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Your Hearing Loss Coverage
Current OHIP Regulations
The question of what OHIP will cover in the way of diagnostic hearing tests
seems to be causing some confusion. The Ministry of Health and Long Term
Care introduced certain changes on 13 August 2001 and, for example,
physicians who supervise hearing tests must now be qualified to perform the
tests themselves. Here are some further observations.
If OHIP is to pay for a diagnostic hearing test, the audiologist who
performs the test must be supervised by a qualified physician. Since August
13, 2001, OHIP no longer pays for hearing aid evaluations since it is not a
service that requires the skill or supervision of a physician. Nor are
hearing aid evaluations covered by any other branch of the Ministry of
Health and Long Term Care.
The Ministry will continue to fund the fitting of hearing aids under its
Assistive Devices Program (ADP), which funds 75% of the cost of dispensing a
hearing aid up to $500.00 for each ear - once every 36 months, but only an
Ontario resident with a valid Ontario Health Number, and who has a physical
disability that has affected him/her for six months or longer is eligible
for this assistance.
A number of hearing aid providers will absorb the cost of the initial
diagnostic hearing test if a hearing aid is purchased. Audiologists in
private practice, like many regulated health professionals e.g. nurses,
psychologists cannot bill OHIP - fee-for-service. This has not changed.
PSHCP Coverage
PSHCP will cover hearing aid costs (purchase/repairs) as follows: 80% of
costs up to a maximum of $500,once every 60 months (after your annual
deductible amount has been satisfied), less any eligible hearing aid
expenses claimed during the previous 60 months. NOTE: Batteries are NOT an
eligible expense.
If you have questions or concerns relating to the PSHCP and / or the PDSP, I
should be pleased to try to provide a satisfactory response. Telephone:
737-2199 Monday through Friday between the hours of 10:00 a.m. and 4:00 p.m.
Jean Aslin, Ottawa Branch Health Benefits Officer
15 November, 2004
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