Costs & Insurance

Cochlear implants and implantable direct bone conduction systems are widely covered by insurance

Unlike hearing aids, which are usually not covered, cochlear implants and implantable direct bone conduction systems are typically covered by Medicare, Medicaid and private insurance. The chart below outlines the insurance coverage for hearing aids, cochlear implants, and implantable direct bone conduction systems.

  Hearing Aids Cochlear Implants Implantable Direct Bone Conduction Systems (osseointegrated auditory implant system)
Private Insurance Typically not covered Covered by almost all private insurance companies May be covered (Need to check with your individual provider to determine coverage)
Medicare By law are not covered Covered (Patients must meet Medicare criteria for implant candidacy) Covered (Patients must meet Medicare criteria for implant candidacy)
Medicaid Typically covered for children Covered (Some states limit to patients under 21 years of age) May be covered (Some states limit to patients under 21 years of age)

Hearing aids can be very expensive

A pair of hearing aids can cost thousands of dollars, depending on the type and style. There are typically additional fees for professional services, testing and fitting. Additionally, hearing aids usually need to be replaced every three to five years.1 This is because they may stop working or your hearing loss will progress to a point where different, stronger hearing aids are necessary. Unfortunately, many forms of private and government health insurance do not cover the costs of hearing aids or the tests and services needed to get them.

In the U.S., a few states are moving toward requiring some insurance coverage, and certain insurance companies let you add hearing coverage to your insurance plan for an additional fee. Unfortunately, these plans usually only cover a small portion of the costs. Before being fitted for a hearing aid(s), you should look into the costs and reimbursement options offered by your insurance.

Cochlear implants are covered by most insurance policies

Unlike hearing aids, most private and government health insurance plans (including Medicare and Medicaid) provide coverage for the costs of cochlear implants and the tests and services associated with getting them, assuming you meet the implant candidacy criteria. However, you should check with your insurance company for more information.

Your plan may require something called “pre-authorization” for certain services. This means that you must first get approval by your insurance company before you receive the recommended treatment. In most situations, your audiologist or physician will obtain pre-authorization on your behalf.

 If you meet the implant candidacy criteria and your insurance policy covers cochlear implants, you can expect to pay your deductible, co-insurance and/or co-pay for the following:

  • The office visit and tests to find out if you are a candidate for a cochlear implant
  • The cochlear implant device itself
  • The surgeon, anesthesiologist, operating room and associated expenses, and sometimes a brief hospital stay
  • The fitting and programming of the cochlear implant, training sessions and rehabilitation services

Some healthcare providers may charge a single flat fee for getting a cochlear implant. Other organizations may bill separately for each part of the process. You should contact your insurance company directly to learn about your particular insurance coverage, billing policies and payment procedures.

Implantable Direct Bone Conduction Systems are often covered by insurance

Implantable direct bone conduction systems are covered by Medicare, and by many private insurance policies and Medicaid programs, assuming you meet the implant candidacy criteria. 

You will need to check with your insurance carrier for information about your plan and benefits. Your plan may require something called “pre-authorization” for certain services. This means that you must first get approval by your insurance company before you receive the recommended treatment. In most situations, your audiologist or physician will obtain pre-authorization on your behalf.

If you meet the implant candidacy criteria and your insurance policy covers implantable direct bone conduction systems, you can expect to pay your deductible, co-insurance and/or co-pay for the following:

  • The office visit and tests to find out if you are a candidate for an implantable direct bone conduction system
  • The implantable direct bone conduction device itself
  • The surgeon, anesthesiologist, operating room and associated expenses
  • The fitting and programming of the implantable direct bone conduction system, training sessions and rehabilitation services

Some healthcare providers may charge a single flat fee for getting an implantable direct bone conduction system. Other organizations may bill separately for each part of the process. You should contact your insurance company directly to learn about your particular insurance coverage, billing policies and payment procedures.

Find a Hearing Specialist in your area to learn more about costs and insurance coverage for hearing aids, cochlear implants and implantable direct bone conduction systems.

Reference: 1. Hearing Aid Express. Frequently Asked Questions About Hearing Aids. Available from http://www.hearingaidexpress.com/hearing-loss/faqs.php. Accessed February 2012.