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Summary: Tricare now provides hearing aid coverage for eligible children of retired service members, enhancing access to essential auditory care for improved developmental outcomes. Takeaways Expanded Eligibility: Tricare's new hearing aid coverage includes children of retired service members enrolled in Tricare Prime, offering benefits for biological, adopted, stepchildren, or court-placed dependents under 21 (or 23 for full-time students). Retroactive Coverage: The benefit applies retroactively to services received on or after Dec. 22, 2023, allowing families to file claims for reimbursement through their regional contractors. Eligibility Criteria: Children must demonstrate a hearing loss of at least 26 decibels in one or both ears through a hearing test, emphasizing the program’s focus on addressing qualifying medical needs. Tricare, a government-managed health insurance program for military personnel, their families, and other eligible individuals recently expanded its hearing aid coverage to include eligible children of retired service members. Providing Pediatric Hearing Care This new coverage results from a new statute. It aims to improve access to life-changing medical technology and help eligible children of retired service members get the hearing aids they need. “Before the passage of the National Defense Authorization Act, TRICARE coverage of hearing aids was limited to dependents of active duty service members with qualifying hearing loss,” says Erica Ferron, management and program analyst, TRICARE Health Plan, at the Defense Health Agency. “Now, more TRICARE beneficiaries will be able to receive hearing aids and services." Keep reading to learn about eligibility, coverage, and more. Who is eligible? For retirees, their children may qualify for hearing aid coverage if: They’re entitled to retired or retainer pay, or equivalent pay; and Their child is enrolled in TRICARE Prime. This includes the US Family Health Plan, as described in the TRICARE Plans Overview Fact Sheet. The benefit covers unmarried children of living sponsors who are: Under 21 years old, or A full-time college student aged 21-23, or Unable to support themselves due to a disability that started before age 21 (or before 23 if they were a student) This includes: Biological children Adopted children Stepchildren Children placed in your legal care by a court Determining Qualification To get coverage for hearing aids, your child needs to take a hearing test. They must demonstrate at least 26 decibels of hearing loss in one or both ears. Important Things to Know The child must be enrolled in TRICARE Prime or the US Family Health Plan. Coverage is retroactive to Dec. 22, 2023. If a child got hearing aids or services on or after that date, you can file for reimbursement for TRICARE covered services. But it won’t happen automatically. You must file a claim with your regional contractor. Further Reading https://hearingreview.com/hearing-products/implants-bone-conduction/cochlear-implants/aci-alliance-pushes-for-expanded-medicare-coverage-on-cis-for-asymmetric-hearing-loss Considering Special cases For whoever is interested in exploring TRICARE’s expanded coverage of hearing aids, please note that the coverage isn’t available overseas. If the child lives in the U.S. but travels overseas, they can keep their coverage, but they need special approval for overseas care. TRICARE doesn’t cover hearing aids for retirees. Those who are interested may, however, qualify for other special programs. Check out TRICARE’s hearing aids page to learn more. For a child to get this benefit, they must have TRICARE Prime and a qualifying hearing loss. The ability to hear properly is essential for your child’s social and physical development. Photo: Dreamstime

Tag: hearing aid coverage

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