SEATTLE, WASHINGTON — According to a report in the Yakima Herald, a Seattle law firm has filed suit against two health insurance companies due to the companies not covering treatment for hearing loss. The suit alleges that the exclusion of hearing loss treatment constitutes illegal discrimination under federal law.
The outcome of the case could set a precedent for insurers across the country.
The class action lawsuit was filed last week against Regence BlueShield and Kaiser Foundation Health Plan of Washington by law firm Sirianni Youtz Spoonemore Hamburger on behalf of three named plaintiffs, who represent thousands of Washington patients possibly effected by the case outcome.
According to comments from attorney Ele Hamburger to the Yakima Herald, she said the lawsuit is the first of its kind nationwide:
“The question that we’re raising in this litigation is… Can insurance companies, under the new anti-discrimination part of the Affordable Care Act, exclude an entire group of people for health coverage to treat their disability?”
The law firm filing the class action suit successfully argued last year that Washington state’s Medicaid program could not refuse coverage for a hepatitis C cure for people whose liver disease hadn’t yet advanced to cirrhosis. Now, because of that case, all patients with Hepatitis C with Medicaid can be considered for the drug.
Hearing Aid Insurance Coverage Denial: Illegal Discrimination?
While some states mandate insurance coverage for hearing aids, the vast majority do not. Typically insurers will cover the audiological examination, but not treatment.
According to the lawsuit:
“By categorically excluding insureds with Hearing Loss of all medical treatment related to their disability (except for cochlear implants), Regence/Kaiser engages in illegal disability discrimination. The Affordable Care Act prohibits discrimination on the basis of disability by covered entities, including health insurers”
In Washington, the state’s Medicaid covers hearing aids for children until age 21, but the hearing aid benefit for adults was cut several years ago due to budget constraints. Insurers in the state are required by state law to cover hearing screening tests, as well as cochlear implants, as part of the “essential health benefits” that are mandated by the ACA.
According to Hamburger, the exclusion of hearing loss coverage relates to “an old-fashioned interpretation of health insurance”, as something that only covers accidents, injuries and illnesses of an immediate nature, while leaving out conditions that people are born with or may struggle with throughout their lives.
Source: YakimaHerald
I’ve had hearing loss for 40 years. I went untreated for many years because I couldn’t afford the aids. I’ve had several sets now and have had to pay out of pocket. Last year I got new hearing aids and had to pay an enormous amount of money for them. I hope this class action suit sets in motion a precedent for all health care insurance to be made to cover at least most of the expenses for hearing loss treatment and aids.
If we succeed in having health insurance cover hearing aids, we will probably see health insurance and hearing aid battery spikes. Additional question would be, will the health insurance also cover hearing aid batteries?
Please succeed! Needing my 3rd pair in a year or so. At $6k it will be a longer wait. Ridiculous that hearing aids are viewed as a luxury for only those that can afford it or sacrifice essentials to purchase. #paidenough.
Don’t give up the fight for health care insurance to cover most of the expenses for hearing loss treatment and hearing aids.
This is the link to a petition we currently have going for hearing aids.
https://www.change.org/p/insurance-coverage-of-hearing-aids-for-children-and-adults
Hallelujah! My son born with permanent conductive hearing loss was denied coverage of a bone conduction hearing aid at 3 years old. Denying a child at the age that speech development is so critical makes absolutely no sense. Deny now pay for speech therapy later.
They will only cover bchas when it’s a part of abutment surgery that only happens at 6 years. So my son can’t hear bilaterally until he’s 6. A bunch of real geniuses making these decisions.
I’m so sorry to hear this. It’s ridiculous that they are denying your son a BAHA until he is 6 and able to have the surgical abutment. He could wear a BAHA on a soft band without surgery. Check out some BAHA support groups on Facebook. In some of them I have seen children get older devices donated by others who have upgraded.
My Cigna insurance covered my BAHA implant and sound processor, but in the past when I had regular hearing aids, they were never covered by insurance. It makes no sense that insurance companies will pay thousands of dollars for surgeries to improve hearing, but refuse to cover the cost of hearing aids which are much cheaper for them. Some people even have a hard time getting approved for a BAHA without proof that they’ve exhausted all other surgical options to improve hearing first. If I would have been denied, I would have needed to fight for it. No one should be denied their right to hear. Eye glasses are covered fully or partially for some by vision insurance, and it should be the same for hearing aids.
I hope it’s a success! I believe it’s discriminatory for health insurances not to include the coverage of hearing loss treatments and hearing aids. I’ve had hearing loss for over 45 years and had to pay out of pocket for many pairs of hearing aids. As everything else prices for hearing aids continue to go up.
I believe it’s discriminatory for health insurances not to include the coverage of hearing loss treatment and hearing aids. I’ve had hearing loss for over 45 years and had to pay out of pocket for many pairs of hearing aids. As everything else prices for hearing aids continue to go up.
I am currently in the market for hearing aids since I have had 3 tests all arriving at the same conclusion: moderate hearing loss. Could I continue to live with this yes? Do I want to no although I was in sticker shock mode when I saw the price of about $3000/pair at the 3 offices I went to and this includes Costco who is now selling Phonax that the other 2 people told me they did not sell them.