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:
- 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.