Stephanie is 8 years old. She was identified at 1 ½ years old with a moderate hearing loss. She was diagnosed at 5 years old with autism. Her parents, Dan and Shelly, work full time and they just welcomed a newborn to their family. Stephanie attends school at the public school down the street from her house.
Dan is out of town on business, and Shelly is scrambling to get Stephanie out the door on time. Her bus arrives at 7:30 and Stephanie is just now getting dressed. Shelly tries to get Stephanie to move more quickly, but Shelly is also holding a crying newborn. Juggling two children has proved more difficult than Shelly imagined. In the hustle and bustle of the morning, she forgets to put new batteries in Stephanie’s hearing aids.
Lately, with things being more hectic around their home, Stephanie’s progress has waned and Dan and Shelly are concerned. Stephanie is not reading on grade level and the other children in her class are making age-appropriate academic gains. They are on the waiting list at the Marcus Autism Center’s Language and Learning Clinic, where Stephanie will receive services to help her improve her communication and social skills.
We received this email from one of our Pathfinders:
I’m writing to inquire about how insurance and Medicaid CHP works in Georgia for families with [D/HH] children. Our son has had hearing aid expenses covered by his secondary insurance, through Medicaid. All of our audiology appointments, hearing aids, and a small supply of batteries every three months are all fully covered. Our son has gone through 3 sets of hearing aids, and he will be four [years old] in a few days. He grew out of his first pair, had a second pair, then his hearing got a bit worse so his audiologist recommended he get a stronger type of aid made by a different company.
We asked our experts and here’s what they said: Hearing Aid information for PeachCare (Medicaid for children in GA)
Call 1-(866) 211-0950 for more information on specific eligibility regarding hearing aids
• Prior authorization from ENT
• For members under the age of 21
• 2 every three years
• Ear molds, cords, wires, batteries, repairs and labor are covered and reimbursable
• Audiology evaluations, audiograms, hearing aid evaluation included in reimbursement
• Responsibility of provider to provide appointment at no additional cost
• Medicaid will not provide coverage for old hearing aids that were purchased prior to new ones
• Annual repair card cannot exceed $225 parts labor and delivery
Let Georgia Hear is a parent-led initiative working towards the goal of securing insurance coverage for children’s hearing aids in Georgia. Many Georgia families are unable to provide hearing aids for their children who are deaf or hard of hearing in order to improve access to their children’s communication. Hearing aids can cost as much as $6,000 per pair and must be replaced every 3-5 years. This is the equivalent of roughly $42,000 per child who requires hearing aids before they reach the age of 21 – a hardship for any Georgia family regardless of household income.
As of 2012, 20 other states have passed legislation requiring insurance companies to cover hearing aids for children. We want Georgia to be the next state to take this important step!