Longitudinal Policy Surveillance of Private Insurance Hearing Aid Mandates in the United States: 1997–2022

Michelle L Arnold; Brianna J Heslin; Madison Dowdy; Stacie P Kershner; Serena Phillips; Brandy Lipton; Michael F Pesko

doi:10.2105/AJPH.2023.307551

. 2024 Apr;114(4):407–414. doi: 10.2105/AJPH.2023.307551

Longitudinal Policy Surveillance of Private Insurance Hearing Aid Mandates in the United States: 1997–2022

Michelle L Arnold ^1,^✉, Brianna J Heslin ¹, Madison Dowdy ¹, Stacie P Kershner ¹, Serena Phillips ¹, Brandy Lipton ¹, Michael F Pesko ¹

PMCID: PMC10937611 PMID: 38478867

Abstract

Objectives. To produce a database of private insurance hearing aid mandates in the United States and quantify the share of privately insured individuals covered by a mandate.

Methods. We used health-related policy surveillance methods to create a database of private insurance hearing aid mandates through January 2023. We coded salient features of mandates and combined policy data with American Community Survey and Medicare Expenditure Panel Survey–Insurance Component data to estimate the share of privately insured US residents covered by a mandate from 2008 to 2022.

Results. A total of 26 states and 1 territory had private insurance hearing aid mandates. We found variability for mandate exceptions, maximum age eligibility, allowable frequency of benefit use, and coverage amounts. Between 2008 and 2022 the proportion of privately insured youths (aged ≤ 18 years) living where there was a private insurance hearing aid mandate increased from 3.4% to 18.7% and the proportion of privately insured adults (19–64 years) increased from 0.3% to 4.6%.

Conclusions. Hearing aid mandates cover a small share of US residents. Mandate exceptions in several states limit coverage, particularly for adults.

Public Health Implications. A federal mandate would improve hearing aid access. States can also improve access by adopting exception-free mandates with limited utilization management and no age restrictions. (Am J Public Health. 2024;114(4):407–414. https://doi.org/10.2105/AJPH.2023.307551)

Hearing loss is the third largest contributor to years lived with disability in global burden of disease¹ and poses a significant public health threat, given its high and growing prevalence and known association with numerous costly outcomes. Hearing loss affects 23% of those aged 12 years and older in the United States and prevalence increases as age increases, so that more than two thirds of adults older than 70 years have significant hearing loss.² For children, incidence of permanent hearing loss is approximately 1.7 in 1000 live births annually, and untreated hearing loss is associated with suboptimal speech, language, academic, and social outcomes.³^,⁴ Approximately 88% of adult hearing loss cases go untreated,⁵ and hearing loss has independent associations with incident dementia,⁶ falls,⁷ and increases in health care costs and hospitalizations.⁸ The economic impacts of hearing loss are significant and pervasive, affecting more than 13% of US workers, with lost productivity costs estimated at $615 billion in 2013.⁹

Hearing aids are largely underutilized in the United States, despite being a highly efficacious treatment of hearing loss associated with improvements in speech understanding and socialization and higher quality of life.¹⁰^–¹² High out-of-pocket costs are a barrier for many who would benefit from hearing aids.¹²^,¹³ A recent survey of audiologists and hearing aid dispensers reported a median hearing aid unit price of $2000 ($4000 for a set), with costs reaching up to $3000 per unit ($6000 for a set), which makes hearing aids unaffordable for most adults with hearing loss living in the United States.¹⁴^,¹⁵

Despite the benefits of hearing aids, traditional Medicare Parts A and B do not cover hearing aids or related services for beneficiaries. Medicare benefits are federally regulated; thus, individual states cannot modify Medicare coverage or mandates. The lack of hearing aid coverage by traditional Medicare is especially problematic given higher rates of hearing loss among older adults and associated comorbidities such as Alzheimer’s disease and related dementias, falls, and increased hospitalizations.⁶^–⁸ In the absence of federal action, many states have adopted private insurance hearing aid mandates that apply to fully insured private health plans covered by a commercial insurance carrier.

Private employer self-insured group health plans regulated by the Employee Retirement Income Security Act of 1974 (Pub L No. 93-406) are not required to adhere to state mandates, which significantly hinders state efforts to expand coverage, as these plans were estimated to cover 58% of privately insured workers in 2021.¹⁶ An additional limitation is that in the absence of a federal mandate, states’ legislation for private health insurance varies. One previous study found high variability in hearing aid coverage through state Medicaid programs,¹⁷ but little is known about policy variability in state private insurance hearing aid mandates.

We used health-related policy surveillance methods¹⁸ to create a database of private insurance hearing aid mandates and summarize salient features of legislation across time. Policy surveillance, which is the ongoing, systematic identification, collection, interpretation, and dissemination of laws, focuses on published, enacted legislation and involves a coding process that allows the quantification of features of the law.¹⁸^,¹⁹ Several such policy surveillance databases are available that describe variations in statutes for important health issues, including the regulation of tobacco and e-cigarettes,²⁰ cytomegalovirus screening and treatment,²¹ and diabetes treatment.²² These databases can be easily incorporated into relevant health outcomes research.

In addition to building a database that can be used by researchers and other key stakeholders, we used a subset of our collected information combined with population-level insurance data from American Community Survey (ACS) and Medical Expenditure Panel Survey (MEPS) to quantify national yearly averages of the share of privately insured youths 18 years and younger and adults aged 19 to 64 years covered by a private insurance hearing aid mandate. We demonstrate how mandate exceptions potentially affect coverage and identify strategies to expand coverage.

METHODS

Using consensus guidelines for legal epidemiology methods from Temple University Center for Public Health Law Research,¹⁹^,²³ we conducted longitudinal policy surveillance of state statutes to compile a database of private insurance hearing aid coverage mandates. Three individuals were responsible for the systematic retrieval, review, and coding process: an expert in hearing health care and public policy (M. L. A.), an expert in clinical hearing health care (M. D.), and an expert in health ethics and law (B. J. H.).

Data Sources

We collected the data from June 2022 to January 2023. Primary data sources were published statutes retrieved using Westlaw Campus and Lexis Uni legal search engines and state legislature Web sites. We consulted the American Speech–Language-Hearing Association Web site compilation of hearing health care coverage data as a secondary source.²⁴

Inclusion and Exclusion Criteria

We included statutes and amendments in the data if they were published and effective between January 1, 1997, and December 31, 2022, and described private insurance requirements for covering hearing aids. We excluded statutes if they described only coverage for diagnosis of hearing loss; the scope of practice for audiologists and hearing instrument dispensers; price transparency of devices and services; or receipt, packaging, disclaimers, and return policies related to hearing aid sales.

We retrieved statutes using the terms “hearing aid/instrument/device,” “audiologist,” “hearing aid/instrument dispenser/specialist,” “cochlear implant,” “bone-anchored hearing aid,” “osseointegrated/implantable device/aid,” “hearing loss treatment/rehabilitation,” “aural rehabilitation,” and “hearing rehabilitation.”

Data Retrieval and Coding

We collected data from 50 US states, the District of Columbia, and the unincorporated territories of American Samoa, Guam, Puerto Rico, and the US Virgin Islands, for a total of 55 jurisdictions. We were interested in whether a jurisdiction had enacted a hearing aid coverage mandate, when the mandate was effective, amendments to the mandate during the period coded, and the comprehensiveness of coverage based on best practices for hearing aid provision.²⁵^,²⁶ We coded effective start dates of coverage directly from the statutory language when available; otherwise, we used individual jurisdiction standard effective dates. In addition to details about allowable costs and exemptions, we coded coverage for hearing devices, supplies and batteries, allowable frequency of benefit use, and follow-up programming and rehabilitation. A list of variables coded, cited statutes, and statutory language coded can be found online (Table A, available as a supplement to the online version of this article at http://www.ajph.org).

M. L. Arnold coded data from an initial subset of 2 states (IL and CT), which M. Dowdy and B. J. Heslin then replicated. Once the search strategy and coding scheme were replicable, we coded remaining jurisdictions, with 80% of jurisdictions redundantly coded to ensure continued consistency between coders. We resolved differences in coding with input from health law expert S. P. Kershner.

Data Analysis

We estimated the annual national share of the population of privately insured youths aged 18 years and younger and adults aged 19 to 64 years living in states or territories with private insurance hearing aid mandates with and without exceptions from 2008 to 2022, including all 50 states and the District of Columbia. Mandates we considered to have exceptions were those only requiring optional coverage, only covering government employees, or having carve outs for small employers or cost-prohibitive benefits (exception details are listed in Table 1).

TABLE 1—

Status of Private Insurance Hearing Aid Coverage Mandates as of January 1, 2023: United States

States and Territories	Date Coverage Effective	Age Maximum	Frequency of Use, Mo	Total Coverage Amount, $	Supplies and Repairs	Follow-Up or Rehabilitation^a	OOP Cost Limits/Cost Sharing Allowed	Coverage Exceptions
AR	Jan 1, 2010	≥ 99	NS	2800	NS	NS	No	No
CO	Aug 5, 2009	18	60	NS	NS	Yes	Yes	No
CT	Jan 1, 2020^b	≥ 99	24	NS	NS	NS	NS	No
DE	Jun 18, 2008	24	36	2000	NS	NS	Yes	No
GA	Jun 1, 2018	18	48	6000	Yes	Yes	Yes	Yes^c^,^d
IL	Aug 22, 2018^a	≥ 99	24	5000	Yes	Yes	Yes	Yes^c^,^d^,^e
KY	Jul 15, 2002	18	36	2800	Yes	Yes	Yes	No
LA	Jan 1, 2004	18	36	2800	NS	NS	NS	No
ME	Sep 20, 2007^a	≥ 99	36	6000	Yes	NS	Yes	No
MD	Oct 1, 2001	18	36	2800	NS	NS	NS	No
MA	Nov 4, 2012	21	36	4000	Yes	Yes	Yes	No
MN	Aug 1, 2007	18	36	NS	NS	NS	Yes	No
MO	Aug 1, 2021	18	48	NS	Yes	Yes	NS	No
MT	Jan 1, 2022	18	36	NS	Yes	NS	Yes	No
NE	Jan 1, 2020	18	48	6000	Yes	Yes	Yes	Yes^d
NH	Jan 1, 2011	≥ 99	60	3000	Yes	No	Yes	No
NJ	Mar 30, 2009	15	24	2000	NS	NS	Yes	No
NM	Jul 1, 2007	21	36	4400	NS	Yes	Yes	No
NC	Jan 1, 2011	22	36	5000	Yes	Yes	Yes	No
OK	Nov 1, 2010	18	48	NS	NS	NS	NS	No
OR	Jan 1, 2010	25	36	NS	Yes	Yes	Yes	No
RI	Jan 1, 2006	99	36	1400	Yes	NS	NS	Yes^c^,^e
TN	Jan 1, 2012	18	36	2000	Yes	Yes	Yes	No
TX	Sep 1, 2017	18	36	NS	NS	Yes	Yes	No
WA	Jan 1, 2019	≥ 99	60	NS	Yes	Yes	NS	Yes^f
WI	Jan 1, 2010	18	36	NS	Yes	Yes	Yes	Yes^f
US Virgin Islands	May 16, 2004	18^g	36	4400	NS	Yes	Yes	No

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Note. NS = not stated; OOP = out of pocket. ≥ 99 indicates no maximum age limit on benefits coverage.

^{^a}

Equals “yes” if rehabilitation (general) or rehabilitation. Fittings columns are “yes” in Table A (available as a supplement to the online version of this article at http://www.ajph.org).

^{^b}

CT, IL, and ME changed coverage between first adoption and the current status as reported in the table. A database providing more detailed information on these mandates and changes over time is available online.

^{^c}

Small employer benefit plans are exempt from providing coverage.

^{^d}

Health insurance plan is exempt from providing coverage if benefit costs exceed 1% of annual premiums.

^{^e}

Coverage offered as an optional rider.

^{^f}

Hearing aid coverage mandated for state employees and their dependents.

^{^g}

Virgin Islands mandate covers up to age 21 years if beneficiary still attends high school.

We used effective start dates of coverage at the month level to calculate the fraction of each year that a hearing aid mandate was in place for each state and age group. We downloaded individual-level 2008 to 2020 ACS survey data—containing age, state, and private insurance coverage status—from Integrated Public Use Microdata Series USA.²⁷ We did not have ACS individual-level private insurance information from earlier than 2008, even though our policy surveillance started with 1997. We also obtained annual state-level proportions of private sector enrollees with self-insured plans at establishments offering health insurance (i.e., those not subject to state hearing aid mandates) from the MEPS Insurance Component data,¹⁶ and we set the proportion enrolled in fully insured plans (i.e., those subject to mandates) to be the remaining individuals. Because ACS data were available through 2020 and MEPS were available through 2021 at the time of analysis, we imputed through the end of our policy data collection period in 2022 using values from the final data years available.

We linked the hearing aid policy, MEPS, and ACS data by state and year, so we considered privately insured individuals in the ACS data residing in a state with a mandate covering their age to be covered for the fraction of the year that the relevant mandate was in place. Because plan type information is not available in the ACS data, we multiplied the hearing aid mandate status variable by the MEPS-derived state percentage of fully insured enrollees to account for differences in applicability of mandates for self- versus fully insured plans. We then used ACS survey weights to calculate weighted means by age group and year to obtain nationally representative estimates of the percentage of the privately insured covered by hearing aid mandates in the United States, creating separate estimates for all mandates and mandates excluding those with exceptions as previously defined.

RESULTS

We identified 26 states and 1 US territory (US Virgin Islands) with private health insurance hearing aid mandates effective as of January 2023. Summaries of key current mandate features are displayed in Table 1. Three states (CT, IL, and ME) had earlier versions of mandates that predate the status shown in Table 1. This historical information and additional mandate features not shown in Table 1 are available as part of Table A.

A number of states have current mandates that are weakened by 1 or more exceptions: requirement to offer optional hearing aid coverage (n = 2), exemptions for small employers (n = 3), coverage for state employees only (n = 2), and allowing insurers to drop the benefit if the costs exceed 1% of premiums (n = 3). Texas additionally has a trigger provision that will cause the mandate to dissolve if the Centers for Medicare & Medicaid Services determine that the hearing aid mandate exceeds federal essential health benefits (thus otherwise forcing the state to make payments to provide the benefit).²⁸ We did not count Texas’s provision as an exception in our coding because it did not affect subgroups in the state.

Most states with current mandates (n = 18/26) allowed but curtailed the use of cost sharing, for example, by allowing hearing aids to apply to the deductible or allowing coinsurance at a rate equal to other medical equipment. Only Arkansas explicitly prohibited cost sharing in its statute. Seven states (CT, LA, MD, MO, OK, RI, WA) did not specifically restrict cost sharing in any way; thus, health insurance companies in these states could provide coverage to fulfill their legal obligation but with high coinsurance rates to reduce use.

Allowable frequency of benefit use, or how often an insured beneficiary was eligible for new hearing aids, varied from 24 (n = 3; CT, IL, NJ) to 60 months (n = 3; CO, NH, WA), with a mode of 36 months (n = 15 states). One state (AR) did not specify the allowable frequency of benefit use in its published statute. Of the 26 states with mandates, 16 statutes defined maximum total coverage amounts per period of benefit use, ranging from $1400 (n = 1; RI) to $6000 (n = 3; GA, ME, NE) for 2 hearing aids. The statutes of 10 states (CO, CT, MN, MO, MT, OK, OR, TX, WA, WI) did not specify coverage amounts. An independent samples t test revealed no differences in coverage amounts between states with mandates focused on hearing aid provision for youths compared with states with no age limits (t[15] = 0.051; P = .59).

Age eligibility cutoffs were included in 19 of 26 states with current mandates. For states with eligibility cutoffs, the ages ranged from 15 to 25 years, and the mode maximum age cutoff was 18 years (n = 13). Seven states (AR, CT, IL, ME, NH, RI, WA) had no maximum age limits.

Some states included statutory language addressing coverage of supplies and repairs (e.g., earmolds and replacement parts; n = 15/26) and follow-up or rehabilitation (e.g., hearing aid adjustments and self-management skills training services; n = 14/26). Otherwise, states did not address this coverage, except for New Hampshire, which defined the “practice of fitting, dispensing, servicing, or sale of hearing instruments” as only those that involved use of a calibrated audiometer to test hearing and make selection and fitting recommendations. Note that for most individuals, hearing aids require multiple adjustments as well as self-management skills training over an acclimatization period to optimize outcomes.

Table 2 shows that between 2008 and 2022 the national share of private sector enrollees in fully insured plans ranged from 39.9% to 44.6%, with state-level minimums and maximums ranging from 24.0% to 29.7% and 60.3% to 72.1%, respectively. Figure 1 shows that between 2008 and 2022, the proportion of privately insured youths in the 50 US states and the District of Columbia living under a private insurance hearing aid mandate increased by approximately 5 times, from 3.4% to 18.7%. Meanwhile, for privately insured adults aged 19 to 64 years, this proportion increased from 0.3% in 2008 to 4.6% in 2022. When we excluded mandates with exceptions, these shares of youths (aged ≤ 18 years) and adults (aged 19–64 years) in 2022 decreased to 13.8% and 3.3%, respectively.

TABLE 2—

Percentage of Private Sector Enrollees in Fully Insured Plans at Establishments That Offer Health Insurance, by Year: United States

Year	States and DC, No.	State Level			National Level, Mean %
Year	States and DC, No.	Mean %	Minimum %	Maximum %	National Level, Mean %
2008	51	44.2	29.0	62.1	44.6
2009	51	43.4	29.5	71.1	43.8
2010	51	42.2	26.2	72.1	42.4
2011	51	41.0	26.2	69.5	41.6
2012	51	39.6	26.0	62.9	39.9
2013	51	40.9	26.5	64.5	41.8
2014	51	40.0	27.7	68.4	40.4
2015	51	39.3	24.0	60.3	39.9
2016	51	41.0	28.2	62.4	42.3
2017	51	40.4	27.6	68.8	40.6
2018	51	40.0	27.3	68.6	41.3
2019	51	41.1	29.7	71.1	41.5
2020	51	40.7	26.8	65.2	42.3
2021	51	41.2	24.5	66.4	42.1
2022	51	41.2	24.5	66.4	42.1

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Note. Fully insured plans are expected to be affected by hearing aid mandates. The firm-level data are drawn from the Medical Expenditure Panel Survey (MEPS) Insurance Component. The table includes all 50 states and the District of Columbia; it does not include US territories. We imputed values for 2022 from 2021, the last available year of MEPS data at the time of analysis. We derived national values by weighting state-level values by state populations obtained from the Surveillance, Epidemiology, and End Results Program (2008–2020), with population values for most recent years imputed from 2020.

FIGURE 1— — Annual Share of Privately Insured Youths ( ≤ 18 Years) and Adults (19–64 Years) Covered by Private Insurance Hearing Aid Mandates From 2008 to 2022 With and Without Exceptions: United States

*Note.* The figure includes all 50 states and the District of Columbia and does not include US territories. This graph starts in 2008, despite longitudinal policy surveillance starting in 1997, because American Community Survey individual-level private insurance coverage data are only available starting in 2008.

DISCUSSION

To our knowledge, this study is the first to examine US private insurance mandates for hearing aids using a detailed policy surveillance approach. Results of our policy surveillance and coding methodologies revealed measurable variability between state mandates for private insurance coverage of hearing aids, consistent with previous work that documented meaningful differences in the generosity of state Medicaid coverage of hearing aids.¹⁷ Policy surveillance of private insurance mandates for, for example, autism²⁹ and mental health care, for adolescents³⁰ demonstrated variability similar to this analysis in the areas of age limits, maximum allowable costs, and covered treatments.

Our research revealed substantial gaps in current (as of January 2023) effective statutes. Many states limit the total coverage amount, and only 1 state prohibits cost sharing. Nine states have coverage limits that were less than $4000, which is lower than the median cost of a pair of hearing aids.¹⁵ Furthermore, most mandates pertain to individuals younger than 25 years and do not address access to hearing aids for older adults, who have a higher prevalence of hearing loss. Reflecting these limitations, we estimated that in 2022 only 18.7% of privately insured youth aged 18 years and younger and 4.6% of privately insured adults aged 19 to 64 years were covered by a mandate. Although these shares are likely to grow in the future as additional states implement coverage mandates, we are aware of only 1 state (VT) that has enacted a hearing aid coverage statute since the conclusion of our policy surveillance time horizon in 2022. Like many existing mandates, Vermont’s law applies to beneficiaries up to 25 years of age and allows a maximum hearing aid benefit reimbursement of $4000 every 48 months.

Although the share of privately insured children covered by a mandate remains low, the fact that more states have opted to cover more children than adults is consistent with the prioritization of children’s health in other policy contexts. For example, Medicaid eligibility limits are higher for children than for adults,³¹ and the early and periodic screening, diagnostic and treatment benefit requires that all states cover hearing aids and other preventive services for children enrolled in Medicaid.³² Providing hearing aid coverage is likely to be less costly for children than for adults given the lower prevalence of hearing loss at younger ages.⁴ Finally, access to sound during childhood is crucial for language and speech development.³ Policymakers may be more likely to invest in children’s hearing health for these reasons.

Our review also found a lack of statutory language regarding coverage of aural rehabilitation services. Although hearing aids are an efficacious treatment, devices alone do not address the self-management skills training necessary to optimize treatment benefits for adults.²⁵ For youth, aural rehabilitation is a crucial aspect of normal speech, language, and academic ability, without which children are at significant risk for delays in these areas.³³ Given that coverage limits were lower than the median cost of entry-level hearing aids in 9 states and never exceeded $6000 in any of the 16 states with a specified limit, it is unlikely that providers in these states would be able to deliver appropriate aural rehabilitation in addition to devices without high out-of-pocket expenditures.

Federal and state policymakers have recently focused on improving hearing health care access and utilization, including by finalizing the Over-the-Counter Hearing Aid Act in August 2022.³⁴ Although the availability of over-the-counter hearing aids is likely to increase access and affordability, there is no over-the-counter option for severe hearing loss. The National Academies also prioritized addressing the affordability of hearing health care, with recommendations for mandated coverage of hearing loss treatment, highlighting hearing aids as primary treatment options.¹² The Medicare Audiologist Access and Services Act of 2021 (MAASA; S.1731) proposed amendments to the Social Security Act to address statutory barriers to accessing hearing health care for Medicare beneficiaries. However, MAASA only proposes to mandate coverage for services that would otherwise be provided by a physician instead of allowing a licensed audiologist to bill for these services. Databases such as the one we developed will inform future initiatives to broaden access to hearing aids for all US residents.

Our research identifies other legislative strategies to expand coverage. The most beneficial would be a federal mandate, as this would bring coverage to 100% of privately insured individuals and is the only strategy to guarantee this benefit to the approximately 58% of privately insured workers in self-insured plans in 2021. In the absence of a federal mandate, 2 states (WA and WI) do use a strategy to incentivize self-insured plans to offer hearing aid benefits by requiring that governments select insurance offerings for their employees that include these benefits. States that wish to maximize coverage could do so by passing a mandate that government employees be provided health insurance with hearing aid coverage. This is an opportunity for states wishing to expand coverage against the constraints of self-insured plans.

Our analysis had limitations. Our findings were based on coding legislatively enacted mandates and do not include actions such as administrative agency regulations or policies. Our estimates of the percentage of privately insured children and adults covered by a mandate could also underestimate the proportion of people with hearing aid benefits to the extent that self-insured group health plans voluntarily provide coverage or that coverage is available through another source. Self-insured plans may offer some coverage for hearing aids; however, benefit allowances may be capped or offered as discount programs or an optional benefit for recipients with additional out-of-pocket costs.³⁵ Additional research is needed to determine whether self-insured plans may be influenced by state mandates to cover hearing aids even though these plans are not subject to state mandates.

In summary, extensive variability exists across states with laws mandating private insurance hearing aid coverage. Hearing aid mandates cover a small but growing share of US residents. Future work is needed to understand the effects of these mandates and their provisions on hearing aid utilization and out-of-pocket payments.

ACKNOWLEDGMENTS

Research reported in this publication was supported by the National Institute on Deafness and Other Communication Disorders, National Institutes of Health (NIH; grant R01 DC019661-01A1).

Note. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

CONFLICTS OF INTEREST

The authors have no conflicts of interest from funding or affiliation activities to declare.

HUMAN PARTICIPANT PROTECTION

The study was deemed exempt from Human Participants Protection by the institutional review board at the University of South Florida because no human participants took part.

See also Garcia Morales and Reed, p. 361.

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34. Over-the-Counter Hearing Aid Act of 2017 . Pub L No. 115-263 ( 2017. ).
35.Whelan C. Insurance and financial assistance for hearing aids. 2023. Available at: https://www.healthyhearing.com/help/hearing-aids/insurance-financial-assistance. Accessed August 15, 2023.

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PERMALINK

Longitudinal Policy Surveillance of Private Insurance Hearing Aid Mandates in the United States: 1997–2022

Michelle L Arnold, AuD, PhD

Brianna J Heslin, JD

Madison Dowdy, BS

Stacie P Kershner, JD

Serena Phillips, DrPH

Brandy Lipton, PhD

Michael F Pesko, PhD

Abstract

METHODS

Data Sources

Inclusion and Exclusion Criteria

Data Retrieval and Coding

Data Analysis

TABLE 1—

RESULTS

TABLE 2—

FIGURE 1—

DISCUSSION

ACKNOWLEDGMENTS

CONFLICTS OF INTEREST

HUMAN PARTICIPANT PROTECTION

REFERENCES

ACTIONS

PERMALINK

RESOURCES

Cite

Add to Collections

PERMALINK

Longitudinal Policy Surveillance of Private Insurance Hearing Aid Mandates in the United States: 1997–2022

Michelle L Arnold, AuD, PhD

Brianna J Heslin, JD

Madison Dowdy, BS

Stacie P Kershner, JD

Serena Phillips, DrPH

Brandy Lipton, PhD

Michael F Pesko, PhD

Abstract

METHODS

Data Sources

Inclusion and Exclusion Criteria

Data Retrieval and Coding

Data Analysis

TABLE 1—

RESULTS

TABLE 2—

FIGURE 1—

DISCUSSION

ACKNOWLEDGMENTS

CONFLICTS OF INTEREST

HUMAN PARTICIPANT PROTECTION

REFERENCES

ACTIONS

PERMALINK

RESOURCES

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