insurance
Understanding your insurance options
Over the past few years I have worked with many individuals who didn’t fully understand their benefits. If this is you, know this, you are not the only one and you certainly won’t be the last person to feel confused by their insurance options. Some of the most common misconceptions I run into are:
- not realizing they have insurance coverage toward Hearing Aids
- misunderstanding where/with whom they can use their insurance benefits, and
- misunderstanding what their insurance actually covers
Some of my conversations have lasted as long as 30-40 minutes where the entire conversation was centered on how insurance coverage works in the Hearing Aid industry because it is different then in other industries. Coverage is different, payment is different, and the parties involved are different.
When it comes to understanding who your benefits come through, the first place to start is on the back of your insurance card. The back of your insurance card is home to several important numbers. They can be numbers to customer service, vision care, hearing care, or dental care. Today, insurance companies often partner with 3rd parties to provide certain non-traditional benefits like dental, vision, and hearing.
One important thing to take note of is that if you have Medicare you will not have insurance coverage through Medicare. Any benefits come through your Managed Care or Supplemental Plans. if you have a Managed Care or Supplemental plan this is where you will want to start. This could be Humana, Wellcare, BlueCross BlueShield, UnitedHealth Care, Aetna, Healthsprings, Cigna, and many more!
3rd Parties are a big part of affordability
Chances are that if you looked on the back of your Insurance Card you may see a name like “TruHearing” or “Epic Hearing.” These companies are “3rd party” groups that have partnered with your insurance company to help bring down the cost of hearing aids to both insurance companies and patients. They also connect prospective patients with reliable health providers in the area. A health provider in the Hearing Aid industry is an Audiologist.
Without 3rd parties, the cost of your hearing aids would be no less than $3,000 and as much as $8,000 in some parts of the country. There are some 3rd parties that can be difficult to work with and others that run very smoothly and very efficiently and actually create accountability for the Audiology community as a whole.
While 3rd parties can be associated with a negative connotation, patients have a lot to be thankful for when it comes to 3rd parties making hearing aids more accessible and affordable.
can i track down my own Audiologist online?
The short answer is yes, but be mindful and make sure that you follow some common sense steps when choosing an Audiologist. When you call your insurance provider they may recommend an audiologist for you. They usually start with your zip code and provide you with the nearest Audiologist. The closest Audiologist might not be the best Audiologist so make sure to do your due diligence first. I would search them online, but I would also call their clinic and find out more about their fitting process. Make them work for you… just a little! If they make you feel like an inconvenience for answering a few questions on the phone, that’s probably how you will be treated as a patient. If you decide you don’t like the recommended Audiologist or received a recommendation from a friend you can always specifically ask the insurance company about that Audiologist. Chances are they are in network.
every plan is different
Every 3rd party has different benefits and within each 3rd party there are different insurance plans. Some plans offer significant benefits toward hearing aids and others are essentially a discount plan that may only offer a few hundred dollars off. The benefits all depend on what plan you fall under within your insurance network. If you’re curious as to what benefits you have, you can call the customer service number and ask to speak with someone who has knowledge regarding your benefits.
It’s important to know that while your insurance does pay for some of the Hearing Aid costs up front, you will still be responsible for paying some of the cost yourself. You also will have to pay it before you receive the Hearing Aids. In my time as an Audiologist I’ve seen Insurance companies completely cover the cost of Hearing Aids on a rare instance. However, most of the time copayments range from $250-2500 per Hearing Aid.
can I change my plan?
You absolutely can. You are welcome to reach out to any insurance carrier and ask them about 1) their coverage for ALL of your healthcare needs (not just hearing), 2) about their process for signing up for a new plan.
However, before you change your plan I would first stop to consider the reason why you chose that specific health insurance plan in the first place. Sometimes people choose a plan because they have a non-hearing related health complication (i.e. heart complications, dementia, stroke complications, parkinsons, etc.) I strongly recommend fully evaluating all your benefits before changing plans just for better hearing aid coverage because you may have some more life threatening conditions that may make it worth spending a little extra for hearing aids versus increased co-payments in other areas. Depending on your health needs you may end up paying more at the end of the year than if you had just stuck with your original insurance benefits. However, if none of those are factors that you could definitely consider looking at different Insurance options.
Unfortunately I will not be able to recommend a specific insurance plan in this article, but I do list some insurance companies on our “Hearing Aids” page and you are welcome to use those plans as a starting point!