Does Anthem Blue Cross Cover Hearing Aids? Caps, Renewal Periods and States

Anthem in the CMS files: one parent company, not every Blue plan

In these files, the Elevance/Anthem group counts every Medicare Advantage segment whose parent organization contains "Elevance", the name of Anthem's parent company. Our Blue Cross Blue Shield page uses a different group, every plan carrying the Blue name, and the two only partly overlap: 127 of the 345 Elevance/Anthem segments also carry a Blue name. The others are sold under names such as Wellpoint, Simply Healthcare, Freedom Health, Anthem HealthKeepers and MMM. Neither group contains the other, so their counts cannot be added together.

• 345 Elevance/Anthem segments, from 320 distinct contract-plans.
• 326, or 94.5%, carry the mandatory supplemental flag for prescription hearing aids.
• 94.5% list a routine hearing exam.
• 60.3% file a mandatory OTC hearing aid benefit (a separate field; flags can overlap).

Each row is a segment filed with CMS, not a person. Employer-only plans and PACE are excluded and special needs plans are kept.

How often Anthem pays: three cap periods on file

An Anthem cap has three parts: the dollar amount, the ear basis and how often it renews. The national file holds three combinations:

• Both ears combined, every year: 271 segments, median cap $2,000.
• Per ear, every year: 40 segments, median cap $750.
• Both ears combined, every three years: 15 segments, median cap $1,250.

A yearly cap for both ears and a three-year cap for both ears are different promises, so we never convert one into the other, and we never split a both-ears amount into a per-ear figure. Each amount is the most the plan pays in its own period, not what a hearing aid sells for. A segment with no cap on file is not an unlimited benefit; its terms sit in its plan documents.

Ohio and Texas at $3,000, Arizona at $1,500

State medians for the both-ears yearly cap spread across a wide band. A segment serving several states counts in each, so these rows are not shares of the national total. The name in parentheses is the most common marketing name in that state's filings.

• California (Anthem Blue Cross, all 44 segments): 88.6% with the aid flag; the 39 with a cap have a median of $3,000.
• Ohio (Anthem Blue Cross and Blue Shield), Texas (Wellpoint, all 25 segments) and Missouri (Anthem HealthKeepers on 5 of 7): median cap $3,000, across 15, 24 and 7 segments with a cap.
• New York: 14 segments, 8 sold as Anthem Blue Cross and Blue Shield and 6 as Centers Plan for Healthy Living; only 71.4% with the aid flag; the 10 with a cap have a median of $2,500.
• Indiana (9 Anthem Blue Cross and Blue Shield, 9 Anthem HealthKeepers), Kentucky (Anthem Blue Cross and Blue Shield) and Virginia (Anthem HealthKeepers on 13 of 17): median cap $2,000, the same as the national median, across 18, 10 and 16 segments.
• Arizona (Wellpoint, all 12 segments): all with the aid flag, median cap $1,500.

In each of these rows the median minimum copay per aid is $0. The copay floor holds still while the cap moves, so the cap is the figure to compare across Anthem markets.

Florida files two designs, Puerto Rico a three-year cap

Two rows break from the single yearly both-ears pattern.

• Florida: 103 segments, all with the aid flag and all sold under non-Blue names: Simply Healthcare (50), Freedom Health (25), Optimum HealthCare (15) and HealthSun (13). 63 of them file a both-ears yearly cap with a median of $2,000; 40 file a per-ear yearly cap with a median of $750. The median minimum copay is $0.
• Puerto Rico: 20 segments, all sold as Medicare y Mucho Mas (MMM); 75.0% with the aid flag. The 15 with a cap file it for both ears every three years, median $1,250. 0 segments report a minimum copay, so that value stays unknown.

The same parent company files different promises, under different names, in different markets. Reading the period and the ear basis matters as much as reading the amount.

Colorado, Iowa, Kansas, Louisiana, New Jersey, South Carolina, Washington and West Virginia each hold 3 segments or fewer: too few segments for a median, so the table gives the count alone.

Anthem coverage outside Medicare Advantage

The CMS file covers Medicare Advantage only. An individual or job-based Anthem policy states its hearing aid terms in its Summary of Benefits and Coverage and in the policy contract. Those terms depend on the plan and, where one applies, on the state's insurance law, which we track on hearing aid insurance by state.

Anthem Medicaid plans follow each state's Medicaid program rather than these filings; see Medicaid and hearing aids. Original Medicare, for its part, doesn't pay for hearing aids; the federal rules are on Medicare and hearing aids.

What the Anthem rows leave open

• The brand on the card. The group follows the parent organization; the state rows give the most common marketing name, not every product sold there.
• Individual plans. We do not list, rank or link to plans; the table groups filings by state.
• Membership. A small segment and a large one count the same.
• Add-on packages. Optional supplemental hearing benefits were not read.
• Providers and devices. The fields hold amounts, ear bases and periods, with no maker or network named.

To check one plan, open the hearing section of its Evidence of Coverage and find the cap amount, whether it is per ear or for both ears, and how often it renews. For other carriers, see Medicare Advantage hearing aid coverage and the Wellcare page.