Understanding Hearing Aid Coverage

Active duty servicemembers should always consult with their primary care manager (PCM) with questions about hearing loss. A referral from the PCM is required to see an audiologist for TRICARE Prime and TRICARE Prime Remote enrollees. In addition, an authorization from TriWest is needed.

According to TRICARE Policy Manual Chapter 7, Section 8.2, TRICARE covers hearing aids only for active duty family members who meet the following specific hearing loss requirements:

Profound hearing loss (adult). An “adult” (a spouse of a member of the Uniformed Services on active duty for more than 30 days as defined in 32 CFR 199.3(b)) with a hearing threshold of:

• 40 dB HL or greater in one or both ears when tested at 500, 1,000, 1,500, 2,000, 3,000, or 4,000Hz; or
• 26 dB HL or greater in one or both ears at any three or more of those frequencies; or
• A speech recognition score less than 94%.

Profound hearing loss (child). A “child” (an unmarried child of an active duty member who otherwise meets the criteria (including age requirements) in 32 CFR 199.3 of this part) with a 26dB HL or greater hearing threshold level in one or both ears when tested in the frequency range at 500, 1,000, 2,000, 3,000, or 4,000Hz.

Medically necessary and appropriate services and supplies, including hearing examinations provided by authorized providers, required in connection with this hearing aid benefit, are covered.

Hearing aid and hearing aid services for retirees and their family members and implantable hearing aids (Not to be confused with cochlear implants which are covered under TRICARE.) are excluded from the policy. Retirees may participate in the Retiree-At-Cost Hearing Aid Program (RACHAP) at participating facilities accepting retirees. For more information about RACHAP and participating facilities, please visit the Military Audiology Web site.

For more information, visit the TRICARE Web site.