Blue Cross Blue Shield Hearing Aid Coverage

The Ultimate Guide on Whether Blue Cross Blue Shield Pays for Hearing Aids

Hearing loss impacts 30 million Americans from mild to profound levels that greatly affect quality of life. But with new hearing aids costing $2,000 - $8,000 per device out-of-pocket, costs become a major barrier for those who need them most.

So does Blue Cross Blue Shield pay for hearing aids? And what about Medicare benefits? This complete guide on hearing aid coverage under Blue Cross and other top insurance programs will uncover your options.

Understanding Blue Cross Blue Shield Healthcare Plans

Blue Cross Blue Shield is a network of over 30 major insurance companies that provide coverage for hospital visits, medical procedures, prescription drugs and other healthcare. It is one of the largest health benefit providers in the U.S. with over 100 million members.

Blue Cross plans are offered through Medicaid and also available as commercial plans from employers, healthcare exchanges or directly from website. But benefits vary significantly between these programs.

Does Blue Cross Cover Hearing Aids for Adults?

Unfortunately, the vast majority of Blue Cross plans do not cover any hearing aids or costs for adults due to hearing aids being classified as an assistive listening device. Outside of individual state Medicaid benefits explained below, most Blue Cross beneficiaries must pay for devices 100% out-of-pocket.

There are exceptions if hearing loss treatment and technology are deemed medically necessary by clinical standards (sensorineural hearing loss severity, word discrimination ability, etc.). But pursuing this exemption is challenging and rarely approved, leaving huge costs for those needing assistance.

Understanding Blue Cross Medicaid Coverage by State

Blue Cross does provide Medicaid plans in certain states where they administer benefits. And state Medicaid programs sometimes offer more robust hearing aid coverage for children and/or adults depending on location. Benefits can include:

• Full or partial cost coverage
• Hearing exams
• Fittings
• Hearing aid devices
• Repairs / replacements

But which states actually provide hearing aid benefits under their Medicaid programs? Lets analyze some top states more closely.

Does Blue Cross Blue Shield Cover Hearing Aids in California?

Californias Medicaid program called Medi-Cal provides pediatric hearing aids and services for those under 21. For adults, hearing aids are covered when medically necessary based on hearing loss severity. Blue Shield administers Medi-Cal benefits for some CA residents.

Does Blue Cross Blue Shield of Texas Cover Hearing Technology?

Under Texas Medicaid, minimal coverage exists. Only cochlear implants are covered - not external hearing aids. Blue Cross and Blue Shield of Texas manages the state Medicaid program but can not expand benefits beyond approved services.

What About Blue Cross Blue Shield of Illinois?

In 2023, Illinois Medicaid expanded benefits to include hearing aids and audiology services for beneficiaries of all ages when clinically necessary. Fitting, repairs and replacements are also included. Blue Cross Blue Shield of Illinois is a major Medicaid provider in the state which now covers these enhanced benefits.

Check locally to understand exactly what your states Medicaid plan may or may not cover so there are no surprises.

Can I Appeal a Claim Denial for Hearing Aids?

If Blue Cross denies your hearing aid claim, all is not lost. Every plan has an appeals process you can initiate if hearing loss severity meets clinical thresholds. Just know that overturning any decision is very challenging.

Having an audiologist write a letter of medical necessity is extremely important. Be sure to highlight impacts to quality of life and risks from leaving hearing loss untreated.

Do Medicare and Medicare Advantage Plans Cover Hearing Aids?

Original Medicare does not provide any coverage for hearing exams, hearing aids, fittings or audio repairs. And when people enroll in Medicare Advantage plans through private insurers, their policies usually exclude hearing coverage as well.

But in recent years, some Medicare Advantage plans have started offering extra benefits for hearing care due to its importance for health. Lets take a closer look.

A Closer Look at Medicare Advantage Hearing Benefits

In 2020, Congress approved a new supplemental benefit for Medicare Advantage plans that allows coverage for hearing treatment including aids and devices.

These plans are now allowed to bundle routine hearing exams, hearing aid evaluations, cost assistance for devices and more. Benefits are typically part of HMO or PPO plans insured privately but available to Medicare beneficiaries.

Over 25 Medicare Advantage providers now offer plans with robust hearing aid packages. And more insurers continue adding coverage every year as demand from retirees keeps growing.

Comparing Top Medicare Advantage Plans for Hearing Coverage

Whileenrollment periods, costs and exact benefits differ, here are a few top-rated Medicare Advantage plans providing hearing coverage:

• AARP Medicare Advantage - $599/$899 copay for advanced/premium hearing aids
• TruHearing Medicare Advantage - Up to 2 hearing aids for $699 copay
• UnitedHealthcare Medicare Advantage - $375-$2,025 copay for 4 tiers of hearing aids

By shopping carefully during open enrollment, significant savings on high-quality hearing aids are possible with the right Medicare Advantage insurer.

What About Hearing Aid Insurance, Discount Plans or Financing?

Beyond government programs, three other options to reduce hearing aid costs include:

1. Private Hearing Aid Insurance

Similar to dental insurance, private insurers now offer policies specifically for hearing exams and hearing aids. Monthly premiums apply but can be as low as $8-15/month. Annual maximum benefits generally cover $500 to $2,500 per ear depending on plan level purchased.

2. Hearing Aid Discount Plans

Like dental discount plans, membership programs provide 25-60% off name brand hearing devices when visiting select audiologists in these networks. Fees are $6-$15 monthly for individuals or $9-$30 monthly for entire households.

3. 0% Financing Options

Instead of large lump sum payments, companies like Wells Fargo Health Advantage, CareCredit and others offer 12-24 month financing for hearing aids with no interest. This breaks costs into affordable monthly payments to ease financial pain.

Final Thoughts on Insurance Coverage for Hearing Loss Treatments

Although original Blue Cross plans provide minimal hearing aid benefits for adults, options still exist! An increasing number of Medicare Advantage plans are bundling free or discounted devices with affordable copays during open enrollment.

Those under 21 should have most costs covered through state Medicaid programs as well. And private insurance, discount plans or financing make devices much more accessible for anyone still falling through the cracks. Just make sure to consult experts on navigating the incremental coverage options in your unique situation!

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.