Programs to Help Families Pay for a Child’s Hearing Aid
Financial Assistance for Hearing Aids
When our son was born with a hearing loss, we went through a period of grief and acceptance. We were ultimately grateful for the early discovery, as it meant he would have access to the world of sound at a very young age. We were dismayed when we learned that our health insurance plan would not cover hearing aids, as they are considered a “lifestyle choice” rather than a medical necessity. For a child who could not develop spoken language without access to sound, we were astounded that hearing aids could be regarded as a lifestyle choice!
We paid $5,000 out of pocket for his first set of hearing aids, when he was four months old. We didn’t have knowledge of any programs that would help pay for a child’s hearing aids, so we took some kind donations from family to help finance his new “ears.”
Children need new hearing aids more often than adults, since technology improves at a rapid pace. In addition, children are harder on their hearing aids – exposing them to dust, dirt, water, and other damaging materials.
Financing Children's Hearing Aids
Early Intervention/School services
Most children with congenital hearing loss will be enrolled in auditory rehabilitation therapy, obtain services from a teacher of the deaf (hearing itinerant), or speech therapy services. Often, there is a provision for “assistive technology” in the Individual Family Service Plan (IFSP). If you do not live in a state that requires health insurance coverage of hearing aids, you may be able to get some assistance from Early Intervention.
Likewise, if your child is entering the school district (this usually happens at age 3 or age 5, depending on the state), hearing aids may be covered under assistive technology on your child’s Individualized Education Plan (IEP). Phrase the request as obtaining equal access to the curriculum. Be aware, however, that some school districts will provide hearing aids for your child, but require them to remain on school property. Since children need to wear hearing aids during all waking hours to achieve the maximum benefit for language development, ensure that any hearing aids provided by the school district may be worn by the child at home as well as at school.
We did not manage to get our son’s hearing aids covered by Early Intervention, as there was an income cap applied to those requesting assistance for assistive technology. We did manage to get Early Intervention to cover our son’s earmolds ($120 every 2 weeks when he was an infant). When our son transitioned to the school district, we used the assistive technology section of his IEP to obtain an FM system and batteries – since the FM system drains batteries very quickly, the school district will cover his power source while he is actively attending school.
SSI Assistance for Hearing Aids
Depending on income level, some children may qualify for Medicaid coverage. In addition, children with extensive health conditions may qualify for an SSI waiver, which does not have an income requirement. Unfortunately, the SSI program requires “total deafness” for disability coverage in most cases. Since most children who need hearing aids are hard of hearing and not profoundly deaf, they will not automatically qualify for SSI based on a moderate or severe hearing loss. Most profoundly deaf children will require the use of cochlear implants, which are covered by medical insurance – so hard of hearing children are often not covered by either SSI or medical insurance. Income limits are placed on those applying for SSI, so middle-class families will not qualify for assistance.
If your child has extenuating circumstances (other health conditions or a known syndrome), they may qualify for the SSI/Medicaid waiver program. Children with developmental disabilities qualify for this program, which does not have income limit requirements. Medicaid will pay for medical appointments, adaptive equipment, and other therapies for children who qualify.
My son does not qualify for the Medicaid Waiver program, despite having a g-tube, hearing aids, and requiring the use of nighttime ventilation. He does not have a developmental disability and does not have a known, listed syndrome, so he does not qualify for this program. In general, the Medicaid Waiver program is for children who have developmental disabilities, and not necessarily complex medical conditions.
The Lion’s Club has a hearing aid and eyeglasses assistance program, to help struggling families. Families can contact the Lions Information System at 1-866-623-9053 to inquire about the program.
Audient, part of the Lions Club, is the Alliance for Accessible Hearing Care. They will provide new hearing aids to people who fall within 250% of the poverty level. Hearing aid recipients must pay $600 per aid, even with this grant, but this is much cheaper than paying full price for each hearing aid. Audient may be contacted at 1-877-283-4368.
If your child has a severe to profound hearing loss and is expected to receive a cochlear implant, ask your audiology center about a hearing aid loaner program. Some audiology clinics will have allow children to use “loaner” hearing aids until their cochlear implant surgery takes place.
Hearing Aid Banks
Like audiology clinics, some states offer hearing aid loans through “banks.” The state of Kansas, for instance, has a hearing aid bank that provides hearing aids for children up to the age of three years old. This allows newly identified families more time to come up with the finances for their own hearing aids.
Assistance for Middle Class Families
The United Healthcare Children's Fund is a non-profit organization that will dispense grants to families who need assistance paying for hearing aids, orthotics, assistive devices, or therapy. Families must already have health insurance (through their company or privately funded) to qualify for this program. The grants (up to $5,000 per family) will cover items and therapy not covered by the family's medical insurance. A family of four may earn up to $100,000 per year to qualify for this program.
Charitable Organizations for Children with Hearing Loss
Hearing Aid Funding Poll
How did you pay for your child's hearing aids?
Other Charitable Foundations for Hearing Aid Assistance
The John Tracy Clinic
The John Tracy Clinic in Los Angeles provides free hearing tests, correspondence courses, international summer school sessions, and has a hearing aid bank for families in need.
John Tracy Clinic
806 W Adams Blvd Los Angeles, CA 90007
Disabled Children’s Relief Fund
This agency assists children with physical handicaps and limited or no medical insurance.
Families wishing to apply for hearing aid assistance may reach the DCRF at:
Disabled Children's Relief Fund
P.O. Box 89
Freeport, New York 11520
Children of the Silent World
This charity assists low income families with the purchase of hearing aids.
P.O. Box 2425
Cridersville, OH 45806
Dorothy Ames Trust Fund
For those living in New England, the Dorothy Ames program provides families with assistance for purchasing hearing aids and other assistive technology.
Key Trust Company of Maine
P.O. Box 1054
Augusta, ME 04332-1054
(207) 623-5527 Voice
(207) 623-5662 Fax
FOUNDATION FOR SIGHT & SOUND
This foundation will help low income families by providing grants for hearing aids.
P.O. Box 1245
Smithtown, NY 11787
The Optimist club may assist families in obtaining hearing technology. Optimist International Youth Program
Help Them Hear Program
Contact your local Optimist Club
Children Listen Differently than Adults
While most insurance programs do not cover hearing aids for children under the age of 18, some programs do offer full coverage or partial coverage. It is wise to check your insurance policy to determine if the insurance company will pay for hearing aids, and if so, how much they will contribute toward the expense. We recently obtained a new health insurance policy and were thrilled when the insurance company claimed they “covered hearing aids for children.” Upon reading the policy, however, we discovered the company would only contribute a maximum of $600 for a pair of hearing aids. Since two hearing aids cost approximately $6,000, the insurance company would only contribute 10% of the final cost.
Appeal to the Insurance Company
I know at least one person who has had success with appealing to their insurance company directly – while the insurance company did not routinely cover hearing aids for children, a letter from both the member and the child’s physician may help turn the tide in your favor. If your insurance company covers prosthetic devices, but does not cover hearing aids, you can try sending the insurance company the following letter:
“I am a member of thehealth insurance plan, which recently denied coverage for a prosthetic ear (also known as a hearing aid) for my child. This letter is a formal appeal: on page #of your manual, prosthesis, home medical equipment, and orthotics are listed as COVERED, but on page # hearing aids are listed as NOT COVERED. Hearing aids are a prosthetic device, designed to improve or replace a missing body part. Children with congenital or pre-lingual loss of hearing cannot develop spoken language without access to sound, which is provided by the prosthetic ear. Hearing aids have been prescribed by my child’s doctor as medically necessary devices, which will prevent or reduce the atrophy of the auditory processing centers in my child’s brain. Failure to obtain these necessary medical devices will cause permanent harm and deterioration to my child’s neurological development. I am eagerly awaiting your response.”
Mandated Hearing Aid Coverage by State
Several states require hearing aid coverage for minor children. Unfortunately, many companies manage to avoid this requirement, as self-insured companies are not required to provide the state mandated coverage. The table below lists the states that require insurance companies to cover hearing aids for children:
Hearing Aid Mandates by State
Employers offering healthcare insurance must choose an option that provides coverage of at least $1,400 for each hearing aid purchased (i.e., minimum of $2,800 for two hearing aids) every three years. There is no age limit for this law, so the insurance company must cover hearing aids for children and adults.
Arkansas Code Ann. §23-79-1401
Hearing aids must be covered for children under the age of 18. Healthcare providers must cover new hearing aids every five years or when the current hearing aid cannot be programmed to suit the changing hearing needs of a child. The Colorado law also requires coverage of auditory therapy, hearing aid adjustments, fittings, and the initial assessment.
Colorado Rev. Stat. §10-16-104
Hearing aid coverage is mandated for children ages 12 and under, though healthcare policies may place a cap at $1,000 every 2 years.
. Connecticut Gen. Statute §38a-490b and §38a-516b
Hearing aids must be covered for dependent children under the age of 24 years, as long as the child is a dependent of the policy holder. Insurance policies may limit the coverage to $1,000 every three years.
Delaware Code Ann. tit. 18 §3357
One of the best states for hearing aid coverage laws, Kentucky requires insurance providers to cover the full cost of each hearing aid, with a maximum coverage amount of $1,400 per ear for children under the age of 18. This coverage allows for new hearing aid purchases every 3 years and covers all related services (including assessment and fitting of the aids).
Kentucky Rev. Stat. Ann. §304.17A-132
Similar to the Kentucky law, insurance companies in Louisiana must cover hearing aids for children under the age of 18, providing new hearing aids every 3 years. The benefit amount is up to $1,400 per ear; parents may choose a more expensive hearing aid and pay the difference, if desired.
Louisiana Rev. Stat. Ann. §22:1038
Healthcare providers must cover hearing aids for children under the age of 18, though coverage may be limited to $1,400 per ear. Coverage must allow for new hearing aids to be purchased every 3 years.
Maine Rev. Stat. Ann. tit. 24-A §33-2762
Similar to other state laws requiring hearing aid coverage for children, insurance companies must provide hearing aid coverage for children under the age of 18: limits may be set to $1,400 per ear and new hearing aids may be purchased every 36 months.
Maryland Code §15-838
Insurance companies must cover the full cost of hearing aids for children with congenital hearing loss that is not correctible by surgical or medical procedures. New hearing aids must be covered every 3 years.
Minnesota Stat. §62Q.675
The state law in Missouri requires insurance providers to cover the first set of hearing aids. Healthcare companies are not required to cover subsequent sets, though they must cover newborn screenings, diagnostic hearing tests, and follow-up appointments with an audiologist.
Missouri Rev. Stat. §376.1220
Insurance companies must cover hearing aids every 5 years, and must pay at least $1,500 per ear.
New Hampshire Rev. Stat. Ann. §415-6p and §415:18-u
Children ages 15 years and under must be covered for hearing aids under the New Jersey law. Healthcare insurance companies must provide at least $1,000 per aid every 2 years.
New Jersey Stat. Ann. §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
Possibly the very best state for children’s hearing aid coverage, New Mexico requires insurance companies to cover up to $2,200 per aid every three years. Children under the age of 18 are covered, though the coverage extends to those under 21 if the child is still attending high school. The insurance coverage must include all hearing assessments, related services, and earmolds to maintain a good fit for the child.
New Mexico Stat. Ann.§13-7-10; §59A-22-34.5; §59A-23-7.8; §59A-46-38.5; §59A-47-37.1
The state law in North Carolina requires hearing aid coverage up to $2,500 per ear every 3 years for children under the age of 22 years.
North Carolina Gen. Stat. §58-3-285
Hearing aid coverage is mandated for children under the age of 18, though a dollar limit is not assigned. New hearing aids must be covered every 4 years.
Oklahoma Stat. tit. 36 §6060.7
Hearing aids must be provided every 4 years to children under the age of 18, with a maximum requirement of $4,000 for both ears. Children over the age of 18 must be covered if they are a dependent on their parent’s health insurance plan and attending an accredited educational facility.
Oregon Rev. Stat. §743A.141
Children under the age of 18 must be provided hearing aids every 3 years, and the insurance company must pay at least $1,000 per ear.
Tennessee Code Ann. §56-7-2368
Insurance providers must cover hearing aids for children under the age of 19, and must pay at least $1,500 per aid every 3 years. Healthcare providers must also provide hearing aids to those ages 19 and up, but the coverage requirement is reduced to $700 per ear.
Rhode Island Gen. Laws §27-18-60
Flex Spending Account (FSA)
If your employer offers a Flex Spending Account, use it to finance your child’s hearing aids. This money is tax-free and placed into an account by your employer – we used this option when purchasing our son’s first set of hearing aids.
Deduct Hearing Aid Expenses From Your Taxes
If you itemize your taxes, healthcare expenses (including hearing aids) are deductible if the amount you spend exceeds 10% of your gross income. When determining medical expenses for the year, remember to include travel costs, earmolds, parking fees, and copays in your calculations.
© 2012 Leah Lefler