing aids also require replacement every five years, which is an additional expense for the insurance provider.
As it stands, insurance companies are less likely to make a profit on high-risk individuals like those with hearing loss. This is a major reason why they’re less likely to offer coverage for hearing aids. Even if insurance companies do eventually provide coverage for hearing devices, they will have a major impact on the pricing of hearing devices and services, setting lower allowed contractual amounts for what can be billed.
If you have questions or would like us to find out if your insurance has a benefit for hearing please call us at 843-839-2389\ to schedule an appointment.