DSS/Medicaid Responds
to The AT Messenger

The following letter was received in response to an article in the Spring 2003 issue of The AT Messenger regarding funding for hearing aids in Delaware. It is printed here in its entirety.

April 25, 2003

Dear Dr. Mineo Mollica:

Recently, the Assistive Technology Messenger carried a very informative article on "Funding for Hearing Aids." We would like to clarify reference to Medicaid coverage of hearing aids for adults.

While the Early and Periodic Screening, Diagnosis and Treatment Benefit within Medicaid assures coverage of all federally allowable, medically necessary services for individuals under the age of 21, including the provision of hearing aids, there is no equivalent policy or coverage for adults in the Medicaid program who are at or above that age level.

In fact, according to State Medicaid Policy, there is no coverage for hearing aids for adults, even when medically necessary. And, there is no individual consideration policy that would exempt an adult client from this exclusion. Under General Policy Section 1.15.1 of the Provider Policy Manual, "Hearing aids for individuals twenty-one years of age and over" are identified as non-covered services.

Further, neither the Diamond State Partners managed care program nor the First State Health Plan Managed Care Organization cover hearing aids for adults. These service delivery systems follow State Medicaid policy and adhere to its benefit exclusions.

Thank you for the opportunity to clarify Medicaid policy on this issue.

Sincerely,

David Michalik
Senior Administrator
Division of Social Service