Understanding insurance coverage as it relates to prescription hearing aids can be a complex topic. Here, we offer seven questions you should be sure to ask your provider before making a purchase.
One of the most confusing aspects of purchasing prescription hearing aids is whether your insurance plan covers the cost. For example, not every hearing aid provider accepts insurance benefits as payment. Some big box stores only accept private payment, as do many other clinics. So here are some important questions you should ask your audiologist so that there are no surprises when it comes to paying for hearing aids.
1. Do you accept my insurance as payment for hearing aids?
As mentioned, many retail stores and other providers don’t accept any type of insurance as payment for hearing aids. Some may accept insurance, but only specific plans. Before getting too far into the buying process, be sure to ask the staff of the audiologist you see whether your plan is included.
2. What’s covered by my insurance plan?
This can vary widely depending on the plan you have. Some plans offer a benefit for hearing aids, but it may only cover limited services or the hearing aids it covers are only entry-level devices. Be sure you find out if there are any restrictions.
3. Does Medicare cover hearing aids?
Medicare covers the cost of a comprehensive hearing evaluation when medically necessary. However, Medicare DOES NOT have any provision to help cover the cost of hearing aids, anything related to hearing aids, or costs associated with hearing aids, such as batteries, services, or repairs. If you have Medicare and a traditional supplemental policy, you may have to cover the cost of hearing aids yourself as an out-of-pocket expense.
4. Do Medicare Advantage plans cover the cost of hearing aids?
Medicare Advantage plans are an “all in one” alternative to original Medicare. They are offered by private insurance companies approved by Medicare.
Medicare Advantage plans cover all Medicare services. Some plans also offer extra coverage, like vision, hearing and dental coverage. This is where things can get complicated regarding hearing aids. Even though some Medicare Advantage plans claim to offer a hearing aid benefit, you should be fully educated about how this works. After working with several of these plans, Associated Audiologists has found that sometimes the hearing aid benefit covers only a low-end hearing aid that may be less sophisticated than some of the older hearing aid technology a patient may already be wearing, or is not appropriate for the type of hearing loss the patient has. In other cases, the plans are so restrictive in terms of providers or treatment choices, the hearing aid coverage turns out to be of little benefit at all. For patients who have purchased these plans thinking they now have coverage, not only for hearing aids, but for other services, like dental or vision, this can be very frustrating. Be sure to verify your plan, what’s covered, what you are expected to pay and what you’ll receive for those dollars so that there are no surprises.
5. Does traditional insurance cover hearing aids?
If you have traditional insurance and it helps cover hearing aids, you need to meet your deductible before coverage kicks in. That’s also the case with an Advantage Plan. Then, the coverage is often a percentage of the total expense. If you have funds still left in your FSA or HSA, you could even use them to cover your share of the cost, allowing you to use tax-advantaged dollars as well.
6. How do I guard against surprises when I’m purchasing new hearing aids?
Associated Audiologists provides all patients with an estimate regarding the cost of hearing aids and what, if any, their insurance plan will help cover.
If you are uninsured, have non-covered services, or you do not wish to submit a bill for your care to your insurance plan for your care, then you have a right to receive an estimate of your bill before receiving any health care items or services. Learn more about a good faith estimate here.
7. How can I learn more?
Associated Audiologists provides a list of insurance plans we accept, as well as payment options, on our website. In addition, you may contact our clinics with any questions or concerns related to insurance. Our staff members know the right questions to ask in order find out whether you have coverage, and if you do, how it can help, as well as what your financial responsibility will be. It’s also important to be aware of the difference between prescription and over-the-counter hearing aids. In some cases, insurance plans only provide coverage for prescription hearing aids.
To learn more about insurance and hearing aids, download our free e-book, Your Guide to Insurance and Hearing Aids.
