Use Your Health Benefits for Hearing Aids Before December 31

Many extended health plans pay part of the cost of hearing aids. If your plan runs on the calendar year, any yearly amount you do not use by December 31 is usually gone, and health spending account money may expire too. If you live in Edmonton and have put off a hearing test, check your plan and book now.

This guide explains how hearing aid coverage usually works, what to ask your insurer, and how to fit it all in before the end of the year.

Do health benefits cover hearing aids?

Many do, but not all. A lot of extended health plans through work, a union or a private policy pay part of the cost of hearing aids, usually up to a set dollar amount and only once every few years. Some plans also help with the cost of a hearing test. Coverage depends on your plan, so check your benefits booklet or ask your insurer.

Plans differ a lot, even between two people at the same company. The details that matter are how much the plan pays, how often it pays, and whether it wants anything from you first.

Why does December 31 matter?

Many workplace plans run from January 1 to December 31. When the new year starts, yearly limits and health spending account balances often start over. Money you did not use in the old year does not always carry forward.

A few things to keep in mind:

• Not every plan follows the calendar. Some plan years start on another date, so look at your booklet or your insurer’s app for the exact end date.
• Health spending accounts have their own rules. Some let an unused balance carry forward for a year before it expires. Others do not. Your plan administrator can tell you which applies to you.
• Hearing aid coverage is often tied to your last claim. If your plan pays once every few years, the clock usually starts from the date of your last hearing aid claim, not from January 1. Ask when you are next eligible.

If your coverage resets soon and you already know your hearing has changed, booking in November gives you time for a hearing test, a quote and any paperwork before the holidays.

How much of a hearing aid will my plan pay?

That depends on your plan’s limit. Hearing aids at our Edmonton clinics generally cost $1,000 to $4,000 per hearing aid depending on the technology level, or about $2,000 to $8,000 for a pair. Prices vary, and we give you an exact quote after your hearing test. Our guide to hearing aid prices in Alberta explains what each price tier includes.

If your plan covers hearing aids, it usually pays up to its limit. If you also qualify for AADL, AADL covers its portion and your plan may cover another portion. A plan through your spouse or partner may pay part of what is left, and you pay the rest. That remaining amount may count toward the medical expense tax credit, since you can claim the part that insurance or another program did not reimburse.

How does AADL fit in?

Alberta Aids to Daily Living (AADL) does not run on the calendar year. Its benefit year runs from July 1 to June 30. Most clients pay a 25% cost share, up to $500 per person or family each benefit year, and low income Albertans and people receiving income assistance or the Alberta Seniors Benefit can have that cost share waived.

If you qualify for AADL and also have private benefits, ask us how the two can work together for you. As a registered AADL vendor, we confirm your eligibility and handle the AADL paperwork. Read more in our guide to AADL hearing aid coverage in Alberta.

What should I ask my insurer before I book?

A five minute call or a look in your insurer’s app can save you a surprise later. Ask:

1. Are hearing aids covered, and how much does the plan pay?
2. How often can I claim, and when was my last hearing aid claim?
3. When does my plan year end?
4. Do you need anything before I buy, such as hearing test results, a written quote or a note from a doctor?
5. Can I send in a quote for approval before I pay?
6. Does my plan help with the cost of a hearing test?
7. Do I have money in a health spending account, and when does it expire?

Write down the answers and the date you called. It makes the rest much easier.

Can I claim hearing aids through my spouse or partner?

Often, yes. If you are listed on the plan of your spouse or partner, that plan may pay part of what your own plan does not. Insurers call this coordination of benefits. Ask both insurers how they handle it before you buy, and keep every receipt and statement.

How to use your benefits before December 31 in Edmonton

1. Check your plan. Use the questions above so you know your limit, your end date and what your insurer needs.
2. Book a hearing test. Hearing tests are free for adults 65 and over at our two Edmonton clinics, 97 North and East. See our free hearing test page. If you are under 65, call either clinic for current pricing.
3. Bring your benefits card. If you are also covered through AADL, Veterans Affairs, NIHB or WCB, bring any paperwork or authorization numbers you have.
4. Get your quote. After your test, we explain your results and your options in plain language and give you an exact price. If your insurer wants to approve it first, send it in right away.
5. Keep your paperwork. Hold on to your receipts and insurance statements for your claim and for tax time.

Our 97 North clinic at 13514 97 St NW is open weekdays from 9 AM to 5 PM and Saturdays from 9 AM to 3 PM. Our East clinic at 4243 118 Ave NW in Beverly is open Monday to Friday, 9 AM to 5 PM. Both are a short drive for people in north and northeast Edmonton.

Common questions

What if my benefits have already reset or run out?

You still have options. AADL funding for Albertans who qualify runs on its own benefit year, from July 1 to June 30. What you pay out of pocket may count toward the medical expense tax credit. And if your plan year has just reset, ask your insurer what the new year covers, since hearing aid coverage often depends on the date of your last claim rather than January 1.

Do I have to buy hearing aids after my hearing test?

No. There is no obligation to buy hearing aids after your test. You get your results and a clear price, and you can take that to your insurer and decide in your own time.

Is it worth rushing to beat December 31?

Only if you need hearing aids anyway. Using your benefits is a good reason to stop putting off a hearing test, but it is not a reason to buy something you do not need. We recommend what suits your hearing and your budget.

Ready to check your hearing before the year ends? Book a hearing test at 97 North or East.

This article is general information. Your benefits booklet and your insurer have the final word on what your plan covers.