Hearing Aid Insurance Benefits | Health


Some health insurance programs place a lot of emphasis on providing hearing aids. People have chosen these policies thinking that they will be able to use this benefit. What is not clear is that this benefit comes with significant limitations and it may not be possible to get the best hearing aids for your needs. Most of the time, the hearing aids in your plan are NOT free. The plans usually offer a discounted price only.

Some insurers allow direct billing for hearing aids. Many insurers contract with a third-party provider to provide hearing aids. For example, Cigna generally works with Amplifon and Aetna generally works with Nations Hearing. These third-party companies then contract with vendors to do the work for them. Each “middleman” slows down the process and complicates it. This means that your local audiologist must receive a referral for your services and need permission from the third-party company for anything. If you use one of these programs, you will see your local audiologist but make your payment to the third-party company. Thus, your local audiologist cannot issue refunds. You need to get this from the third party company.

When you want hearing aids, you have to start the process. It starts with a call to your health insurance company and you follow the steps they advise you to take. Sometimes you also need to contact the third-party company. It can get tedious. At Audiology Specialists, we work with a number of these third-party companies, such as Amplifon, Nations Hearing, United Health Care Hearing and a few others.

For people who are still working and working in NH for an employer who takes out insurance for them, there is the NH Mandate. This law requires that hearing aids be covered by employee insurance. The NH mandate requires insurance companies to cover up to a maximum of $1,500 per ear, every five years, for hearing aids. There are things you need to know: Do you have to pay your deductible before you can use the benefit? What if you need something better than what insurance companies call “standard” hearing aids? Can you pay the difference to get better hearing aids? Insurance companies sometimes pay less than the amount of the mandate. Then they expect the supplier to absorb the loss. This is a problem for your local supplier. If your employer is self-insured, meaning they contract with a company to administer their plan, the insurance is not required to provide a benefit for hearing aids.

For retired people, Medicare NEVER covers anything related to hearing aids. Some retirees buy Medicare replacement plans, where a hearing aid benefit can feel like a bonus. However, the hearing aid choices they offer are very limited and are usually only offered at a discount. Very few plans provide everything that is fully covered by the policy. Hearing aids available under the plan are low-end products or non-standard models. Covered hearing aid models that are offered may have a limited ability to help you hear in noise. Nothing can make the noise go away completely, but there may be better options available outside of your insurance plan. Covered hearing aids may have limited adjustments available to customize to individual needs. Your insurance is only interested in adequate, not optimal hearing. Be aware that buying older models of hearing aids means they will be discontinued sooner. They cannot be repaired once they are stopped. Thus, Medicare replacement insurance plans can be misleading when it comes to hearing aid benefits.

Some large companies give the impression that hearing assessments and proper audiological care are unnecessary. Major companies recognize that there are more and more elderly people and that they often need hearing aids. Big companies see an opportunity to increase their bottom line through your hearing needs. Online sites tell you that you don’t need a hearing test to use their hearing aids. Or they tell you that their online test is enough to tune their product to your hearing needs. Neither statement is true. Remember that the Internet is a trash can, not a library.

Eargo is a company that has been selling its hearing aids online for a few years now. In late April 2022, Eargo agreed to pay $34.37 million to settle a misrepresentation lawsuit. Information about this lawsuit is available through the US Department of Justice, Office of Public Affairs. They were sued for charging insurance for people’s hearing aids and for their online hearing tests. Both actions were illegal. Just because a company says something online doesn’t mean it’s true.

Bose sold hearing aids on the Internet. They made a big deal out of their product and price. On May 3, 2022, they announced they were discontinuing their hearing aids.

Insurance often covers basic hearing tests consisting of beeps and repeated words. This test identifies the extent of the hearing loss. It does not provide enough information to determine which hearing aids are most appropriate or how to adjust the hearing aids to your individual needs.

To find out which hearing aids are right for you, an additional assessment is needed. The Speech in Noise test determines the level of interference felt when hearing competing voices at the same time. It’s also important to gauge which level is most comfortable and clear for you to listen to, and which level is too loud for you. The Cognivue Thrive computer assesses aspects of cognition that are relevant to the use of hearing aids. Cognition is your brain’s ability to process and respond to information. Additionally, your audiologist can use research-based questionnaires to identify how your hearing loss interferes with your life and what circumstances are most troubling. This combination of tests is called a Communication Needs Assessment for Audiology Specialists. The results of these important tests take a lot of the guesswork out of fitting your hearing aids. After your fitting, the Real Ear test can measure your hearing aids while you wear them.

Recent research demonstrates that even small changes in hearing can lead to changes in cognitive performance. When the brain does not receive all the sound information it is supposed to receive, the brain begins to shrink. Shrinking of the brain leads to reduced cognitive function. A reduced brain area also leads to the development of Alzheimer’s disease or dementia. Research shows that even mild hearing loss causes these changes. This means you don’t have to wait to take care of your hearing.

If you have any questions about your hearing insurance benefits, you can call the phone number on your insurance card. You may end up talking to someone from abroad who is just reading information on their computer screen and doesn’t really know the answers.

If you prefer to get hearing aids without the frustrations of insurance, audiology practices have options available. This may include payment plans through Care Credit, different technology choices, or a special purchase program with private discounts. Working directly with your supplier is the most efficient way to get what you need. By working privately, you may even be able to get a same-day fitting. Supporting small independent local businesses is good for everyone.

Submitted by Laura O’Brien Robertson, AuD, Doctor of Audiology at Audiology Specialists, 211 South Main Street, Laconia. Dr. Robertson can be reached at 603-528-7700 or via www.audiologyspecialists.com


Comments are closed.