Hearing aid on the National Health Fund: how to get funding? Find out about other refund options

Buying a hearing aid without a refund is associated with considerable expenses, which are a heavy burden, among others for parents of children with disabilities and seniors. For many years, the amount of funding from the National Health Fund for the purchase of hearing aids has remained at a constant level. Only recently, at the beginning of 2023, changes were introduced in this area, increasing the value of refunds for hearing aids, earmolds and FM hearing aid systems, used, among others, in in bilateral hearing loss. It is worth finding out who can benefit from the National Health Fund’s subsidy for the purchase of a hearing aid, how to obtain a refund from the National Health Fund and what additional programs allow you to reduce the costs associated with the purchase of a hearing aid.

What does the funding for hearing aids depend on?

Eligibility criteria for financing hearing aids from the National Health Fund depends on the age of the insured person and the degree of hearing loss. In accordance with applicable regulations, the following may benefit from the co-financing:

• persons under 26 years of age, if the hearing loss exceeds 30 dB HL,

• people over 26 years of age if the hearing loss exceeds 40 dB HL.

The refund can be used by people registered for universal health insurance. Reimbursement from the National Health Fund for persons under 26 years of age is granted once every 3 years and covers:

• in-ear and extra-ear air conduction hearing aids – the co-financing amount is PLN 3,000 for each ear with hearing loss exceeding 30 dB HL;

• bone conduction hearing aid – the co-financing amount is PLN 3,000 for each ear with hearing loss exceeding 30 dB HL;

• an individual earbud – the amount of co-financing is PLN 60 if it is necessary to use it, the amount is due each time in accordance with the doctor’s recommendations;

• use of FM systems supporting hearing – the amount of co-financing is PLN 3,850 for people whose hearing defects make it difficult to understand speech.

Reimbursement from the National Health Fund for persons over 26 years of age is granted once every 5 years and covers:

• in-ear and extra-ear air conduction hearing aids – the co-financing amount is PLN 1,050 for each ear with hearing loss exceeding 40 dB HL;

• bone conduction hearing aid – the co-financing amount is PLN 2,100 for each ear with hearing loss exceeding 40 dB HL;

• an individual earbud – the co-financing amount is PLN 50;

• assistive hearing systems are not reimbursed for persons over 26 years of age.

Changes regarding the reimbursement of hearing aids to the National Health Fund do not only cover the amounts of co-financing. It is worth knowing that in the case of people with a significant degree of disability, the limit on the period of use of a medical device has been lifted. Currently, according to the doctor’s recommendations, you can use the subsidy to purchase a hearing aid without time limits.

The NFZ refund is also addressed to war invalids, military invalids and repressed persons, who are entitled to it once every 5 years and covers:

• in-the-ear and extra-ear air conduction hearing aids – the co-financing amount is PLN 1,500 for each ear with hearing loss exceeding 40 dB HL;

• bone conduction hearing aid – the co-financing amount is PLN 3,000 for each ear with hearing loss exceeding 40 dB HL;

• using an individual earbud – the co-financing amount is PLN 50;

• the refund does not cover the hearing aid system.

Co-financing for the purchase of a hearing aid – additional possibilities

By meeting the currently applicable criteria, you can additionally benefit from a refund from PFRON funds and a refund from the Program of the Office for War Veterans and Victims of Oppression.

Who can obtain funds from PFRON for the purchase of a hearing aid?

Reimbursement from PFRON (State Fund for Rehabilitation of Disabled Persons) for the purchase of a hearing aid can be obtained by:

• people with a disability group,

• people with a disability certificate.

In this case, the income criterion applies – co-financing from PFRON can be obtained by persons whose monthly income per person in the family does not exceed 50%. average wage rate or 65 percent. average wage rates for persons running a household alone. In this case, it is important that people who have previously received a refund from the National Health Fund can apply for co-financing from PFRON. The amount of funding for the purchase of a hearing aid from PFRON is not fixed – funding for a hearing aid from PFRON depends on the poviat and the period in which a person with hearing loss applies for funding.

Depending on the place of residence, a person in need of hearing aid may apply for funds from PFRON, which are issued by:

• Municipal Social Welfare Centers (MOPS),

• Municipal Social Welfare Centers (GOPS),

• Poviat Family Support Centers (PCPR),

• Communal Family Support Centers (GCPR).

The refund depends on the limits set for a given province. The combination of funding from the National Health Fund and funding from PFRON is one of the ways to significantly reduce the cost of purchasing medical devices.

Co-financing for the purchase of a hearing aid from the Program of the Office for War Veterans and Victims of Oppression

The program of the Office for War Veterans and Victims of Oppression assumes co-financing of up to 100 percent. the difference between the total price of one hearing aid or hearing aids and an earmold or earpieces and co-financing from other sources, i.e. the National Health Fund, the State Fund for Rehabilitation of the Disabled, Poviat Family Support Centers and Social Welfare Centers in the amount not more than PLN 5,000 gross per one hearing aid and one earmold.

Co-financing from the Program of the Office for War Veterans and Victims of Oppression can be used by:

• combatants,

• Siberians,

• people repressed by the communist system,

• war veterans,

• civilian victims of warfare.

The condition for obtaining a refund for the purchase of a hearing aid or earmold from the Program of the Office for War Veterans and Victims of Oppression is meeting the income criteria.
Important! The program of the Office for War Veterans and Victims of Oppression lasts until December 31, 2023.

Reimbursement of the hearing aid on the National Health Fund step by step

What should I do to obtain funding from the National Health Fund for the purchase of a hearing aid? First, you need to detect hearing loss, which is the basis for applying for funding. There are many places where you can get a free hearing test.

If the test confirms the hearing loss, you need to register with a general practitioner who will issue a referral to a doctor with a specialization entitling you to issue an application for a hearing aid, an earmold or an FM hearing aid system. An application for medical devices may be issued, for example, by an ENT doctor, an audiology and phoniatrics specialist, and an otolaryngologist. The order will be confirmed using the NFZ IT system. The confirmation of the right to a refund from the National Health Fund is the feedback with the order number assigned by the IT system, which enables its implementation at the hearing care professional.

When you receive an order for medical devices, you go to your hearing care provider and begin the process of fulfilling your order, which includes fitting hearing aids, earmolds or FM hearing aids that meet your individual needs.

Sources:

• Regulation of the Minister of Health of 29 May 2017 on the list of medical devices issued to order

• “Co-financing the purchase of hearing aids for anti-communist opposition activists and people repressed for political reasons in 2023”, kombatanci.gov.pl

• diabetyk.org.pl