Determining insurance coverage for hearing aids can be stressful, but understanding what’s available under Medicare and commercial insurance plans can help you save time and money. Our guide to maximizing your insurance benefits for hearing aids, breaks down the essentials, so you can confidently take the steps needed. Read on for how to get the best coverage for hearing aids.
Guide to Maximizing Your Insurance Benefits for Hearing Aids
1. Medicare Coverage
While Medicare doesn’t directly cover hearing aids, it may assist under specific circumstances. Here’s what’s included:
Part B Coverage
Medicare Part B covers diagnostic hearing and balance exams if your doctor deems them medically necessary. These tests are critical for identifying your needs and can set the stage for further steps.
When Hearing Aids May Be Considered
If your hearing aids are deemed medically necessary, Medicare could potentially offer coverage. However, this usually requires thorough documentation and a clear diagnosis.
Requirements for Coverage
To qualify, you’ll need a referral from a doctor, an audiologist-conducted hearing test, and a prescription for hearing aids.
Also, be prepared for out-of-pocket costs, as Medicare often has coverage limitations. As such, you may need to pay a deductible, coinsurance, or copayment unless you have additional Medicare Advantage plans.
2. Commercial Insurance Plans
Benefits for hearing aids under commercial insurance vary widely, but many insurers offer valuable options. Here’s a look at some of the major insurance carriers and their coverage for hearing aids.
UnitedHealthcare
Offers hearing aid benefits under some plans, including the All Savers model in certain states. Coverage could provide up to $1,000 for a pair of aids or up to $400 if you choose one ear only.
However, you may have to pay 20% coinsurance for the total cost of aids and exams.
Cigna
Hearing aid coverage may be available as an add-on feature with some Cigna plans, such as the LocalPlus plan offered through participating employers.
You can get this benefit added when open enrollment begins or during yearly renewal periods. The plan covers up to $2,500 per hearing aid every 24 months.
BlueCross BlueShield
Coverage for hearing aids is provided under many BCBS plans, but its details may vary by state.
The Blue Cross and Blue Shield Association also offers an advanced plan that reimburses up to $3,000 every three years for a pair of hi-tech aids. However, you may need to have the Federal Employee Program or other standard coverage with BCBS to be eligible.
Aetna
Aetna offers hearing aid coverage as part of its Aetna Standard benefits in some locations and through commercial plans from employers who choose this option. You can receive up to $2,000 per ear every year toward devices, exams, and related services.
Keep in mind, you may have to meet a deductible before coverage begins, and coinsurance could be required for the total cost.
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