Hearing Healthcare Center, Inc.

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Hearing aids and Insurance - What's Up With That?

Posted by Hearing Healthcare Center, Inc. on April 5, 2013 at 10:40 AM Comments comments (0)

I’ve been asked at least a hundred times why insurance coverage for hearing aids is so difficult to understand. The answer could take days to discuss, but since space is limited let’s get right to the important bits. The medical community has decided that hearing loss is not life threatening, therefore insurance is not needed to cover a non-threatening incident. Hearing aids have been deemed a luxury, unlike eyeglasses that definitely keep people safer.

Please don’t think I agree with this idea. If the folks who made these decisions could be hearing impaired for a month they would change their tune. I believe that life altering is just as valuable as life threatening. And, hearing impairment definitely changes one’s quality of life!

However, back to insurance. Actual coverage may be total or partial. Total coverage usually limits the type, style, and in some cases the manufacturer of the device. This is great if the individual’s hearing loss fits the feature list of the hearing aid. For example, the benefit offer “one pair of basic, in-the-ear hearing aids every three years.” Basic hearing instruments do not offer background noise reduction, speech enhancement, or frequency lowering technologies. A very active person who happens to have a high frequency hearing loss will need features that are not part of the basic device. When he takes advantage of the “benefit” offered by his insurance, he still cannot understand speech in a noisy environment! His benefit then has very little value.

Partial coverage is most likely stated as a percentage of the allowed amount, and device choice is not limited. The definition of allowed amount, however, can differ with each carrier and could be as little as 50% of the billed amount for the hearing aid only. Follow-up services may not be covered at all. These services are extremely important in that your audiologist will help you get the best performance from your hearing aid fitting. How are these percentages determined? I do not know.

Many insurers are now offering a discount plan as a hearing aid option. Be aware this is NOT coverage. This is an out of pocket expense for you. You will be expected to pay for the hearing aids at the time of fitting. The hearing test may also be charged to you. These plans typically offer select instruments, with limited services, for a set discounted price from in-network providers.

So, hearing aid coverages are tough to understand. There is no industry standard for the carriers to follow. Please call your insurance company to find out exactly what your coverages are. Hopefully, this has given you some insight to the different wording you might see. If it’s still as clear as mud, or you have some specific questions about your own plan, give us a call and we’ll see if we can clear things up for you.

- Dr. Angela Esterline