Resources are available to help you with the insurance and reimbursement process
Read your policy, looking for terms such as “audiology” or “hearing care” to see if hearing tests and hearing aids are covered. Also, check to see how much your insurance will pay for a hearing aid. Typically, the covered costs are far less than the actual costs. In some instances, the insurance may have a lifetime cap and/or may cover costs for only one ear. If you are not sure, contact your insurance company directly to learn about your particular insurance coverage, billing policies and payment procedures.
Medicaid may cover the costs for hearing aids, cochlear implants, and depending on the state, implantable direct bone conduction systems. Each state sets its own rules within federal guidelines. There is no federal requirement to cover hearing services, except for children who are eligible for Medicaid programs. Check with your state Medicaid agency for the rules in your location. To locate your state Medicaid agency, check www.cms.hhs.gov/medicaid/consumer.asp.
Medicare does not cover the costs of hearing aids. Certain hearing tests and services are covered under Medicare, but not all. Typically, hearing tests are only covered one time per year. For more information, check the federal government’s website 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
U.S. veterans may be eligible for hearing aids, hearing services, and/or assistive listening devices. Contact the VA medical facility in your area for additional information.
Certain charity 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, Vocational Rehabilitation and similar organizations. Ask your local hearing professional about what groups are active in your area.
Insurance assistance specifically for
implantable hearing solutions
Some companies provide services to help guide you through the insurance and reimbursement process for cochlear implants and implantable bone conduction systems. These companies usually have dedicated experts to assist you, even if you’re denied coverage at first. For best results, be sure to enlist these services early on in the process.
Cochlear™ Americas can provide pre-surgical assistance to help you (the patient) obtain the necessary predetermination or preauthorization (depending upon insurance plan requirements), or help with appeals to your insurer if you receive a denial of coverage, for surgery with a Cochlear™ product. If you have been identified as a candidate by an implant center and need help with your insurance coverage for a Cochlear™ implant or implantable direct bone conduction system, please call Cochlear’s OMS insurance support at 1-800-633-4667 or visit www.omsinsurancesupport.org or email email@example.com.