health Program to provide children’s hearing aids for uninsured families falls short
A little over a year after
There have been multiple problems with the Hearing Aid Coverage for Children Program. The application process is cumbersome and families with partial insurance coverage are not eligible. For physicians, reimbursement time is long, reimbursement rates are low, and some don’t know about the program or choose not to participate, according to parents and advocates who lobbied the state to fund children’s hearing aids.
The
important program, through program operations and outreach activities, to expand the program’s reach.”
The typical cost of children’s hearing aids ranges from
Hearing aids for 4-year-old
Sutter does participate in state-run programs, company spokesperson
“As we do for new programs, we are reviewing the program’s requirements and processes to determine participation.”
For Kovacevic, the next-closest provider on the state’s program list is in
“There was nothing I could do at this point,” Kovacevic said.
Scarlett was diagnosed as a newborn with sensor neural bilateral hearing loss when the family lived in
“It felt like this (CA) program was literally making me jump through hoops. Like they just wanted to make it as hard as possible and to slow it down. There was no urgency on it,” Kovacevic said. “In Florida, they wanted to get her fitted with hearing aids as soon as possible.”
In its first year, the
This year, the Legislature asked for
Advocates hope the extra money for expanded coverage will be included in a budget amendment, expected this month.
“Families are struggling to afford the cost of medically necessary hearing aids for their children,” said
“They are making difficult decisions and devastating tradeoffs for their families to obtain hearing aids so that their child can hear, learn and connect with the world,” she said.
California’s program focuses solely on the hearing impaired children without health insurance. The families it serves make too much money to qualify for
Advocates had hoped the program would ease the burden for families with some insurance coverage, but it does not include them because it focuses only on those without any coverage for hearing services or hearing aids. Commercial health insurers offer a range of coverage, from zero benefits to some coverage, such as
Early access to hearing aids is critical for infants and children who are hearing impaired. Children who cannot access sound as soon as possible lose speech, language, and social-emotional development, according to a 2020 study in the journal Pediatrics. Children have the best outcomes when they receive hearing aids or cochlear implants before 6 months of age, the study found.
Once that development time is lost it cannot be regained, said Dr.
“There is a cascade of effects and all of those things can be mitigated by a kid having easy access to hearing aids,” Chan said. “It is really frustrating because this is something we know works.”
One in 500 U.S. babies is born deaf or hard of hearing, Chan said.
As of
One of the chief complaints from providers and families, said Marciniak, of Let California Kids Hear, has been providers not being reimbursed quickly or at all because the billing system was not fully set up for the program. Kovacevic said this is why her daughter’s doctors in
During a hearing in February,
The email the department spokesperson sent CalMatters said the department has improved its billing code system after consulting with experts.
Doctors can opt onto the list, but very few have because they do not treat children or have chosen not to participate. In
Marciniak, of Let California Children Hear, said many of the state’s largest providers are not taking the program based on a survey by the organization.
Advocates say most
Pediatric audiologist Dr.
Frintner, who was the only practitioner in
“Their brains are developing, their speech and language is developing. You have to have different skill levels, different test equipment and a different knowledge base,” Frintner said. “For me, it’s the patients I’ve already been seeing.”
But she is considering opting out, she said. It’s a lot of paperwork, data entry and approvals even before the child visits for the first time. Reimbursement is slower than it is with other state programs, she said, and her office staff often are submitting and resubmitting information to the state.
Frintner said she has not been paid for any of the services or hearing aids she provided through the program since she joined in
Every child she treats on state programs is considered a financial loss, she said. Which is why she sometimes finds that after paying her staff and other bills there isn’t money left to pay herself.
“Thankfully I have a small staff and we work our buns off,” she said. “I love all my patients, the joy I see when I put a hearing aid on a child for the time or new ones or when I test a child and we are able to tell parents that their child is OK. That’s what I get, which makes me rich.”
In 2019, legislation that would have required private insurers to fully cover children’s hearing aids was headed to Newsom’s desk, said
The bill was opposed by the
Before it could get to Newsom, Santa Monica Democratic Assemblyman
In
“I was thrilled when it passed. I was shocked to find out that I didn’t qualify,” said Nguyen, who had advocated for the bill and testified before the Legislature with her daughters. “I felt it was a waste of time. I waited three years.”
Every month Nguyen saves money for the next round of hearing aids for her girls, 10 and 7, and herself. She has foregone vacations, days off work and extra activities for her kids to put money away for the hearing aids. Only recently did she pay for a soccer program, which the girls love.
“My kids love to sing, love to dance, love to watch movies. It’s a quality of life issue,” she said.
Chloe, the 7-year-old, has been wearing her old hearing aids while her mom waits for the program to include kids with partial insurance. Chloe said she wants purple devices but said her mom told her to be sure because she will have them a long time.
Nguyen, who works for the
“I feel it’s not fair. She is losing access to the world,” she said. “I’m going to have to buy them.”
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