Bone-Anchored Hearing Aid

This policy covers bone‑anchored hearing aid (BAHA) systems — implantable devices for patients aged ≥5 years (headband devices for children <5 or those medically unable to receive implants) — for unilateral or bilateral conductive or mixed hearing loss and single‑sided sensorineural deafness when conventional air‑conduction hearing aids are unusable or provide inadequate benefit (e.g., ear canal atresia, chronic infections, allergy, or large conductive loss). Coverage requires device‑specific criteria (pure‑tone bone conduction thresholds consistent with FDA labeling, unaided speech discrimination ≥60%, for unilateral deafness the hearing ear BC ≤20 dB, and for bilateral BAHA a mean interaural BC difference <10 dB); services are not covered if conventional aids suffice, criteria are unmet, or replacements/upgrades are requested solely for convenience or premature technology upgrades.

"Members with physical or medical complications that prevent adequate functional improvement from conventional (air-conduction) hearing aids"