Hearing Aids and Health Insurance

With the cost of hearing aids being so high, many people look to their health insurance to cover part of the costs. Unfortunately, the vast majority of health insurance providers offer little to no coverage for hearing aids. In my experience, it’s the lucky few (less than 5% of patients), who have the entire cost of their hearing aids covered. I’d estimate that about 10% of folks have a percentage of their hearing aids covered, while the vast majority of patients have no hearing aid benefits whatsoever. So it’s not likely that your health insurance will pay for even part of your hearing aids; but as you begin to consider purchasing hearing aids, you should definitely check your benefits with your insurance provider, because you never know.

Checking for hearing aid benefits

It’s smart to check your hearing aid benefits before you start this whole process. Here’s how to do that.

1) Read your booklet
At the time you enrolled in your health plan, you should have been mailed a booklet with an explanation of benefits. Search the index of this booklet for keywords like audiology, hearing care, or durable medical equipment (DME).

2) Call your health insurance provider
I have found that sometimes the booklets are not the most reliable source for explanations of benefits. I would strongly recommend that you actually call your health insurance provider (an 800 number should be listed on your card) and specifically ask about hearing aid coverage. When you speak to this representative, write down their name, the date you called, and the benefits as explained to you. While some insurance providers will not oblige, request that you get your coverage details in writing. A little due diligence here goes a long way. Many times, I’ve seen an insurance company give a patient one answer with regards to their benefits, and a hearing provider another answer. As a patient, you may even call your health provider and get conflicting information from different representatives. This is why you want benefits in writing if you can get it. In addition, when you actually visit your hearing provider, have them check your benefits as well.

Find out which hearing providers you can visit

Often, if you have hearing aid benefits, you can only take advantage of those benefits by visiting hearing providers who are in-network with your health insurance, so you’ll need to find out who these providers are. Chances are you’ll be able to choose from a few different providers in your community. But before you call and make an appointment with your in-network provider, you want to make sure you don’t need any sort of “pre-authorization” first. Depending on your health plan, this could mean a number of things. You may need a prescription from your primary care physician, results of a completed hearing test, or a document from your insurance provider.

Find out who is going to deal with the insurance company

If you find out that you don’t need to go to an in-network provider, you are free to go to whatever hearing provider you want. However, the logistics of how everything will work are going to vary from one hearing provider to the next. For example, if the hearing provider you choose doesn’t deal with health insurances at all, you may be stuck submitting the claim yourself and waiting for reimbursement. On the other hand, you may be able to find a hearing provider that will reduce your out-of-pocket cost by the amount your insurance is expected to pay, submit your claim for you, and wait for the reimbursement to be paid directly to their office. Before you choose a hearing provider, you may want to call around and see how different providers may handle this for you. Don’t be surprised if most hearing providers require you to pay in full (upfront), for the hearing aids. As I mentioned earlier, health insurance providers often give incorrect information about benefits, and can take 6 months or longer to submit a reimbursement, so hearing providers often won’t assume this risk.

If you don’t have hearing aid benefits, there are other ways to reduce your out-of-pocket expenses

If you don’t have benefits for hearing aids, that doesn’t necessarily mean you have to pay the full retail price for hearing aids. In fact, you may have an alternative option that will allow you to save just as much as someone that actually has hearing aid benefits.

Imagine you have a $2000 hearing aid benefit through your health insurance. You go to your local provider, buy a set of premium hearing aids for $6200, and end up only paying $4200 out of pocket when it’s all said and done. So you’ve saved $2000.

Now, if your insurance doesn’t cover hearing aids, your option is to simply find a provider that will sell you that same set of premium hearing aids for $4200. While this may sound daunting- calling providers around town, getting quotes, negotiating, etc, the good news is, that job has already been done for you. The ZipHearing provider network is a nationwide group of hearing providers who sell brand name hearing aids at pre-negotiated reduced prices. To find out if there’s a ZipHearing provider near you, all you need to do is search here.

From there, the process couldn’t be any easier. If you see that there is a ZipHearing provider near you, give us call at 800-731-6794 and we’ll give you the contact information for your local office. Then, if you choose to buy hearing aids from that provider, they’ll honor the discounted pricing and other perks advertised on our site, potentially saving you as much money as those lucky folks with hearing aid benefits!

If you’d like a free phone consultation with a licensed hearing provider, please feel free to call us at 800-731-6794.

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