Medicare/Medicaid

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Medicare/Medicaid

1965 Medicare and Medicaid were enacted as Title XVIII and Title XIX of the Social Security Act, extending health coverage to almost all Americans aged 65 or older (e.g., those receiving retirement benefits from Social Security or the Railroad Retirement Board), and providing health care services to low-income children deprived of parental support, their caretaker relatives, the elderly, the blind, and individuals with disabilities. Seniors were the population group most likely to be living in poverty; about half had insurance coverage.

Medicare is the federal health plan for citizens 65 years of age and older and/or those with significant disabilities. Medicare reimbursement rates are determined at the federal level under the auspices of the Centers for Medicare and Medicaid Services (CMS).

Medicaid provides medical assistance for qualifying individuals with low incomes and few resources. Medicaid is funded jointly by State and Federal governments in order to provide States the ability to offer adequate medical care to those in need. Medicaid is run within broad federally mandated guidelines which allow states the flexibility to establish their own eligibility standards, determine the type, duration, and scope of services, and set the rate of payment for services. As a result, benefits and programs vary considerably from state to state.

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Medicaid Coverage of Hearing Aids

What is Medicaid?

Title XIX of the Social Security Act outlines a program to provide medical assistance for certain individuals with low incomes and few resources. The program, known widely as Medicaid, is federal law and is funded jointly by State and Federal governments in order to provide States the ability to offer adequate medical care to those in need. Medicaid is run within broad federally mandated guidelines which allow states the flexibility to establish their own eligibility standards, determine the type, duration, and scope of services, and set the rate of payment for services. As a result benefits and programs vary considerably from state to state.

This research details the coverage of hearing aids and related services under Medicaid programs in the fifty states. Hearing health services are optional under Federal guidelines for minimum coverage and as a result many states do not cover hearing health services for adults.

Children are covered by a federally mandated program referred to as EPSDT, (Early and Periodic Screening, Diagnosis, and Treatment program) which provides for hearing health services as well as other services for eligible children up to the age of 18 in all states, unless otherwise listed. Individuals interested in the Medicaid services should contact their state’s Medicaid office using the information provided in the database.


Hearing Aid Coverage Under Medicare: You CAN Make a Difference!

April 2014

In October 2013, HLAA sent out a letter in support  for a bill introduced in the US House of Representatives that if passed would provide hearing aid coverage under Medicare.

Introduced by Representative Matt Cartwright from Pennsylvania, the Help Extend Auditory Relief Act of 2013, the HEAR Act (HR 3150), would:

  • amend the Social Security Act to include Medicare coverage for hearing rehabilitation, including a comprehensive audiology assessment to determine if a hearing aid is appropriate, a threshold test to determine audio acuity, and various services associated with fitting, adjusting, and using hearing aids.
  • extend Medicare coverage to hearing aids, defining them as any wearable instrument or device for compensating for hearing loss.

The bill has picked up 20 co-sponsors but will surely need more to for this bill to move forward. To do that, members of the US House of Representatives need to hear from you. They need to know how this bill would change your life, and the lives of so many others.

[Read more]


Medicaid Coverage for Hearing Aids State by State

April 2012

Compiled on the Medicaid Regulations page is the coverage of hearing aids and related services made available to eligible Medicaid recipients in each state. Since the states often make revisions to the scope of their Medicaid benefits, recipients are cautioned to check their state’s Medicaid offices for possible updated coverage.