You have hearing health insurance, but do you know what it covers? October’s Audiology Awareness Month is the perfect time to contact your insurance company to find out for sure, but here are some basics on common insurance benefits.
Commercial/Private Insurance
If your plan does have a hearing health benefit (usually a set dollar amount per year or every few years), you will likely need to meet your deductible before your insurance covers any testing and hearing device costs. This type of insurance may also include out-of-network hearing benefits, which means you have more flexibility in which provider you see.
Third-Party Administrators (TPAs)
If you have a Medicare Advantage plan, a TPA acts as a middleman between this government insurance program and the hearing provider to help control costs.
With a TPA, you can only see in-network providers—there’s no out-of-network coverage. TPAs also control the type of hearing product and level of care you receive, which limits your options and may mean paying out-of-pocket costs for vital services (device fittings, routine maintenance, etc.) and types of hearing devices that aren’t covered.
Medicaid & Vocational Rehabilitation
In general, Medicaid and Vocational Rehabilitation programs only cover the lower levels of hearing device technology. Want/need a device with advanced features? You will have to pay extra for it.
Veteran’s Administration
The VA provides hearing devices at no cost to veterans and all the care and services that accompany them. The VA usually dispenses the highest level of technology.
TriCare
Available for active-duty military members, TriCare covers hearing aids, bone-anchored hearing aids and hearing-related care for individuals and beneficiaries with profound hearing loss.
Workers’ Compensation
If you suffer a work-related injury that impacts your hearing, you may be eligible for workers’ compensation hearing benefits. These include hearing devices and services, available at no out-of-pocket costs.
Willamette ENT can help guide you to the insurance/financing option that works best for your needs and budget. Contact our team for more information today.
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