The Department of Managed Health Care (DMHC) has agreed with Senators Suzette Martinez Valladares and Shannon Grove to prioritize the inclusion of a Hearing Exam and Hearing Aids benefit in California’s essential health benefits benchmark plan. This development follows a letter sent by Senator Valladares in February, advocating for hearing aid coverage for middle-class children and adults. Currently, low-income children receive such coverage through Medi-Cal or the California Children’s Services programs.
Senator Valladares emphasized the importance of hearing aids, stating, “Hearing aids are not just tools, they are bridges to a world of communication, unlocking opportunities for children to connect, learn, and grow while experiencing the world around them.” She expressed gratitude that this benefit will be included in the benchmark plan.
Under the federal Affordable Care Act, individual and small group plans must cover ten broad categories of essential health benefits. These include primary care, hospital services, prescription drugs, and emergency services. States have discretion in selecting specific services as benchmarks within these categories. California is currently updating its benchmark plan adopted in 2015.
The updated state plan will include the hearing aids benefit along with two other proposed benefits. It is set to be submitted to the federal government for final approval by early May.
