This document provides basic hearing services and hearing aid information for all health plans and is not intended to be a full description of coverage. Please refer to the health plan or plan documents to confirm coverage. Supplemental information regarding U-M Premier Care and GradCare is located on their respective web pages.

Covered Benefits for All Health Plans

Hearing aids and services covered (once every 36 months) by in-network hearing aid providers include:

• Audiometric examination (with tests for hearing acuity, summary of findings)

• Hearing aid evaluation test (determines type/model of hearing aid needed)

• Monaural or binaural hearing aids (standard adjustable devices; in-ear, canal, behind ear or on body)

• Bone-anchored hearing aid (if medically necessary and preauthorized)

• Hearing aid fitting and follow-up services for optimal performance

• Conformity evaluation test

Members may "buy up" to more advanced models and be balance-billed for the difference between what the plan pays and the provider charges. Be sure to talk with your provider about what is covered by the plan before ordering your hearing aids.

Exclusions

Exclusions include, but are not limited to:

• Lost or broken aids (if not used in the last 36 months)

• Replacement parts (batteries, maintenance, insurance)

• Eyeglass type/special-feature hearing aids

• Medical/surgical treatment unrelated to hearing aids not covered.

• Drugs or other medications for hearing problems excluded.

• Spare aids, non-FDA-approved or non-conventional devices

• Two aids ordered on different dates (not considered binaural)

• Devices must meet U.S. Food and Drug Administration and Federal Trade Commission requirements.

• Government-provided hearing aids/tests

• Coverage available every 36 months for adults age 18 and older.

• Ear molds for children are covered at a limited frequency:

  • Younger than 3 years: 4 per year

  • Ages 3–13: 2 per year

  • Ages 13–18: 1 per year