Most people would agree that the little things in life, like a gurgling stream, rainfall on a tin roof, and bird songs are what make it worth living. Absence of those and other sounds, along with a decreased ability to hear conversations with friends and family, reduce the quality of life you live. A sad truth reported by Medical Xpress demonstrates that only one in five individuals diagnosed with a hearing loss actually bother to get the help they need from hearing aids. However, they are essential to hearing recovery. The reasons for this statistic are numerous, but one that stands out is a lack of coverage or confusion relating to what costs insurance policies cover.
When I recommend auditory assistance provided by hearing aids to my Houston area patients as a solution to their hearing loss, often express concerns related to cost. Among the common questions asked is, “Does TriCare insurance cover hearing aids?” I wish I could provide a simple and easy answer to that question, but the fact is that there are a variety of considerations like plan type, age, supplements, and other factors involved in the response. I have compiled some general information, which you might find useful in answering questions about TriCare hearing aid coverage.
Medicare Plan Coverage
Most hearing-loss patients fall within the age range of Medicare eligibility, according to National Institute of Deafness and Other Communication Disorders (NIDCD) statistics, which note that “approximately one in three people in the United States between the ages of 65 and 74 have hearing loss, and nearly half of those older than 75 have difficulty hearing.” Because Medicare does not provide benefits to help cover the costs of hearing aids, it complicates answering insurance questions. Active duty military personnel and retired military personnel with Medicare parts A and B coverage can receive some benefits for hearing care through TriCare for Life.
Hearing Aid Coverage by TriCare for Active Duty Personnel
Tricare insurance is for individuals and families who qualify in various capacities as active-duty military personnel. There are a variety of medical plan packages offered at various levels of care to meet specific deployment and duty station needs. Dealing with hearing care, and more specifically hearing aids, Tricare covers active-duty personnel and their families who meet specific criteria as follows:
• Adults: Hearing threshold of at least 40 dB HL (one or both ears tested at 500, 1,000, 1,500, 2,000, 3,000, or 4,000 Hz) or Hearing threshold of 26 dB HL (one or both ears at three or more of the above testing frequencies) or Speech recognition score of less than 94%
• Children: Hearing threshold level of at least 26 dB HL (one or both ears tested at 500, 1,000, 2,000, 3,000, or 4,000 Hz)
This covers all hearing aids and hearing aids services. With its inclusion of hearing care for children, TriCare meets the Texas mandate to provide hearing aid services to children under the age of 18 years.
Hearing Care Coverage by TriCare for Retired Military Personnel
TriCare serves as a wrap-around supplement to those enrolled in Medicare parts A and B. Medicare is their primary insurance and TriCare services to pay a portion of medical bills after Medicare pays their part. Necessarily, those eligible for TriCare coverage will pay 20% coinsurance after Medicare pays. This coverage includes those hearing care services included in Medicare coverage. That means that hearing aids are not a part of TriCare’s coverage benefits.
Though hearing aids are not under their coverage, TriCare facilitates access to other government programs to help pay for hearing aids, including:
• VA Coverage
• Retiree-At-Cost Hearing Aid Program (RACHAP)
• Eligibility to purchase hearing aids at a reduced cost in specified military hospitals and clinics.
In summary, TriCare alone, in relation to hearing aid coverage, provides no specific benefits for retired military, Medicare-eligible individuals, and their families.
Clarity Hearing Service Solutions
Hearing aids not only make it possible to hear the little things in life, but they are also critical in understanding important conversations and independent living. My associates at Clarity Hearing, and I do everything possible to encourage our hearing loss patients to get the help they need from hearing aids. A part of our commitment involves using our experience and expertise to find out what level of coverage their insurance plans provide as well as informing them about associated copayment, deductible, coinsurance, and network discounts or restrictions involved.
To get the help, my patients need in answering insurance questions, I advise them to make use of our online form to provide our team with the insurance information to do our research. My Clarity Hearing associates and I do everything in our power to provide you with excellent hearing care to improve your quality of life.
Scott Marquardt is the owner of Clarity Hearing and a highly skilled audiologist who has been in practice for over 20 years. Dr. Marquardt earned a master’s degree in audiology from Lamar University in Beaumont, Texas, and a doctorate from A.T. Still University. He is a member of the American Speech Language Hearing Association and a fellow of the American Academy of Audiology. He and the team offer comprehensive hearing healthcare services and specialize in the care of tinnitus, imbalance, and auditory processing disorders.