Does OHIP Cover Hearing Tests?
The Cost of a Hearing Test Must Meet Certain Criteria to be Covered by OHIP
It is not uncommon to encounter some degree of confusion about which types of medical expenses are covered or not covered by public or private insurance providers. This can, and often does, relate to certain prescription medications as well as eye examinations, blood tests, and a hearing test.
Individuals with private health insurance have the means, either through their employer or by contacting their provider directly, to gain an appreciation for/understanding of their coverage when the specific need arises. For people who not do have private coverage, and/or for health care services that are paid under the Ontario Health Insurance Plan (or OHIP) a yes-or-no determination of coverage might not always be so clear-cut.
With respect to hearing, OHIP will cover the cost of a diagnostic test, provided that the test is ordered or requested by and/or performed by a qualified physician. A diagnostic hearing test is administered when hearing loss is already suspected and is intended to accurately assess whether that loss can be treated medically or if hearing aids are the best option for the patient.
(Note – it is important to distinguish this type of hearing test from a hearing check or screening, which is primarily used to evaluate whether or not hearing loss in present).
The specific assessments of a diagnostic hearing test include the following:
- Whether hearing loss is permanent or temporary
- Type of hearing loss – conductive, sensorineural, or mixed
- The extent of the hearing loss (range of frequency)
- The area affected – e.g.: inner ear, ear canal
- Eardrum movement
Conversely, OHIP will not pay for the cost of a diagnostic hearing test if the request for testing is made by a party other than a qualified physician. Very often, these third party requests are motivated or compelled by learning-related or employment-related factors. Hence, tests arranged by groups such as those below are not eligible for OHIP coverage:
- Employers
- School boards
- WSIB (workplace safety)
- DVA (veterans’ affairs)
There are other types of hearing-related tests that are also not covered by OHIP. These are services that are provided by audiologists or hearing specialists from a hearing test centre, like Bravo Hearing Centre, and do not need to be initiated or supervised by a physician. Such services or tests include:
- The evaluation or re-evaluation of hearing aids
- Evaluation of tinnitus (ringing in the ear) masker devices
Our Hearing Test Centre offers complete complimentary Audiological Assessments to our clients & patients.
Residents of Etobicoke and the surrounding area can book their hearing evaluation with Bravo Hearing Centre by visiting our Book An Appointment page.
Ask Your Hearing Test Centre if You Qualify for ADP Funding for Hearing Aids
If the results of a hearing test determine that hearing aids are indeed the best course of treatment, patients will then be faced with the all-important aspect of paying for their devices. The cost to manufacture and dispense hearing aids through a certified hearing test centre can be quite prohibitive, and funding may not always be available through personal means or private health insurance coverage.
An option exists in Ontario whereby individuals may qualify for financial assistance from the provincial government to help cover some of their out-of-pocket costs for purchasing their hearing aids. This is known as the Ontario Assistive Devices Program (or ADP) and it is intended to provide support for any permanent resident of the province with a long-term physical disability who requires the use of hearing aids for a period of at least six months, under the provision that they hold a valid Ontario health card issued in their name.
Concerning the actual hearing aids, the ADP customarily pays based on these guidelines:
- 75% (max $500) for a single hearing aid plus ear mold and dispensing fee
- 75%, (max $1000) for two hearing aids plus ear molds and dispensing fee
- 75% (max $1350) for frequency modulated (FM) systems and dispensing fee
The hearing loss specialists at Bravo Hearing Centre are very knowledgeable about the qualifications and processes relative to the Ontario Assistive Devices Program, and are available to answer any questions you may have about eligibility for ADP funding.
If you suspect that you or a family member may be experiencing some hearing loss, call the professionals at Bravo Hearing Centre today at 647-694-4626 to schedule a Hearing Test and to determine the best course of treatment/action moving forward.
Frequently Asked Questions
How Much Does a Hearing Aid Cost in Ontario?
Hearing aids in Ontario range from under $1000 to over $4000 per device after the ADP grant is applied. Bravo Hearing Centre also offers monthly promotions and specials on a variety of styles and makes of hearing aids from big hearing aid manufacturers, including world-renowned brands like Phonak, Starkey, Oticon, Bernafon, and Widex. We feature discounts of up to 50% on top, premium technology hearing aids like the Phonak Marvel M-90, Starkey Livio i2400, Starkey Picasso custom in the canal hearing aids, Oticon ONP 1 S, and Bernafon Viron 9 hearing aids. The most cost-saving promotion at Bravo Hearing Centre is on the Phonak Essential line of RIC and custom in the canal hearing aids, starting at $645 per device after the ADP grant.
Are Hearing Tests Free? What Does OHIP Cover?
Hearing tests are not covered under OHIP unless you are tested at an ENT (Ear Nose and Throat) doctor’s office. Hearing centres may offer no-charge hearing tests and evaluations when ordering hearing aids, but most will charge for their service and time if no decision is made. The Ontario 2020 hearing test fee guide suggests $147 for complete hearing assessments and $120 for hearing aid recommendations. Many clinics will discount these prices or offer these services at no charge, especially if the client decides to order hearing aids at their clinic. Be aware that most hearing tests advertised as “Free” are just hearing screenings and not complete audiological hearing tests. The hearing test results are the property of the clinic who performed it, and they are not obligated to give you a copy. However, they may offer to fax it to your family physician for their records.
ADP (Assistive Devices Program) is a division under OHIP that covers 75% of the price of hearing aid up to $500 for each type of aid every three years or every five years if the existing hearing aids were lost. To be covered under ADP, you need to have a current hearing test (within the last six months), an ADP form from a licenced hearing aid clinic and a recommendation for hearing aid amplification from your hearing specialist. It is usually all done at one visit with your local hearing aid clinic.
Are There Any Other Sources of Funding for Hearing Aids?
- Social Services: In Ontario, you could request to qualify for a one-time hardship fund, which, together with OHIP’s ADP Assistive Devices Program, can cover the cost of entry-level hearing aids. You require a hearing test, a hearing aid recommendation, a hearing aid quote, ADP from, and a contact for the social services office near you. All of the above can be provided at our office. When contacting them, you would request an over the telephone or in-person appointment for financial help in getting hearing aids.
- ODSP: The Ontario Disability Support Program may cover the cost of your hearing aids. You will need a hearing test, a hearing aid recommendation, and a hearing aid quote from your hearing aid specialist.
- DVA: Veterans Affairs Canada may cover the cost of your hearing aids. What you require is a hearing test, hearing aid recommendation, and a hearing aid quote from your hearing aid specialist. Group B Veterans may require an ADP Assistive Devices Form provided from the place the hearing assessment was performed.
- WSIB: Workers Compensation is a form of insurance that provides medical benefits to employees injured in their place of work. It also may cover the cost of hearing aids. Speak with your hearing care provider to see if you may qualify.
- Private Medical Insurance: Many private and work medical insurances, including shared spousal benefits, may qualify you for hearing aid funding. This funding works in conjunction with the third-party payer, ADP. The coverage is individual, dependent on policy stipulations, and may cover a minimum or unlimited total sum per device once every 3-5 years. These policies can change and vary from one year to another. It is your responsibility to check your insurance provider for the most up to date information.
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