Does Aetna Health Insurance Cover Hearing Aids?

Understanding Hearing Aid Coverage Through Aetna

Hearing loss is a common condition, affecting millions of Americans. As we age, many of us experience some degree of hearing decline. Other times, hearing loss can occur suddenly due to illness, injury or overexposure to loud noise. Whatever the cause, hearing aids offer a solution to improve hearing and communication.

But hearing aids can be expensive, with costs ranging from $1,000 to $5,000 per device. And they may need to be replaced every 5-7 years as technology improves. That's why hearing aid coverage through health insurance is so important.

Aetna is one of the largest health insurance providers in the U.S. The company offers group and individual health plans, as well as Medicare and Medicaid plans. So does Aetna cover hearing aids? Here's what you need to know.

Hearing Aid Coverage Under Aetna Health Plans

Coverage for hearing aids under Aetna health plans varies depending on the type of plan you have. Here are some key points about Aetna hearing aid benefits:

• Most Aetna group health plans do not cover hearing aids as a standard benefit. However, employers can elect to add a hearing aid rider to their group plan for an additional premium.
• Aetna's individual and family plans sold through the Health Insurance Marketplace also do not cover hearing aids as a standard benefit under the Affordable Care Act requirements.
• Some Aetna Medicare Advantage plans may offer partial coverage for hearing aids and exams. This coverage varies significantly by plan.
• Medicaid plans through Aetna may offer limited hearing aid benefits for enrollees under age 21 due to the EPSDT benefit.

So in most cases, hearing aid coverage is limited or excluded from Aetna health plans. However, there are some options to reduce costs...

Discounts and Savings Programs

Even if your Aetna plan doesn't cover hearing aids, you may still be able to save through discounts and contracted rates. Some options to explore include:

• In-network rates: Aetna provides access to discounted hearing aid pricing through preferred providers and manufacturers. This allows you to save 20-60% off retail costs.
• Hearing Care Solutions: This Aetna program partners with Epic Hearing to provide discount hearing aids and exams. You can save up to $2,500 per pair.
• Coverage for exams: Even if hearing aids aren't covered, plans may cover hearing exams to test for hearing loss and determine if hearing aids are appropriate.

Using in-network providers is key to maximizing savings on hearing aids through Aetna. Shopping around and comparing prices from different retailers may also help you find the best deal.

Are Higher Cost Plans Better for Hearing Aid Coverage?

You may think purchasing a more expensive Aetna plan would provide better coverage for hearing aids. But that's not necessarily the case. Hearing aid benefits are usually excluded from coverage, regardless of the premium level.

That said, higher cost plans may sometimes include allowances for hearing care:

• Plans with lower deductibles and copays reduce your out-of-pocket cost for exams.
• Plans with higher premiums may indicate richer benefits selected by your employer.
• Upgrading to gold or platinum plans on the Marketplace opens access to discounts like Hearing Care Solutions.

But in general, you can't count on more expensive Aetna plans to cover hearing aids. Focus instead on choosing a plan to meet your complete healthcare needs within your budget.

Are There Any Aetna Plans That Cover Hearing Aids?

While most Aetna enrollees won't have hearing aid coverage, there are some plans that include this benefit. Here are a few scenarios where Aetna plans may cover some hearing aid costs:

• Employer group plans with riders: As mentioned, employers can purchase add-on benefits to cover hearing services and devices. This results in higher premiums but gives employees hearing aid benefits.
• State and higher education plans: Self-funded plans for state and education employees sometimes include hearing aid coverage, even if most commercial Aetna plans don't.
• Medicaid for children: EPSDT mandates coverage of hearing aids for Medicaid enrollees under 21. So Aetna Medicaid plans cover pediatric hearing aids in accordance with state and federal guidelines.

Outside of these limited circumstances, Aetna enrollees pay for hearing aids out of pocket. Knowing your employer's plan details is the best way to find out about any covered hearing benefits.

Does Medicare Cover Hearing Aids Through Aetna?

Original Medicare does not cover hearing aids or exams. But Medicare Advantage plans through private insurers like Aetna may offer supplemental hearing benefits.

Here's an overview of how Aetna MA plans may cover hearing costs for seniors:

• Hearing aid stipend: Many plans provide an annual allowance for hearing aids, usually $500-$1,000 per year. This can be used to purchase devices.
• Routine hearing exam: Most plans cover one exam per year with either a small copay or no copay.
• Hearing aid fittings: The cost of hearing aid fittings and evaluations may be included in the stipend or covered separately.
• Covered brands: Aetna contracts with major hearing aid manufacturers, with discounted pricing on covered devices.

These benefits vary significantly between different Aetna Medicare Advantage plans. Comparing plans side-by-side makes it easy to see which offers the hearing coverage you need.

Aetna Medicare Advantage Plans with Hearing Aid Coverage

Here are some popular Aetna MA plans that include hearing aid coverage:

• Aetna Medicare Premier (PPO): Offers an annual $1,000 allowance for hearing aids along with $0 copay on routine hearing exam.
• Aetna Medicare Value (PPO): Includes a $750 per year hearing aid allowance and covers one hearing exam annually.
• Aetna Medicare Eagle (HMO): Provides a $500 stipend for hearing aids each year. Hearing exam copays vary by region.

PPO plans give you flexibility to see out-of-network providers, while HMO options offer lower copays but require seeing in-network providers. All plans use the Aetna network of hearing aid retailers.

Are There Limitations on Hearing Aid Coverage?

While Aetna MA plans provide welcome assistance with hearing aid costs, be aware coverage does have some limitations:

• Allowances only cover a portion of total costs for devices and fittings.
• You must use Aetna's contracted hearing aid providers and brands.
• Copays may apply for exams and follow-up adjustments.
• Plans only cover what they deem "medically necessary" services.
• Benefits are usually limited to one aid per ear annually.

Understanding these limitations allows you to plan for any out-of-pocket expenses not covered by your Aetna Medicare Advantage plan.

Tips for Using Aetna Hearing Benefits

Very few Aetna plans provide comprehensive coverage for hearing care. But by shopping smart and tapping into discounts, you can save on the cost of hearing aids and services.

Here are some top tips for using Aetna hearing benefits:

Check Your Plan Details

Review your plan documents or get confirmation from Aetna about exactly what hearing services are covered before proceeding with an exam or hearing aid purchase.

Compare In-Network Providers

Make sure to shop Aetna's contracted hearing aid retailers and compare prices. In-network providers offer the best discounts.

Look Into Employer Riders

Ask your benefits manager at work if your employer offers optional riders to add hearing aid coverage to your Aetna group health plan.

Bundle Services

If your exam, hearing aids and fittings are separate copays or coinsurance, ask your provider to bundle services to reduce your costs.

Apply Allowances Carefully

Use your annual hearing aid stipend from Aetna Medicare plans strategically. Get quotes on different models to make the allowance go as far as possible.

Understanding your options for hearing aid coverage under Aetna is the first step to accessing benefits available to you. A little planning ensures you make the most of your insurance to get the hearing assistance you need.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.