Federal government approves expanded coverage of Vermont Essential Health Benefits Reference Plan

The new plan will require coverage for most hearing aids from 2024

Vermont Business Magazine Governor Phil Scott announced today that beginning in 2024, individual and small group health plans will cover one set of prescription hearing aids every three years and annual exams. This week, the Centers for Medicare & Medicaid Services approved Vermont’s expansion of Essential Health Benefits (EHB) coverage for services, including prescription hearing aids.

With the Food and Drug Administration’s recent announcement establishing a new category of over-the-counter hearing aids, the new EHB Benchmark Plan ensures that Vermonters will have greater access to affordable hearing aids than ever before.

“Expanding this coverage is a significant step forward, and I appreciate the hard work of my teams in the Department of Health Access and the Department of Financial Regulation for their dedication to getting things done,” said Governor Scott. “Ensuring better access to care is a priority for my administration.

“Hearing loss has a profound impact on those who have it,” said Kevin Gaffney, Commissioner of the Department of Financial Regulation. “The new referral plan will allow hearing-impaired consumers to have hearing aids if they choose to use this technology to support their communications with family, friends and co-workers.”

A 2018 report from the Vermont Department of Health found that approximately 6% of Vermonters experience severe difficulty hearing and the Governor’s Advisory Council for the Deaf, Hard of Hearing and DeafBlind indicates that up to 70,000 Vermonters identify as hard of hearing. Current research shows that mild to moderate hearing loss doubles the risk of dementia, may increase the risk of falls and contribute to depression.

According to a 2015 presentation from the President’s Advisory Council on Science and Technology, a single hearing aid typically costs around $2,400, which most consumers pay entirely out of pocket. For Vermonters covered by health insurance market plans, these costs will be covered by insurance rather than paid entirely out of pocket.

Vermont’s new EHB Benchmark Plan was approved following a period of public comment, review by the Green Mountain Care Board, and collaboration with a wide range of stakeholders. In Vermont, insurance coverage for hearing aids is already available to people enrolled in Medicaid. The new benchmark plan was proposed by the Vermont Department of Financial Regulation and Health Access Department pursuant to the Affordable Care Act.

“This result shows how state government agencies can partner with outside stakeholders to meet the coverage needs of our healthcare system,” said Emily Brown, deputy commissioner of insurance in the Department of Regulation. financial.

“Vermont can be proud to expand hearing aid coverage and reduce cost pressures for Vermonters who are deaf or hard of hearing,” said Andrea De La Bruere, commissioner of the Vermont Department of Health Access. “We are committed to ensuring that Vermonters have access to comprehensive and affordable health care services that improve health and well-being.

Vermont’s new EHB referral plan will also increase access to nutrition counseling and rehabilitation services. The new changes will take effect for qualified health plans that Vermonters can purchase through Vermont Health Connect, for plan years beginning on or after January 1, 2024.

29.08.2022. Governor. Montpellier www.vermont.gov

About Evelyn C. Heim

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