Certain hearing aid implants are now covered for all Tricare users under a policy update announced Monday.
Existing rules block hearing aid coverage for retirees, Tricare for Life and Tricare Reserve Select users. But the policy change reclassifies a certain type of implanted hearing aid -- Auditory Osseointegrated Implant (AOI) Devices -- as a "prosthetic," opening up coverage of the implant to all Tricare beneficiaries.
The devices improve hearing through an implant inserted in the skull behind the ear, according to the Hearing Loss Association of America. Combined with a microphone and hearing aid components, incoming sounds cause the implant to vibrate, which is then transmitted to the patient's inner ear via bone conduction.
The implants are used to treat conductive and mixed hearing loss or singled-sided deafness, according to the association. Cochlear implants, another implantable type of aid, are used to treat those with non-functioning cochlea or those who have bilateral severe to profound sensorineural hearing loss. Cochlear implants are currently covered by Tricare for all types of beneficiaries.
The change for AOI devices impacts all Tricare users, including Tricare for Life users.
The decision to expand coverage was made as part of a routine policy review, a Tricare official said. While the changes are retroactively effective to June 30, 2016, Tricare's regional contractors won't be ready to answer questions or process claims for the implants until Dec. 7.
The new policy does create parameters for what kind of hearing loss qualifies for coverage.
"AOI devices … are covered as a prosthetic device when necessary due to significant conditions resulting from trauma, congenital anomalies, or disease," it states.
That means that retirees whose hearing loss can be blamed on other causes that are not trauma, disease or a birth defect don't qualify for coverage.
Non-implantable devices, such as the BAHA Softband, which gives hearing help to children who are too young for the AOI implant, are still excluded from coverage, according to the policy.