Hearing Aids and Insurance Coverage
Wednesday, December 17, 2008 – 0 Comments
Hearing Aid Purchases and Insurance Coverage – What’s Best For Me?
As we all navigate the numerous changes that occur regularly with health insurance coverage, some benefits seem very straightforward while others are quite confusing, even misleading. Regarding hearing aid coverage, it is the exception when health insurance offers reimbursement. In those instances in which the coverage may be available, it has been our experience that many hearing aid benefits currently offered can actually deprive you of certain professional services and may not offer a true cost-saving benefit.
We’ll explain some of the different general plans available, examples of true costs, and questions to ask of your insurance representative to make sure you are actually receiving a worthwhile benefit.
Hearing Aid Benefits Allowing Direct Reimbursement to the Patient
These plans offer the best options for the consumer. These plans typically offer a set amount to which you are entitled as a reimbursement and also allow you to buy the hearing aids from the Hearing Professional of your choosing. There are usually few, if any, limitations on the technology or manufacturers, and you able to select the best hearing aids at that most competitive price. This type of insurance plan is most common with HearingPlanet patients. When you purchase hearing aids from us with direct reimbursement from your insurance carrier, our Audiology Department will gladly assist you in preparing any paperwork to submit to your insurance company for reimbursement.
Insurance Companies Partnering with Hearing Aid Distributors
When insurance carriers decide to offer a hearing aid benefit, the vast majority will simply partner with a designated hearing aid seller or distributor who will in turn offer a discount to you for being a subscriber to that insurance company. It has been our experience that you, the consumer, should review these discounts or benefits very closely before proceeding. The discounts are usually given off MSRP or an inflated retail price and the distributor will typically limit you to certain manufacturers and/or models.
Questions to Ask Your Insurance Company if You Have an Insurance Benefit
It is important to ask the following questions:
1) Can I be reimbursed directly? Again, this allows you more control over the purchase if this is allowed. HearingPlanet will gladly assist you with this.
2) What if I do not like the contracted provider? Don’t choose to work with a Hearing Professional with whom you don’t feel comfortable simply because you have a benefit.
3) Will I have choice of different hearing aid brands? It is important you buy your hearing aids from a multi-brand distributor.
4) Do I have any deductibles or co-pays as part of the purchase?
Bottom Line – Look at the overall package of quality, service, current technology, and cost before making any decision.
Examples of Questionable Benefits
While generous hearing aid benefits are not common, they are quite obvious when reviewed and verified. However, there are numerous more common plans that have to be scrutinized carefully. Following are a few true examples recently encountered by HearingPlanet customers.
Example #1
Mary was told she had a $1,000 benefit from her health insurance towards the purchase of two hearing aids. She visited an Audiologist from her plan’s provider directory and was recommended a pair of premium hearing aids which cost $6,800.00. The provider was to take $1,000 off his charge and Mary would pay the rest which made her out-of pocket cost $5,800.00. She did some research and discovered those same hearing aids cost $5,400.00 regularly in comparison to the $6,800. In addition, after receiving a second-opinion hearing test, she was told her hearing loss needs could be resolved with a different set of hearing aids costing substantially less.
Example #2
Bill received a notice in the mail that as a subscriber to his insurance company he would receive a 25% discount off a pair of hearing aids if he visited a major retailer. After receiving his hearing test, he was told his hearing aids would cost $9,000 and with his 25% discount, his out of pocket cost would be $6,750.00. After some research. he discovered a comparable brand and model would cost $5,200.
Example #3
A major insurance carrier announced a partnership with a hearing distributor for its members. John looked into this and discovered that through this company his hearing aid choices were limited to a small hearing aid manufacturer and only 3 of their models. After doing some of his own research, he discovered the three models being offered were using technology that had been on the market for 3-5 years. In addition, the purported savings of more than 50% was off the MSRP and not the actual retail price of the hearing aids.
Summary – In the examples above, the issue is either high markup being given initially by the insurance companies’ designated hearing aid sellers to cover their costs of the required contracted discount or offering discounts which are too good to be true.
The bottom line is to always evaluate your TRUE Out-of-Pocket costs on comparable hearing aids through research. Don’t assume that your insurance plan has the best option for you.
Bill
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