Does Tufts Insurance Cover Hearing Aids?

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"Not many people realize the incredible benefits hearing aids can have for your overall health and well-being."

Unfortunately, people tend to neglect or delay treating a hearing loss for six to ten years. One of the biggest reasons for this is due to common misconceptions surrounding the investment involved in getting hearing aids.

Yes, hearing aids might seem expensive when the device alone is considered – but not many people realize the incredible benefits hearing aids can have for your overall health and well-being.

The ongoing audiological care and support you receive throughout your hearing healthcare journey is usually all included in the initial investment made in hearing aids. One of the most common ways patients receive support with the financial side of hearing care is through their insurance.

Does Tufts Insurance cover hearing aids? Many Tufts insurance plans do include coverage of hearing aids.

If you have a Tufts plan that covers hearing aids, how much that’s covered will depend on the exact plan you signed up for and if you added any supplemental insurance to the plan.

There’s also a list of selection criteria to make sure you will benefit from hearing aids. The results of your hearing test will indicate if you meet these needs.

I lay out more of Tufts’s coverage plans below.

NOT SURE IF YOUR TUFTS PLAN COVERS YOUR HEARING TREATMENT? HAVE US CHECK ON YOUR BEHALF

Tufts Medicare

Medicare doesn’t cover hearing aids or exams for fitting hearing aids. You pay 100% of the cost for hearing aids and exams.

But Tufts works with Medicare to provide additional plans that make your hearing care cheaper:

  • Medicare Advantage HMO Plans: Members are covered for up to two hearing aids per year, one hearing aid per ear. There are five levels to choose from and copay pricing is fixed at each level, ranging from a $250 to $1,150 copay for each hearing aid.

You’re also covered for a $0 hearing aid evaluation once per year with a Hearing Care Solutions provider.

  • Medicare Preferred HMO members: Referrals are not required for annual routine hearing screenings performed by an in-network provider; however, a PCP referral may be required for diagnostic hearing exams and other audiology services performed by a qualified specialist, depending on the member’s plan design.

Members are covered for up to two hearing aids per year, one hearing aid per ear. There are five levels to choose from and copay pricing is fixed at each level, ranging from a $250 to $1,150 copay for each hearing aid.

You only have to pay $15 for a hearing aid evaluation once per year with a Hearing Care Solutions provider.

  • Senior Care Options Plan: You qualify for this if you are eligible for both Medicare and Medicaid. The MA plan does not also cover hearing aids, but they do pay $70/calendar quarter for the purchase of Medicaid-approved OTC items.
  • Medicare Preferred Supplement Insurance: Helps pay some costs that Original Medicare doesn’t cover, such as copayments, coinsurance, and deductibles. You can keep the same doctors and you are still in the Medicare program.

Other Tufts Insurance Plans That Include Hearing Care Benefits

There is no member responsibility for covered services for Tufts Health Plan SCO, Tufts Health Unify, Tufts Health Together, or Tufts Health RITogether members.

  • Compensation for hearing aids includes the initial evaluation and all follow-up tests and adjustments, which may be required to properly fit the hearing aids.
  • One hearing evaluation per member in a 12-month period.
  • Tympanometry will be covered only up to four times in a 12-month period in a child under the age of 12 when the diagnosis is acoustic nerve disorder or sensorineural hearing loss.
  • Removal of impacted earwax in one or both ears will be covered only once per member in a 90-day period.
Tufts Health Plan Commercial (including Tufts Health Freedom Plan) Tufts Health Plan covers medically necessary audiology evaluations and related services, including hearing aids prescribed by an appropriately licensed physician for hearing disorders, in accordance with the member’s benefits.
Tufts Health Plan Senior Care Options (SCO)

Referrals are not required for annual routine hearing screenings performed by an in-network provider; however, a PCP referral is required for diagnostic hearing exams and other audiology services performed by a qualified specialist.

Prior authorization is required for hearing aids, supplies, and repairs.

Tufts Health Direct Members age 21 and younger on the date of service are covered for one hearing aid per hearing-impaired ear and related services (including fitting and adjustment, supplies, and earmolds) every 36 months.
Tufts Health Together Members are covered for one hearing aid per hearing-impaired ear every 36 months. A dollar limit per hearing aid may apply.
Tufts Health RITogether Members are covered for one hearing aid per hearing-impaired ear every 36 months. A dollar limit per hearing aid may apply.
Tufts Health Unify Prior authorization is required for monaural hearing aids over $500 and/or binaural hearing aids over $1000. Prior authorization is not required for accessories, maintenance, or servicing.

Let Us Help You with Your Coverage Questions

We can help you determine exactly what hearing care expenses your Tufts Health Insurance Plan covers and does not cover.

We’ll see if you are covered for a hearing evaluation, the cost of hearing devices, and the cost of a hearing package that includes follow-up visits and maintenance.

We’ll find out what your deductibles are and your copayments or coinsurance amounts. We’ll also find out if you must stay in network or can choose your hearing specialist yourself, which will depend on your HMO, HMO-POS, or PPO.

The easiest way to have South Shore’s insurance specialist check your Tufts insurance coverage for you is to fill out the insurance coverage form at the end of this page.

As your hearing care specialists in East Massachusetts, South Shore Hearing Center wants to make your treatment choice as easy as possible. Feel free to contact us with all your hearing questions, not just those about insurance, and we’ll do whatever we can to make your hearing journey smooth.

All insurance plans are different and benefits will be verified, if you have any questions then please contact our friendly team who are more than happy to answer any questions you may have.

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Alicia L. O'Sullivan, Au.D.

Alicia grew up in Abington, Massachusetts and went to Abington High School. She went to Bridgewater State College for her bachelor’s degree in special education, concentrating in communication disorders, before finishing her education at the University of Connecticut for her Au.D. With a genetic predisposition to hearing loss, Alicia has been getting her hearing tested since childhood. As someone who is aware of the side effects of hearing loss firsthand, she was initially interested in working in special education. However, due to her history of hearing loss, she soon fell in love with the science of audiology.

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