The US Department of Defense (DoD) has reversed its policy on coverage of Auditory Osseointegrated Implants (AOIs), and will now cover them as prosthetic devices for all Tricare beneficiaries. Tricare is a healthcare insurance system for military dependents and members of the military services that covers care not available through the usual US military or public health service facilities.
According to an announcement from the Hearing Industries Association (HIA), this reversal follows a comprehensive analysis and review of AOIs. The DoD contacted Reps David McKinley (R-WV) and Mike Thompson (D-CA), Co-Chairmen of the Congressional Hearing Health Caucus (CHHC), to notify them of the change which they had championed along with HIA, and Reps Betty McCollum (D-MN), Pete Olson (R-TX), David Price (D-NC), and Dina Titus (D-NV).
AOIs are already covered by Medicare, which maintained coverage after a thorough review by CMS in 2014 determined that they are not “hearing aids,” which Medicare is barred by statute from covering. Tricare coverage will be provided when use of AOIs is determined to be necessary because of significant conditions resulting from trauma, congenital anomalies, or disease. Revised policy guidance along with beneficiary educational materials will be published by Tricare.
AOIs are commonly known to people with hearing loss as Baha and Ponto, which are manufactured by Cochlear Americas and Oticon Medical, respectively. These companies, along with surgeons and patients, actively advocated in support of the effort to reverse the Tricare policy as well.
Rep McKinley noted that as an individual with severe hearing loss, he understands the difference these types of devices make in improving quality of life. “Veterans and military personnel deserve access to life-changing treatments for hearing loss,” said Rep McKinley. “We are pleased the DoD listened to our argument and made this change that will help veterans with serious hearing loss. As a Co-Chair of the Congressional Hearing Health Caucus I will continue to fight for improved access to treatments for the hearing impaired.”
Rep Thompson noted that as a veteran and Co-Chair of the Congressional Hearing Health Caucus, he is pleased that Tricare has revised an insufficient coverage policy, and will now expand coverage for auditory implants for all service-members and their families, and veterans. “We have a moral and legal obligation to ensure that returning service members have access to the health services they need,” said Rep Thompson. “The ability to hear is critically important to a person’s overall health and well-being, and these devices are the only option for people with certain types of serious hearing loss.”
Source: Andy Bopp, HIA