Insurance Counseling
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FAQ
Will my insurance cover hearing devices?
More and more private insurance companies and Medicare Advantage Plans are offering at least partial coverage or discount programs for hearing aids. Our insurance specialists are happy to verify your benefits prior to your initial evaluation and consultation. If your insurance plan does include a hearing aid benefit, we will file the claim and follow up with the carrier for you. Let us do all of the work!
Will I need a referral from a primary care physician?
This is dependent on your specific plan. Most commercial PPO plans do not require a referral from your primary care physician to see one of our in-network providers. Certain insurance policies, including Medicare, do require a referral in order to cover testing and treatment recommendations. We are happy to gather your insurance information to determine if a referral is necessary. If it is necessary we will guide you through obtaining the proper referral or documentation for your services to be covered.
Does Medicare cover hearing aids?
While Medicare does not currently cover hearing aids for the treatment of hearing loss, some Medicare supplemental plans do provide some coverage for hearing aids. Some insurance carriers will require a denial from Medicare before a benefit can be eligible. In these cases, our insurance specialists will do all of the work for you to determine if there is a hearing aid benefit available and what needs to be done to use it.
I was told my hearing aids were covered at 100%. What does that mean?
In most cases, there is an allowed amount that this percentage applies to based on your particular insurance plan. The exact amount is plan-specific. Our insurance specialist will check your benefits prior to your appointment to know more specifically what is covered and how it applies to your needs.
What does an out-of-network benefit mean?
Healthcare providers can elect to be in or out of an insurance network. This will determine what type of financial responsibility you may have versus what your insurance plan will pay. We are in-network with most major insurance carriers and will let you know prior to your appointment if we are in or out of network with your insurance carrier. Some insurance carriers do still offer out-of-network benefits for hearing aids and we will contact your insurance carrier to determine if that is available for you.
Can you bill wax removal to my insurance?
Audiologists and Hearing Care providers cannot bill insurance for cerumen (wax) removal. We perform this service to those who have purchased hearing aids from us as a step in providing overall hearing aid care. Those who have not purchased hearing aids from us will be billed a nominal office visit fee for cerumen (wax) removal.