Hearing Aid Remote Control

[Guest lschaab]

Does anyone have a comment on the eligibility of a hearing aid remote control being eligible for reimbursement under a Medical Care spending account? We think no, on the basis that it appears to be a convenience item, rather than a necessity item. Should we request a doctors note, or request the claim be submitted to insurance first (they have an HMO)?

[GBurns]

I cannot think of areason to support even thinking of accepting this as reimburseable, liberal as I am.

[Guest lschaab]

We couldn't think of any reason why a person would need a remote control, unless they were physically incapacitated, but that was a stretch for us. Maybe its for the spouse's use! Thanks for your input.

[mbozek]

IRS pub 502 includes the cost of hearing aids and batteries as a medical expense. There is no distinction between convenience and necssity. If the remote technology is part of the hearing aid why not allow it as a deduction?

[Guest lschaab]

You bring up a good point, however, the cost of the remote was not imbedded in the cost of the hearing aid, it was itemized on the receipt. Because it was itemized, we ask what possible reason, other than physical incapacitation, could a person have for a remote? We ended up rejecting the claim, requesting that it be submitted to insurance and requesting a doctors note of medical necessity. Burns and Bozek's opinions are food for thought, but oppose one another. While we are ultra conservative too, we took the high road and requested more info.

[GBurns]

While mbozek brings up a good analogy, I would still not reimburse. The reason being, that while the batteries are a necessary part of the hearing aid for the benefit of the use, the remote is not. It is an accessory for use by someone other than the user of the hearing aid and for the convenience of someone other than the hearing aid user.

[g8r]

I would reimburse it. As mbozek pointed out, I don't think convenience is a factor. Look at the practical side of this - exactly how do you determine what "convenience" is and do you really want to put yourself in the position of making that determination. I'm sure the IRS doesn't (and can't) make such a determination.

How many of you would use a similar analysis for an electric wheelchair? I don't know how wheelchairs are itemized, but if there are separate itemized costs for an electric motor or control device for a wheelchair vs. a manual one, would you deny that claim? Or, would you only allow it if a person had limited use of the arms?

The point is that for virtually all medical equipment or treatment, I could probably find a lower cost and claim that any payment over this lowest cost is for "convenience" and therefore not reimbursable.

If the remote control can only be used for the hearing aid, then it's for medical equipment and I see no reason, logically or legally, to deny it.

But, that's just my opinion.

[Guest KaranRobertson]

A remote for a hearing aid is for the use of the person using the hearing aid. IT enables the person to change the volume to accommodate the surroundings - too noisy, too loud, too much background noise, etc. - It helps with hearing. Usually it is worn like a watch. Convenient, yes. Better able to make the person hear like a normal person, yes. I guess you might want to check further with the doctor or audiologist. I liked the analogy to the electric wheel chair.

Just my two cents. KR

[mbozek]

Thnk you for confirming my observation that a remote device is part of the hearing aid. I dont know where GBurns got the idea that the remote is an accessory for use by some one other than the person using the hearing aid.

[GBurns]

mbozek,

It seems that on every Forum, I have to repeat this to you.

Read the post by KaranRobertson again.

Nowhere does she say that the remote control is part of the hearing aid. She said .."Usually it is worn like a watch". To wear something like a watch means that it is either in your pocket (like a pocketwatch, which would be rare) or usually, like almost all of us, it is on your forearm near your wrist. I trust that is where you do wear your watch and not around or in your ear where something that is a part of the hearing aid (such as the battery) would be worn.

The remote used to be, until the mid 90s an accessory sold so as to allow others to interrupt the wearer without shouting or turning off the TV or whatever the hearing aid user might be listening to.

With the advent, in the 90s, of digital and programmable hearing aids some manufacturers have made available a remote control device so that the user can control the device themself. This usually works effectively on those hearing aids that are not self-adapting and that is why the remote device is only available from a few manufacturers, with whose technology self adjusting would not conflict.The major drawback with the older technology devices is that they increase all noises at the same time.

The wrist watch remote control device (most likely the Phonak ) has only been out a few years and still is not readily available or useable in the USA. This Phonak device and another device using similar technology allows selective control.

To check for availability of remote control devices or to see who uses self-adjusting technology that would conflict, you could look in the Siemens catalog (maker of over 20% of all hearing aids and maker of over 50% of advanced hearing aids) plus others like Oticon or Widex, or just visit a major hearing aid store. You will find that many have never even heard of a remote control. Or ask any major insurer (preferably Medicare) or large TPA if they know of any insurance plan that covers the item.

I do not know of any insurer that will pay for it. The reasons being unproven, unnecessary, other proven acceptable cost effective methods are available etc etc. Which is probably why this person is trying to use their FSA rather than seeking reimbursement or coverage from their insurance company.

It says volumes to me when an insurance company will pay for a hearing aid and batteries but not for the remote control,

[mbozek]

IRS pub 502 permits a deduction of the additional cost of a TV set that includes the cost of equipment that displays the audio portion of the program as subtitles for the hearing impaired as well as the cost of an adapter. The cost of special telephone equipment that allows a hearing impaired person to communicate over a regular telephone is also a medical expense. The remote device is not, as you described it a device for benefit of someone other a hearing impaired person, but a technological feature (similar to remote devices on a wheechair) that allows the hearing impaired person to better adapt to the surroundings to hear audible sounds for which there is substantial authority under the tax law to claim a deduction as a medical expense.

[GBurns]

The SAP and captioning ability is built into the circuitry of the TV. The hearing aid remote is not.

The special telephone equipment is an instrument/appliance, the hearing aid remote is not.

The use of the device by someone else was addressed, explained, dated and expanded, in my previous post, if you could only read adequately.

Where have you ever seen "substantial authority under the tax law to claim a deduction as a medical expense."?

[g8r]

Obviously, there is some dispute over this one. While I think it qualifies as a medical expense, I'm not the one who has to make that final decision.

However, I strongly disagree with GBurn's comment that the fact that an insurance company won't reimburse the remote control "says volumes to me." To me, that's totally irrelevant. There are many things my general health plan won't cover (e.g., dental care, experimental procedures, etc.). It's a contract - not a statement as to what's a deductible medical expense. Thus, what the insurance "contract" covers doesn't mean a thing to me.

[mbozek]

As noted previously the cost of an adapter that attaches to a TV set is a dedeuctible medical expense. Substantial authority is the basis for claiming a deducton under the IRC. See IRS Circular 230.

[GBurns]

What does Circular 230 which covers "Regulations Governing Practice Before The Internal Revenue Service" have to do with this issue?

While substantial authority might be the basis for claiming a deduction, that was not the question. You staed that there was such substantial authority, I asked you where ever did you find it?

Apparently you either do not know what "substantial authority" is or you really have none that you can cite. I suggest that you look at section 6661 and Treas Regs 1.6661-3 et al for the definition of "substantial authority" that is provided by the IRS and which is the accepted definition in matters of taxation. I doubt that you can provide anything that meets these requirements or anything in case law.

Why do you so very frequently give cites and references that have no relevance? People do check them.

[Lisa Hand]

One more point, since the discussion seems to be this is a personal use item instead of a medically necessary one, the following section of Pub. 502 seems to address it well.

"Personal Use Items

You can not include in medical expenses an item ordinarily used for personal, living, or family purposes unless it is used primarily to prevent or alleviate a physical or mental defect or illness."

I think it is pretty clear that a remote control which controls only a hearing aid meets the definition of a device that itss primary use is to alleviate a phyiscal defect.

[GBurns]

It is the hearing aid that alleviates the physical defect.

[g8r]

You might also look at the two revenue rulings issued today (May 15) regarding medical equipment, drugs and certain surgery. They confirm the issues in this thread on drugs and medical equipment

And, I'm still confident that since the remote control is used solely with the hearing aid, that it's an allowable expense.