Insurance gets a bit more complicated when it come to hearing aid coverage.
Hearing Exam
The first step is always to obtain an accurate measurement of hearing sensitivity. Medicare will pay for one hearing exam a year. However, it is one year from the date of your last exam, not the calendar year. For example, if you were seen for an exam in June of this year, you would have to wait until June or later of next year in order for Medicare to help pay again. An exception to this rule is if the exam is deemed medically necessary (e.g., a perforated eardrum). Medicare also requires a referral from a primary care physician, since audiology is considered a specialty.
Most private insurances will also help to pay for the hearing exam. They also do not require a referral. However, some do require pre-authorization. This essentially means that the insurance is giving the provider permission to bill them after the patient is seen. The audiologist’s office will request the pre-authorization. Just make sure you provide all of your insurance information when scheduling to ensure everything is ready by the time you are seen. If you do not have insurance, or do not wish to use it, you can still be seen for an exam. Ask what the private pay rate is when scheduling your appointment.
Hearing Aids
If you are a candidate for hearing aids, the audiologist will then review the options with you. Sometimes this is done on the same day of the exam, and sometimes it is a separate appointment. But the consultation itself is often free. And most practices offer a trial period with the hearing aids. Some practices require upfront payment, while others collect payment once you decide to keep the devices. Either way, if you decide to return the hearing aids within the designated trial period, you will not be responsible for the cost of the devices.
In regard to paying for hearing aids, there are multiple options. You can, of course, pay for them entirely out-of-pocket. If the cost is too much to pay at once, you can ask about payment plans. There are also government and private organizations that can assist. On the government side, there is Vocational Rehabilitation. Their focus is on getting people prepared for the workforce. So, if you need hearing aids to do your job efficiently and safely, they can buy them for you. To be clear, you would need to meet their qualifications, so it is best to reach out to them directly if interested. Also note that not all clinics are contracted with Vocational Rehabilitation. Still, it can be a great option. If you are a veteran, you may qualify for free hearing aids through the VA. You would need to file a claim and be approved, as the VA requires authorization for everything. (You can’t be fit with hearing aids and then ask for the VA to help after the fact.) On the private side, organizations like the Lions Club often have programs to help the community.
Insurance gets a bit more complicated when it come to hearing aid coverage. Medicare, unfortunately, does not pay anything. Supplemental and private plans may help. It really just depends on the specific plan. If they do help to pay, the deductibles and benefit amounts vary. The best thing to do is provide your information when registering with a clinic, so that they can call and verify your exact benefit before you arrive.
Another important question to ask is about the different models the clinic offers. The more sophisticated the hearing aid, the higher the price. Knowing what each model provides and costs can help you make the most informed decision. It is also good to ask what kind of follow-up services are offered. Some clinics are bundled, meaning their services are included in the initial cost, while other are unbundled, meaning the cost of the hearing aids and services are separate.
As always, if you have specific questions, feel free to reach out to your local audiologist. FBN
By Jeff Lane, Au. D.
Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.