Insurance

State Insurance Mandates for Hearing Aids

Certain insurance plans are exempt from state mandates. contact your plan administrator to see if your plan includes state-mandated hearing aid insurance benefits).

colorado, delaware, georgia, kentucky, louisiana, maine, maryland, massachusetts, minnesota, missouri, montana, new jersey, new mexico, north carolina, oklahoma, oregon, tennessee, texas, and vermont require benefit plans provider in your state pays for hearing aids for children. arkansas, connecticut, illinois, new hampshire, and rhode island require coverage for both children and adults. Wisconsin requires coverage for both hearing aids and cochlear implants for children. requirements vary from state to state for

Reading: What insurance companies cover hearing aids

  • ages covered
  • amount of coverage
  • benefit period
  • supplier qualifications
  • Existing laws in these states are summarized below with a link to each statute. the information is reviewed annually. Keep in mind that laws, regulations, and policies can change at any time, so always check with your state for the most up-to-date information.

    arkansas

    requires insurance companies to offer coverage to employers in the state. if the employer chooses to add this option, the health plan must provide hearing aid coverage of no less than $1,400 per ear every three years for people of all ages.

    citation: code of arkansas ann. § 23-79-1401

    red

    requires insurance providers to cover hearing aids for children under the age of 18 when medically necessary. Coverage must include a new hearing aid every five years, a new hearing aid when modifications to the existing hearing aid cannot meet the child’s needs, and services and supplies such as initial evaluation, fitting, adjustments, and hearing training.

    citation: colorado rev. statistics § 10-16-104

    connecticut

    requires individual and group health insurance policies to provide coverage for hearing aids for children age 12 and under; classifies hearing aids as durable medical equipment and allows policies to limit the benefit to $1,000 every 24 months. As a result of the Affordable Care Act’s prohibition on age-discriminatory benefit design, the Connecticut Department of Insurance requires insurance policies to remove age limits on hearing aid benefits for policies issued or renewed after January 1, 2016.

    citation: connecticut gen. statute § 38a-490b and § 38a-516b. bulletin hc-102 [pdf]

    del

    requires individual and group health insurance contracts to provide coverage for hearing aids up to $1,000 per ear, every 3 years, for children under the age of 24, covered as dependents by the policyholder.

    citation: code of delaware ann. tit. 18 § 3357

    georgia

    Requires health benefit policy to provide coverage of up to $3,000 per ear every 48 months for covered persons age 18 and under.

    quote: ga. code ann § 33-24-59.21 [pdf] [created by s.b. 206 (2017)]

    illinois

    requires insurers to provide coverage to all insured persons, subject to all applicable copays, coinsurance, deductibles, and out-of-pocket limits, for hearing aids once every 12 months, unless there is a significant change in the hearing status of the insured.

    quote: 215 bad. statistical draft 5/356z.29 (created by hb 4516 (2018))

    kentucky

    requires health benefit plans to provide coverage for the full cost of one hearing aid per hearing-impaired ear up to $1,400 every 36 months for persons under the age of 18, as needed, and all related services necessary to evaluate , select and adjust the hearing aid. the insured can choose a higher priced hearing aid and pay the difference in cost; the hearing aid must be prescribed by a licensed audiologist and administered by a licensed audiologist or hearing instrument specialist.

    citation: kentucky rev. ana statistic § 304.17a-132

    Louisiana

    requires individual and group insurers to provide coverage for hearing aids for a child under the age of 18 if the hearing aids are fitted and administered by a licensed audiologist or licensed hearing aid specialist after medical clearance from a licensed physician. medicine and a medically appropriate audiological evaluation for the child’s age. The insurer may limit the benefit payable to $1,400 per hearing aid for each hearing-impaired ear every 36 months. the insured may purchase a hearing aid at a price higher than the benefit payable and pay the difference to the hearing aid provider.

    See also: The Self-Employed Health Insurance Deduction | Nolo

    requires any insurer that also provides coverage for hearing aids to persons over the age of eighteen to allow the insured the option of choosing a hearing aid priced higher than the benefit payable under the policy. any additional amounts payable to the hearing aid provider will be paid by the covered person.

    quote: the. Rev. ana statistic § 22:1038

    main

    requires health insurance policies to provide coverage for hearing aids; coverage may be limited to $3,000 per hearing aid every 36 months.

    citation: maine rev. ana statistic tit. 24-a § 33-2762 modified by ld 38.

    maryland

    requires insurers to provide coverage for hearing aids for a minor child if the hearing aids are prescribed, fitted, and dispensed by a licensed audiologist; coverage may be limited to $1,400 per hearing aid for each hearing-impaired ear every 36 months; the insured can choose a more expensive hearing aid and pay the difference.

    citation: maryland code § 15-838

    massachusetts

    requires certain health plans to provide anyone under 21 years of age or younger coverage for the full cost of one hearing aid per hearing-impaired ear up to $2,000 for each hearing aid, every 36 months with a written statement from such minor . treating physician that hearing aids are medically necessary. the insured can choose a higher priced hearing aid and can pay the difference in cost above the $2,000 limit without any financial or contractual penalty to the insured or the hearing aid provider.

    citation: mass. gene laws:

    • chap. 32a § 23
    • ch. 175 § 47u
    • ch. 176a, § 8u
    • ch. 176b, § 4u
    • ch. 176g, § 4n
    • minnesota

      requires health plans to cover hearing aids for children under the age of 18 for hearing loss that cannot be corrected by other covered procedures. coverage is limited to one hearing aid per ear every three years.

      citation: state of minnesota. § 62q.675

      missouri

      Requires health insurance and Medicaid coverage for infant hearing screening, re-examination (if necessary), audiological evaluation and follow-up, and initial amplification, including hearing aids.

      citation: missouri rev. statistics § 376.1220

      mountain

      requires health insurance coverage to provide coverage for the diagnosis and treatment of hearing loss for a covered child 18 years of age or younger. treatment cannot include more than one hearing aid for each ear every 3 years.

      quote: mont. ann code §33-22 [pdf]

      new hampshire

      As of January 1, 2011, insurers must cover the cost of no less than $1,500 per hearing aid every 60 months. the insured can choose a higher priced hearing aid and pay the difference in cost.

      citation: new hampshire rev. ana statistic § 415-6p and § 415:18-u

      new jersey

      requires health insurers, the state health benefits program, and nj familycare to provide coverage for medically necessary expenses incurred in the purchase of a hearing aid for covered children 15 years of age and younger. coverage includes $1,000 per hearing aid for each hearing impaired ear every 24 months when medically necessary and prescribed or recommended by a physician or licensed audiologist. the insured can choose a more expensive hearing aid and pay the difference between the price of the hearing aid and the benefit.

      citation: new jersey statistics. Ana. § 17:48-6gg; § 17:48a-7dd; § 17:48e-35.31; § 17b:26-2.1aa; § 17b:27-46.1gg; § 17b:27a-7.14; § 17b:27a-19.18; § 26:2j-4.32; § 52:14-17.29n; § 30:4j-12.2

      new mexico

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      Requires individual and group health insurance policies to cover $2,200 per hearing aid every three years for children under 18, or under 21 if still in high school. the insured can choose a higher priced hearing aid and can pay the difference in cost. Coverage includes fitting and supply services, including the supply of ear molds as needed to maintain an optimal fit, provided by an audiologist, hearing aid provider, or physician licensed in New Mexico.

      citation: new mexico statistics. addendum § 13-7-10; § 59a-22-34.5; § 59a-23-7.8; § 59a-46-38.5; § 59a-47-37.1

      north carolina

      Effective January 1, 2011, health plans must provide coverage for one hearing aid per hearing impaired ear up to two thousand five hundred dollars ($2,500) per hearing aid every 36 months for covered individuals under the age of 22. .

      citation: north carolina gen. statistics § 58-3-285 [pdf]

      oklahoma

      requires any group health insurance or health benefit plan to provide coverage for audiological services and hearing aids for children up to age 18; adds the requirement for prescription and dispensing of hearing aids by a licensed audiologist; Allows hearing aid benefit every 48 months with no dollar limit.

      citation: oklahoma stat. tit. 36 § 6060.7 [rtf]

      oregon

      requires health benefit plans to cover one hearing aid per hearing-impaired ear for enrollees under the age of 18, or over the age of 18 if eligible as a dependent under the plan and enrolled in an accredited educational institution. hearing aids must be prescribed, fitted and dispensed by a licensed audiologist with the approval of a licensed physician and the maximum benefit amount is $4,000 every 48 months; however, a member may purchase a hearing aid priced above the benefit amount and pay the difference in cost.

      citation: oregon rev. statistics § 743a.141

      tennessee

      requires each individual or group health insurance policy renewed on or after January 1, 2012 to provide coverage of one thousand dollars ($1,000) per individual hearing aid per ear, every three (3) years, for each child under the age of 18 years of age covered by said policy, either as a dependent of the policyholder. an insured may purchase a hearing aid priced above the benefit amount and pay the difference in cost.

      citation: code of tennessee ann. § 56-7-2368

      texas

      requires a health benefit plan to provide coverage for the cost of a medically necessary hearing aid or cochlear implant and related services and supplies for a covered person who is 18 years of age or younger. coverage is limited to one hearing aid every three years and one cochlear implant in each ear with internal replacement as medically or audiologically necessary.

      citation: tex. in s. ann code § 1367.251 [created by h.b. 490 (2017)]

      vermont

      requires a health insurance plan to cover the cost of one hearing aid for each ear and associated hearing aid professional services when the hearing aid(s) is prescribed, fitted and dispensed by a hearing care professional, every three years or sooner if medically necessary. coverage will include hearing aid batteries when prescribed by a hearing care professional. requirements are effective for health plans issued or renewed on or after January 1, 2024.

      requires vermont medicare to provide coverage for medically necessary hearing aids and audiology services, including audiological exams, hearing exams, hearing aid fittings, and prescriptions for hearing aid batteries.

      quote: 8 v.s.a. §40881 (created by h. 266 [2022]) [pdf]

      rhode island

      Requires individual and group insurance policies to provide coverage of $1,500 per individual hearing aid, every three years, for children under 19, and $700 per individual hearing aid for those over 19.

      citation: rhode island gen. laws § 27-18-60

      wisconsin

      requires health insurance plans and policies to pay for cochlear implants, hearing aids, and related treatments prescribed by a physician or audiologist for any child under the age of 18. hearing aid coverage includes the cost of one hearing aid per ear per child once every three years.

      citation: wisconsin stat. § 609.86; § 632.895 (16)

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