Hearing aid insurance benefits

Some health insurance programs make a big deal out of providing hearing aids. People chose these policies thinking 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 obtain the hearing aids that are most appropriate for your needs. Most of the time, the hearing aids from your plan are NOT free. The plans typically offer a discounted price only.

Some insurances allow direct billing for hearing aids. Many insurances contract with a third party provider to provide hearing aids. For instance, Cigna typically works with Amplifon and Aetna typically works with Nations Hearing. These third party companies then contract with providers to do the work for them. Each “middle man” slows the process down and makes it more complicated. This means your local audiologist must receive a referral for your services, and needs the third party company’s permission for anything done. If you are using one of these programs, you will see your local audiologist but make your payment to the third party company. Thus, your local audiologist can’t issue a refund. You have to get that from the third party company.

When you want hearing aids, you have to initiate the process. This starts with a call to your health insurance company and you follow whatever steps they advise you to do. Sometimes, you also have 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 some others.

For people who are still working, and work in NH for an employer who purchases insurance coverage for them, there is the NH Mandate. This law requires hearing aids to be covered by employee’s insurance. The NH Mandate requires insurance companies to cover up to a maximum of $1500, per ear, every five years, for hearing aids. There are things you need to find out: Do you have to meet your deductible before you can use the benefit? What if you need something better than what insurance calls “Standard” hearing aids? Can you pay the difference to get better hearing aids? Insurances sometimes pay less than the mandate amount. Then they expect the provider to absorb the loss. This is a problem for your local provider. If your employer self-insures, meaning they contract with a company to administer their plan, then the insurance is not required to provide any benefit for hearing aids.

For people who are retired, Medicare does not EVER cover anything related to hearing aids. Some retirees purchase Medicare Replacement plans, where a benefit for hearing aids can sound like a bonus. However, the hearing aid choices they offer are severely limited and, usually only offered at a discount. Very few plans provide anything that is fully covered by the policy. Hearing aids which are available through the plan, are low-end products or not current models. The covered Hearing aid models which are offered may have limited ability to help you hear when noise is present. Nothing can make the noise go entirely away but there may be better options available outside of your insurance plan. Covered hearing aids may have limited adjustments available to customize them for individual needs. Your insurance is only interested in adequate, not optimal hearing. Be aware that buying older model hearing aids means they will be discontinued sooner. They can’t be repaired once they are discontinued. Thus, Medicare replacement insurance plans can be misleading when it comes to hearing aid benefits.

Some big businesses make it appear that proper hearing evaluations and Audiological care are unnecessary. Big business recognizes that seniors are increasing in number and seniors frequently need hearing help. Big business sees an opportunity to increase their bottom line via your hearing needs. On line sites tell you that you don’t need a hearing test to use their hearing aids. Or they tell you their on-line test is sufficient to set their product for your hearing needs. Neither statement is true. Remember, the internet is a dumpster, not a library.

Eargo is one company that has been selling their hearing aids on-line for a few years now. In late April of 2022, Eargo agreed to pay $34.37 million to settle a law suit for false claims. Information about this lawsuit is available via the US Department of Justice, Office of Public Affairs. They were sued because they were billing insurance for people’s hearing aids and for their on-line hearing tests. Both actions were illegal. Just because a company says something on-line does not make it true.

Bose was selling hearing aids over the internet. They made a big deal about their product and their price. On May 3rd, 2022, they announced they are discontinuing their hearing aids.

Insurances often cover basic hearing test consisting of beep sounds and repeating words. This testing identifies the extent of the hearing loss. It does not provide sufficient information to determine which hearing instruments are most appropriate, or how to set the hearing aids for your individual needs.

To know which hearing aids are right for you, additional evaluation is necessary. “Speech in Noise” testing determines the level of interference experienced from hearing competing voices at the same time. Measuring what level is the most comfortable and clear for you to listen to, and what level is too loud for you is also important. The Cognivue Thrive computer evaluates aspects of cognition which are relevant to hearing aid use. Cognition is your brain’s ability to process and respond to information. Additionally, your Audiologist may use research-based questionnaires to identify how your hearing impairment interferes with your life and what circumstances are most troubling. This combination of tests is called a Communication Needs Assessment at Audiology Specialists. The results of these important tests take much of the guess work out of setting your hearing aids. After your fitting, Real Ear testing 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 intended to receive, the brain starts to shrink. Brain shrinkage leads to reduced cognitive function. Reduced brain area also leads to developing Alzheimer’s disease or Dementia. Research shows that even mild hearing impairment causes these changes. This means you should not wait to take care of your hearing.

If you have questions about your hearing insurance benefits, you can call the phone number on your insurance card. You may end up speaking to a person from overseas who is only reading information from their computer screen and who doesn’t really know the answers.

If you prefer to obtain hearing aids, without the frustrations of insurance, Audiology offices have options available. This may include payment plans via Care Credit, different technology choices or a special purchase program with private-pay discounts. Working directly with your provider is the most efficient way to get what you need. Working privately, you may even be able to get same-day fitting. Supporting small, independently owned, local business is good for everyone.

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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