Insurance for hearing aids

My insurance covers hearing aids…doesn’t it???

As a Doctor of Audiology for over 15 years, the absolute most wonderful part of my work is seeing my patients thrive and enjoy their lives with better hearing. However, like all jobs, there is one part of my job that I HATE…and that’s dealing with the insurance companies!

Hearing aids can be a sizable investment in your health, often costing anywhere from $3000 to $6000 if you do not have insurance coverage for hearing care. The cost of hearing aids are a combination of factors, including the professional expertise and services required to fit and adjust them for the patient’s hearing loss and the advanced computer circuitry built into the devices.

Many people don’t realize that there is more computing and processing power in those tiny devices than a full-size desktop computer (and a desktop computer would not last long if you kept it in your shower 14 hours a day- a wet, warm environment similar to your ear canal).

Hearing aid technologyAlthough the cost of technology has come down over the years, another aspect that contributes to the cost of hearing devices is the research and development that goes into creating the advanced algorithms that make hearing aids so “smart” (for example, most advanced hearing aids can tell the difference between speech that you want to hear, like your spouse sitting in front of you, versus the speech of the table next to you, which is actually processed as background noise and reduced instead of amplified).Millions of dollars are spent by the laboratories to develop this technology, so although the manufacturing of the device itself may be relatively inexpensive, the R&D costs are recouped when the technology is released into the market.

Finally, some of the cost that you pay is for the time and expertise of the professional, someone like me, a Doctor of Audiology, to evaluate you and recommend the right options for your hearing loss as well as the fitting and programming and continued care for those devices. This is similar to having a knee replacement. The implant itself may be $2000 or $3000, but the success of treatment lies heavily in the hands of the surgeon who is performing the surgery, and that is where most of the cost comes from. Luckily, most patients do not need surgery to hear better!

Unlike knee surgery however, most insurance plans, including Medicare do not cover hearing aids. In fact, Medicare does not cover hearing aids, dental care or vision care. If you have a Medicare supplement that follows Medicare guidelines, your supplement will not cover them either. I wish they did! Over 80% of seniors over the age of 60 will have some degree of hearing loss, so the need is there.

Some private insurance companies have a hearing aid benefit, for example, they will cover $500 or $1000. This often depends on whether the doctor is in or out of network, or whether a patient has met their deductible or out of pocket. To make things even more complicated, some insurance companies contract their hearing care benefits out to “Third-Party” Providers, bringing yet another entity into the mix.

This can all be very confusing for patients (and doctors)! In fact, some of the cost of the professional services that you pay to the doctor when you get your hearing aids goes to employing the people who must verify, file and follow-up on the insurance coverage for the patient. For third-party coverage, many patients will find that they don’t actually have a real hearing aid benefit- it is a discount plan where you must choose from a limited list of hearing aids, and then you get a “discount” off the MSRP of the price of the device.

Due to the limits on the technology available, and the reduced services that are covered, many professionals have opted out of participating in those third-party plans. Depending on the plan, sometimes the reimbursement the clinic receives does not even cover the cost of providing the service, making it impossible to participate. Because of this, many private-practice doctors do not participate with 3rd Party Plans.

To summarize, healthy hearing is a priority and care can be a significant investment. The success of your results depends on many factors, including the expertise of the provider and the quality of the technology. Be an informed consumer and investigate what benefits you have available, do your research, choose the most qualified provider and work with your doctor to choose the best treatment plan and hearing aids to maximize your success- your ears depend on it!