Indiana Medicaid reports that they will cover hearing aids for their policy holders. And while this may be true on the surface, it is often challenging to get them to approve this coverage.
Here is one person’s story.
Jane* came to me with a classic hearing loss that occurred slowly over many years. She had difficulty conversing with most people and it was starting to affect her performance at work and ability to communicate with supervisors. When she called to set up a hearing test, we let her know she would first have to see her primary care physician (PCP) to obtain a referral to our office. Once she was seen by her PCP we were able to get her into our office within 2 days. Jane’s hearing loss was confirmed and our report was faxed back over to her PCP. Jane then had to schedule another appointment with her PCP to have the doctor fill out a state specific medical clearance form as well as write a letter of medical necessity for the hearing aids. Once this was done, Jane then had to come back to our office to finish testing to prove that the hearing aids would help her. After completing this step, we were required to write a letter on her behalf detailing Jane’s struggles with her hearing loss, how often she needed to hear, how it was affecting her life and why she needed 2 hearing aids versus one. Finally, we took all these forms and letters and submitted them to the state to see if they would approve Jane’s hearing aids. The results: for Jane it was approved and it took about 6 weeks and 4 doctor appointments from her initial call to being fitted with hearing aids. For others, we have seen responses range from “no” to “hearing aids for hearing loss alone are a convenience and not a need.”
We know that untreated hearing loss leads to social isolation, depression, decreased brain cognition and lower overall income levels. Indiana has created enormous barriers for low-income patients to attain proper diagnosis and treatment to the point that many simply give up. For some Indiana patients, only one hearing aid is approved. Research shows that when a person has hearing loss in both ears and one side is fitted with a hearing aid, the opposite side goes through auditory deprivation. Essentially this means we are killing off a nerve because we are not properly treating it. The patient then must decide to let this happen or come up with funds to purchase a second hearing aid out of pocket. Even with low-cost devices available, often this is an economic hardship that is too great to overcome.
Navigating insurance is a challenge and even more so when dealing with state run health insurance. We are here to help and navigate these issues at your local audiology clinic in Lawrenceburg. Follow us on Facebook at Flex Audiology to find out more and keep up to date on local health care issues.