Understanding Your Hearing Aid Insurance Benefits

Over the past few years, many health insurance companies have added some sort of hearing aid benefit to their policies. Let’s take a moment and ask the right questions to evaluate the options that are available.

Is it a benefit or discount is the first question you may ask? Some policies actually pay towards your hearing aid purchase and some provide a discount that is usually off an inflated suggested retail price. If you actually have hearing aid benefits, there may be several steps that need to be taken to obtain the benefit.

Benefit situations:

1. The insurance company pays an allowed amount or percentage and you are able to obtain the hearing aid directly from a local audiologist. The insurance company pays the audiologist directly and you pay your deductible. This type of policy is the best in our opinion. It is straight forward and allows you to obtain your service from a local provider of your choice.
2. The insurance company has a contract with an out of state provider to obtain the hearing aid, but the service can be obtained locally. In this situation, the insurance company requires that you deal with and send your money to their contracted hearing aid distributer and then the distributor sends the hearing aid to the local audiologist to fit the device. While this situation allows you to obtain service locally, your choices may be limited to specific “contracted” brands and it adds several steps to the process.
3. The insurance company has their “own brand” of hearing aid and they send it to you directly through the mail. You take an “online” hearing exam on the internet and they send the hearing aid to you in the mail. There is no audiologist to assist you with the fitting. There is no “verification” of the fitting. If your hearing aid needs service, there is no audiologist to help trouble shoot your problem. You send it back to the insurance company via the mail. The State of Wisconsin requires “direct examination of the ear” and considers this practice illegal. In addition, a recently passed Indiana law requires direct patient contact. We DO NOT recommend mail order or internet hearing aid purchases.

Discount situations:

1. Some companies have offered discounts to patients who have certain types of insurance. When a discount is offered, the insurance company does not pay towards your hearing aid. The insurance company shares their member listings with the hearing aid company and they then entice you with discount if you purchase from them.  Generally the huge discounts are off of suggested retail and in the end you may end up paying more. Beware of this type of discount. Even though they may be recommended by your health insurance company, you may be able to obtain better pricing and service by simply shopping around.