Over-the-counter (OTC) hearing aids have emerged as a new, affordable, and accessible option for hearing healthcare in the U.S. But with a new product comes new questions, especially when it comes to navigating the world of health insurance. This blog aims to unpack the relationship between OTC hearing aids and health insurance to help you understand your coverage options.

Can my health insurance help pay for OTC hearing aids?

There's no one-size-fits-all answer. Health insurance coverage for OTC hearing aids varies depending on your specific plan and state regulations. Here's what you need to know:

Firstly, check with your insurance provider directly

The most reliable way to find out about your coverage is by contacting your insurance company. Ask them specific questions like:

• Do I have a hearing aid benefit?
• Am I eligible for the hearing aid benefit?
• What is my coverage amount per hearing aid?
• Are OTC hearing aids covered by insurance?
• What documentation do I need to submit for a claim?

How to ask your health insurance plan to cover OTC hearing aids

If your insurance plan doesn’t currently cover OTC hearing aids, you can take action by reaching out to your provider. To help you get started, we've created a template letter that you can use to lobby your health insurance company to include OTC hearing aids as part of your coverage. We encourage you to customize this letter with your personal details and send it to your insurance provider.

Download the letter here

Note: This letter is just one step in the process—be sure to follow up with your insurance company to confirm their response and explore other options like FSAs, HSAs, or HRAs if applicable.

Medicare coverage

Original Medicare (Part A & Part B) doesn't cover hearing aids. However, most Medicare Advantage plans do provide a hearing benefit that either offer a discount, partial coverage, or total coverage on hearing aids. You may want to ask if OTC hearing aids are covered by insurance under your specific Medicare Advantage plan.

Federal employee plans

If you're a federal employee, your plan might include coverage for hearing aids. It's always best to check your specific plan details. You can also ask if OTC hearing aids are covered by insurance as part of your hearing healthcare coverage.

Examples of plans offering coverage

While not exhaustive, some insurance companies known to offer coverage for OTC hearing aids include United Healthcare and NationsBenefits. However, remember to confirm your specific plan details directly with your provider. Insurance coverage for OTC hearing aids may not be explicitly mentioned, so ask if you can apply your hearing aid benefit to OTC hearing aids.

Alternative Payment Options

Even if your insurance doesn't cover hearing aids, there are other ways to manage the cost:

Flexible spending accounts (FSA)

These employer-sponsored accounts allow you to contribute pre-tax dollars for qualified medical expenses, including OTC hearing aids. Check with your plan administrator to confirm eligibility and plan rules. Remember, unused funds in an FSA typically expire at the end of the plan year, so plan your purchases accordingly.

Health savings accounts (HSA)

If you have a qualifying high-deductible health plan (HDHP), you might be eligible for an HSA. This allows you to set aside pre-tax money for qualified medical expenses, including OTC hearing aids. Unlike FSAs, unused HSA funds typically roll over from year to year.

Health reimbursement arrangements (HRA)

These employer-funded plans allow for reimbursement of medical expenses incurred by employees, up to a certain amount set by the employer. As with other plans, confirm eligibility and specific rules with your plan administrator.

Important note: Always check with your plan administrator or provider before purchasing your hearing aids, regardless of the payment method you plan to use. This ensures you understand your coverage and can maximize any available benefits.

Moving Forward with OTC Hearing Aids

We understand that navigating insurance and hearing healthcare can be confusing. By following these steps, you can gain a clearer picture of your coverage options for OTC hearing aids:

1. Contact your health insurance provider directly.
2. Explore alternative payment options like FSAs, HSAs, or HRAs.
3. Confirm eligibility and specific plan rules with your plan administrator.

By taking these steps, you can make informed decisions about your hearing healthcare and explore whether OTC hearing aids are a good fit for you financially.