Hearing Loss Education Center

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Hearing Loss Education Center
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Insurance and Reimbursement

A pair of hearing aids can cost several thousands of dollars, depending on the type and style. There are additional fees for professional services, testing, and fitting. 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 coverage, and certain insurance companies let you add hearing coverage for an additional fee. Before being fitted for a hearing aid, you should investigate costs and reimbursement options, which may include:

  • Private insurance – read your policy looking for terms such as “audiology” or “hearing care” to see if hearing tests and hearing aids are covered. If you are uncertain, contact your insurance company directly to learn about your particular insurance coverage, billing policies, and payment procedures.
  • Medicaid – is the U.S. federal program of health assistance for certain individuals with low incomes. Each state sets its own rules within federal guidelines. There is no requirement to cover hearing services. Check with your state Medicaid agency for the rules in your location. To locate your state Medicaid agency, check: http://www.cms.hhs.gov/medicaid/consumer.asp
  • Medicare – is the U.S. federal government program of health assistance for people age 65 and older and some disabled people. Certain hearing tests and services are covered under Medicare, but not all. For more information, check the federal government’s web site: http://www.medicare.gov/
  • Individuals with Disabilities Education Act (IDEA) – provides children with disabilities—including speech, language, and hearing disorders—who go to public schools with appropriate assistance. Check with your local school district for more information on what is available in your area.
  • U.S. Veterans Administration – some U.S. veterans are eligible for hearing aids, hearing services, and/or assistive listening devices. Contact the VA medical facility in your area for additional information.
  • Civic/Service Organizations – certain social groups help people, especially children, to get hearing aids. Some provide financial assistance while others sponsor hearing aid “banks,” where donated, pre-owned hearing aids are reconditioned and recycled for new users. Groups that may help include certain chapters of Lions International, Kiwanis Clubs, Rotary Clubs, and similar organizations. Ask your local hearing professional who is active in your area.


     
       

    Hearing Loss

    For hearing loss, refers to less than average ability to hear and understand sounds due to one or more parts of the hearing system not working properly.

    Hearing Loss

    For hearing loss, refers to problems hearing in both ears, not just one.

    Hearing Loss

    For hearing loss, refers to problems hearing in one, but not both ears

    Mild Hearing Loss

    People with mild hearing loss have some difficulty following speech, mainly in noisy situations; quietest sounds they can hear in their better ear average between 25 and 39 decibels (a standard measure of sound)

    Moderate Hearing Loss

    People with moderate hearing loss have difficulty following speech without a hearing aid; quietest sounds they can hear in their better ear average between 40 and 69 decibels (a standard measure of sound).

    Severe Hearing Loss

    People with severe hearing loss get help from powerful hearing aids, but often rely on lip-reading even when using an aid; quietest sounds they can hear in their better ear average between 70 and 89 decibels (a standard measure of sound).

    Profound Hearing Loss

    People with profound hearing loss mostly rely on lip-reading and/or sign language; the quietest sounds heard in their better ear average from 90 decibels or louder (a standard measure of sound).

    Otosclerosis

    A disease in which bone grows abnormally in the middle ear preventing structures within the ear from working properly and causing hearing loss.

    Cochlea

    Part of the ear that contains both the organ of hearing (the cochlea) and the organ of balance (the labyrinth).

    Feedback

    A high-pitched, sometime painful, whistling sound that occurs when a microphone picks up sound from a nearby speaker and replays it again and again (commonly occurs when a poorly fitting hearing aid earmold allows sound to “leak” from the speaker back into the microphone).

    Assisstive Listening Devices

    Electronic devices or accessories for hearing aids that provide extra help in specific listening situations (telephone, noisy backgrounds, small or large group settings, etc.).

    Sensorineural Hearing Loss

    Hearing loss due to failure of the auditory nerve, also called nerve deafness.

    Mastoid Bone

    A portion of the lower skull bone that contains the inner ear.

    Rehabilitation

    For individuals who previously experienced hearing and get a cochlear implant, the comprehensive training program that “re-teaches” them how to hear and interpret sounds, to recover any lost speech skills, and to properly use the cochlear implant speech processor and controls.

    Habilitation

    For individuals who had not previously experience hearing and get a cochlear implant, the comprehensive training program that teaches them to hear and interpret sounds, to develop or improve speech skills, and to properly use the cochlear implant speech processor and controls.

    Coverage

    For health insurance, coverage involves making sure a health plan or policy pays for the cochlear implant device and related professional services (for example, physician and audiology services). Usually, you go through a preauthorization process. This means getting a guarantee from the health insurance plan that they will pay for the implant and services before getting treatment.

    Billing

    For health insurance, billing involves the process by which health care providers charge, code, and submit their bills (in the form of a claim) to the health insurance company or plan.

    Payment

    For health insurance, payment involves getting the full amount allowed for services given a health plan’s limitations, allowables, deductibles, and co-payments.

    Menieres

    A disorder of the fluid volume of the inner ear that can cause hearing loss, dizziness/vertigo, tinnitus (ringing in the ear), and/or pressure or pain in ear.

    Meningitis

    a viral or bacterial infection that causes inflammation and swelling of the membranes covering the brain and spinal cord; among possible serious complications are hearing loss or deafness.

    Mumps

    a viral infection that causes swelling of the salivary glands; sometimes spreads to central nervous system which can result in hearing loss.

    Measles

    a viral infection that causes rash, fever, and cold-like symptoms; sometimes causes complications like ear or brain infections which can result in hearing loss.

    Unilateral

    on one side, but not the other; used to describe a type of hearing loss in which there is normal or somewhat impaired hearing in one ear and little or no hearing in the other ear.

    Unilateral Hearing Loss

    condition in which one ear has little or no hearing ability and the other ear has normal or close to normal hearing. Also referred to as Single Sided Deafness (SSD).

    Osseointegration

    the natural process of bone growing into the titanium fixtures creating a direct connection between an artificial implant and living bone.