DME devices include, but are not limited to, daily living and personal care aids, mobility and positioning aids, standing and walking devices, hearing aids and listening devices, and visual aids and nutritional supplements. Coverage for a medical device may vary depending on how the insurance industry classifies it. Health care products are durable medical devices or classified medical devices. Insurance companies cover some durable medical devices (e.g.
A durable medical device is described as durable (long-lasting), used for medical reasons, is not usually useful to a sick or injured person, is used at home and is expected to last at least three years. Durable medical devices must be medically necessary and your doctor should prescribe them for you to use at home. Hearing aids are NOT considered durable medical devices. Your One Care plan covers the same DME as MassHealth and Medicare, and may cover an additional DME.
Everyone's needs are different, so work with your care team (your healthcare providers and care partner, care manager or care coordinator) to find out if your DME will be covered. Your care team can also help coordinate accessories, repairs, and more. The DME has no out-of-pocket cost. This site includes information on the difference between hearing aids, which are designed for use by people with hearing loss, and personal sound amplification products (PSAPs), which are intended for consumers without hearing loss who want to make sounds louder in certain environments, such as for recreational activities such as birdwatching or hunting.
While the FDA regulates hearing aids as medical devices, PSAPs are not medical devices. The purpose of this notice is to remind suppliers of the pre-approval requirement for binaural hearing aids in accordance with 89 Ill. Binaural hearing aids will only be considered when medical documentation shows that a patient needs more than one hearing aid. Insurance companies, including Medicare, consider hearing aids to be elective medical devices that are not medically necessary.
Hearing loss can have a negative effect on communication, relationships, school or work performance, and emotional well-being. This site also provides information on other hearing devices and products, such as PSAPs, that are not intended to improve hearing loss. The professional who ordered the binaural headphones must be signed and dated within the last 12 months. If you have questions about your health, the best source of information is your hearing care professional.
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