Hearing aids covered up to $1,000 per hearing aid, per ear, every three years for ... Excluded are all hearing services
Affordable Care Act (ACA) State Plans and Hearing Aids STATE
STATUS OF BENCHMARK
BENCHMARK PLAN
COVERAGE
Alabama
Default to Federal Exchange
BCBS of Alabama, 320 Plan, PPO, Small Group Plan
Hearing aids not covered.
Alaska
Default to Federal Exchange
BCBS of Alaska – Alaska Heritage Select Envoy, PPO, Small Group Plan
Hearing aids not covered.
Arizona
Default to Federal Exchange
State Employee Benefit – United HealthCare EPO
One (1) hearing aid per ear per year and hearing exam covered.
Arkansas
HHS conditionally approved State Partnership Marketplace plan.
Arkansas BCBS Health HMO Advantage Partnership Open Access (POS)
Hearing aids not covered.
California
HHS conditionally approved State Marketplace plan.
Kaiser Small Group HMO
Hearing aids not covered.
Colorado
HHS conditionally approved State Marketplace plan.
Kaiser Ded/CO HMO 1200D Small Group Plan
Hearing aids covered for persons under the age of 18. (State required benefit under Colo. Rev. Stat. §10-16-104(19).)
Connecticut
HHS conditionally approved State Marketplace plan
ConnectiCare HMO Commercial HMO
Hearing aids covered for children age 12 and under. (State required benefit under Connecticut Gen. Stat. §38a-516b: §38a-490b.)
Delaware
HHS conditionally approved State Partnership Marketplace plan.
BCBS Small Group EPO plan
Hearing aids covered up to $1,000 per hearing aid, per ear, every three years for persons under age 24. (State required benefit under Del. Code, Title 18, §3357 and §3571A.)
District of Columbia
HHS conditionally approved State Marketplace plan
BCBS CareFirst Blue Preferred, PPO Small Group Plan
Hearing aids not covered.
Florida
Default to Federal Exchange
BCBS of Florida – Blue Options, PPO, Small Group Plan
Hearing aids not covered.
As of August 6, 2013
Affordable Care Act (ACA) State Plans and Hearing Aids STATE
STATUS OF BENCHMARK
BENCHMARK PLAN
COVERAGE
Georgia
Default to Federal Exchange
BCBS of Georgia – HMO Urgent Care Copay Small Group Plan
Excluded are all hearing services including hearing aids, hearing devices, and related or routine examinations and services.
Hawaii
HHS conditionally approved State Marketplace Plan
Hawaii Medical Services Assoc. (BCBS), PPO, Small Group Plan
One (1) hearing aid per ear, every 60 months. Fitting, adjustment, repair of hearing aids and batteries are not covered.
Idaho
HHS conditionally approved State Marketplace Plan
Blue Cross of Idaho – Preferred Blue, Small Group Plan
Hearing aids not covered.
Illinois
HHS conditionally approved State Partnership Marketplace plan
BCBS of Illinois Blue Advantage Small Group Plan
Hearing aids not covered except for bone anchored hearing aids (osseo integrated auditory implants). Examinations for the prescription and fitting of hearing aids are not covered.
Indiana
Default to Federal Exchange
Anthem (BCBS) – Blue Access, PPO, Small Group Plan
Hearing aids and fitting and examinations for hearing aids not covered.
Iowa
HHS conditionally approved State Partnership Marketplace plan
Wellmark (BCBS) – Alliance Select, PPO, Small Group Plan
Hearing aids not covered.
Kansas
Default to Federal Exchange
BCBS of Kansas Comprehensive, Major Medical PPO, Small Group Plan
Hearing aids not covered.
Kentucky
HHS conditionally approved State Marketplace plan
Anthem (BCBS), PPO Small Group Plan
Hearing aids, fittings, and examinations for hearing aids covered for persons under 18 years of age, limited to no more than 1 per ear, every 3 years (State required benefit under Kentucky Revised Statute (KRS) 304.17A-132.)
Louisiana
Default to Federal Exchange
BCBS of Louisiana – Group Care, PPO, Small Group Plan
Hearing aids covered for persons 17 years of age and under, limited to 1 hearing aid per ear, every 3 years. Maximum amount allowable is $1400 per hearing aid. (State required benefit under Louisiana Revised Statutes (RS) 22:1038.)
As of August 6, 2013
Affordable Care Act (ACA) State Plans and Hearing Aids STATE
STATUS OF BENCHMARK
BENCHMARK PLAN
COVERAGE
Maine
Default to Federal Exchange
Anthem (BCBS) of Maine, Blue Choice, PPO, Small Group Plan
Hearing aids covered for persons age 18 and under, limited to 1 hearing aid per ear, every 3 years. (State required benefit under Maine Revised Statutes (RS) Title 24-A, §2762.)
Maryland
HHS conditionally approved State Marketplace plan
CareFirst (BCBS) – HMO HSA Open Access, Small Group Plan
Hearing aids covered for persons up to age 18, limited to 1 hearing aid per ear, every 3 years. (State required benefit under Maryland Code, Insurance Article, 15-838.)
Massachusetts
HHS conditionally approved State Marketplace plan
BCBS of Massachusetts HMO Blue, Small Group Plan
Hearing aids covered for persons 21 years of age and under, limited to 1 hearing aid per ear, every 3 years. Maximum allowable amount per hearing aid is $2000. Related services, including the initial hearing aid evaluation, fittings and adjustments and supplies including ear molds are covered. (State required benefit under Massachusetts General Laws, Ch. 175, §47X.)
Michigan
HHS conditionally approved State Partnership Marketplace plan.
Priority Health HMO, commercial HMO
Hearing aids not covered.
Minnesota
HHS conditionally approved State Marketplace plan.
Health Partners – Small Group Product, PPO, Small Group Plan
Hearing aids covered for persons 18 years of age or younger and have a hearing loss that is not correctable by any other means. Coverage is limited to 1 hearing aid per ear, every 3 years. (State required benefit under Minnesota Stat. §62Q.675.)
Mississippi
State-based blueprint rejected by HHS. Default to Federal Exchange.
BCBS Network Blue, PPO, Small Group Plan
Hearing aids not covered.
Missouri
Default to Federal Exchange
Healthy Alliance (BCBS) – Blue Access Choice, PPO, Small Group Plan
Treatment for hearing loss covered only for newborns.
As of August 6, 2013
Affordable Care Act (ACA) State Plans and Hearing Aids STATE
STATUS OF BENCHMARK
BENCHMARK PLAN
COVERAGE
Montana
Default to Federal Exchange
BCBS of Montana – Blue Dimensions, PPO, Small Group Plan
Hearing aids not covered.
Nebraska
Default to Federal Exchange
BCBS of Nebraska – Blue Pride, PPO, Small Group Plan
Hearing aids not covered.
Nevada
HHS conditionally approved State Marketplace Plan
Health Plan of Nevada (United) – POS CXV-500-HCR, Small Group Plan
Hearing aids covered up to a maximum amount of $5,000 and limited to a single purchase per calendar year. Repairs and replacement are allowable, but limited to once every 3 years.
New Hampshire
HHS conditionally approved State Partnership Marketplace plan
Anthem (BCBS) – Matthew Thornton Blue, HMO, Small Group Plan
Hearing aids covered for persons age 18 and younger, with a limit of 1 hearing aid per ear each time a hearing aid prescription changes. (State required benefit under New Hampshire RSA §415:6-p; §415:18-u; §420-B:20; §420-A:2.)
New Jersey
Default to Federal Exchange
Horizon (BCBS) – HMO Access, Small Group Plan
Hearing aids covered for children 15 years of age and younger, with a limit of 1 hearing aid per ear every 2 years. (State required benefit under New Jersey Stat. 17B:26-2.1aa; 17B:27A-7.14; 17B:27-46.1gg.)
New Mexico
HHS conditionally approved State Marketplace plan
Lovelace Classic PPO plan, Small Group Plan
Hearing aids covered for persons 17 years of age and younger, or 20 years of age and younger if still attending high school. Limited to $2200 per hearing aid every 3 years. (State required benefit under New Mexico Stat. Ann. 59A22.34.5.)
As of August 6, 2013
Affordable Care Act (ACA) State Plans and Hearing Aids STATE
STATUS OF BENCHMARK
BENCHMARK PLAN
COVERAGE
New York
HHS conditionally approved State Marketplace plan
Oxford EPO, Small Group Plan
Hearing aids covered; however, bone anchored hearing aids are excluded except when either of the following applies: (a) persons with craniofacial anomalies whose abnormal or absent ear canals preclude the use of a wearable hearing aid, or (b) persons with hearing loss of sufficient severity that it not be remedied by a wearable hearing aid. Covered hearing aids, except for bone anchored hearing aids, are limited to a single purchase (including repair/replacement) every 3 years, with a maximum recoverable amount of $1500. Covered bone anchored hearing aids are limited to 1 per lifetime.
North Carolina
Default to Federal Exchange
BCBS of North Carolina – Blue Options, PPO, Small Group Plan
Hearing aids covered for persons 21 years of age and younger. Limited to 1 hearing aid per ear up to $2500 per hearing aid every 3 years. (State required benefit under N.C. Gen. Stat. §58-3-285.)
North Dakota
Default to Federal Exchange
Sanford Health Plan, HMO, Commercial HMO
Hearing aids not covered.
Ohio
Default to Federal Exchange
Community Insurance Co. (Anthem BCBS) – Blue Access, PPO, Small Group Plan
Hearing aids not covered.
Oklahoma
Default to Federal Exchange
BCBS of Oklahoma – Blue Options, PPO, Small Group Plan
Hearing aids and audiological services for persons up to age 18, limited to 1 per ear every 4 years. (State required benefit under Okla. Stat., Title 36, §6060.7.)
Oregon
HHS conditionally approved State Marketplace Exchange
Pacific Source Preferred CoDeduct Small Group Plan
Hearing aids covered for persons 18 years of age and younger, or 25 years of age and younger for persons enrolled in a secondary school or accredited educational institution, limited to 1 hearing aid per ear per year up to $4000. The benefit amount is adjusted on January 1 of each year. (State required benefit under Ore. Rev. Stat. §743A.141.)
As of August 6, 2013
Affordable Care Act (ACA) State Plans and Hearing Aids STATE
STATUS OF BENCHMARK
BENCHMARK PLAN
COVERAGE
Pennsylvania
Default to Federal Exchange
Aetna, POS, Small Group Plan
Hearing aids not covered.
Rhode Island
HHS conditionally approved State Marketplace Exchange
BCBS of Rhode Island – Vantage Blue PPO, Small Group Plan
Hearing aids are covered. For persons 19 years of age and older, coverage is limited to a maximum amount of $700 per ear every 3 years. For persons 18 years of age and younger, coverage is limited to a maximum amount of $1,500 per ear every 3 years. (State required benefit under Rhode Island Gen. Laws §27-20-46; §27-18-60.)
South Carolina
Default to Federal Exchange
BCBS of South Carolina – Business Blue Complete, PPO, Small Group Plan
Hearing aids not covered
South Dakota
Default to Federal Exchange
Wellmark (BCBS) – Blue Select PPO, Small Group Plan
Hearing aids not covered
Tennessee
Default to Federal Exchange
BCBS of Tennessee, PPO, Small Group Plan
Hearing aids covered for persons age 17 and younger, limited to $1,000 per year every 3 years. Infant hearing screening is covered as a state required benefit under Tenn. Code §56-72508.
Texas
Default to Federal Exchange
BCBS of Texas – Best Choice, PPO, Small Group Plan
Hearing aids covered up to $1,000 every 3 years. Infant hearing screening is covered as a state required benefit under Texas Health and Safety Code, Title 2, Subtitle B, Ch. 47.
Utah
HHS conditionally approved State Marketplace plan
Utah Basic Plus State Employee Plan, HMO
Hearing aids not covered.
Vermont
HHS conditionally approved State Marketplace plan
Vermont Health Plan (BCBS) – BlueCare, HMO, Commercial HMO
Hearing aids not covered.
Virginia
Default to Federal Exchange
Anthem (BCBS) – Key Care, PPO, Small Group Plan
Hearing aids, exams and fitting for hearing aids are excluded.
As of August 6, 2013
Affordable Care Act (ACA) State Plans and Hearing Aids STATE
STATUS OF BENCHMARK
BENCHMARK PLAN
COVERAGE
Washington
HHS conditionally approved State Marketplace plan
Blue Shield Regence Innova, PPO, Small Group Plan
Hearing aids not covered.
West Virginia
HHS conditionally approved State Partnership Marketplace plan
Highmark (BCBS of West Virginia) – Super Blue Plus 2000, PPO, Small Group Plan
Hearing aids not covered.
Wisconsin
Default to Federal Exchange
United – Choice Plus, POS, Small Group Plan
Hearing aids covered; however, bone anchored hearing aids are excluded except when either of the following applies: (a) persons with craniofacial anomalies whose abnormal or absent ear canals preclude the use of a wearable hearing aid, or (b) persons with hearing loss of sufficient severity that it not be remedied by a wearable hearing aid. A maximum allowable amount is $2500 per year, except for dependent children for whom there is no limit. For persons age 18 and older, coverage is limited to a single purchase (including repair and replacement) every 3 years. For persons age 17 and younger, coverage is limited to one hearing aid per ear every 3 years. For bone anchored hearing aids, coverage is limited to 1 per lifetime. (Coverage for persons age 17 and younger is a state required benefit under Wis. Stat. §632.895.)
Wyoming
Default to Federal Exchange
BCBS of Wyoming – Blue Choice Businesss, PPO, Small Group Plan
Hearing aids not covered.
As of August 6, 2013
