Seeing a Hearing Instrument Specialist: Your Insurance Questions Answered – KNBN NewsCenter1 – Newscenter1.tv
RAPID CITY, S.D. — The majority of Americans rely on health insurance to cover essential needs, including hearing instruments. Unfortunately, there’s no standard for hearing coverage, so knowing what is or isn’t covered by your insurance plan can be confusing. When you need to see a hearing instrument specialist, it’s important to answer these questions prior to your appointment. Cassandra Garver, licensed hearing instrument specialist (HIS) and owner of Lifetime Hearing Solutions, breaks down what you need to know.
Does Health Insurance Cover Hearing Instruments?
Health insurance varies by the insurance company, plan, and location. Some states, like Illinois and Rhode Island, require that health insurance covers hearing aids for adults and children. Others do not. According to Garver, “Usually, insurance will just cover a flat amount every year towards hearing aid purchases.” For example, your insurance plan might cover $400 per year. If you’re getting a set of hearing aids, that won’t cover the entire cost. You’ll pay the rest of the cost beyond the $400.
It’s always best to contact your provider to get definitive answers. Garver says you should ask “whether they take the insurance and if they’re in-network or out of network. Ask if they submit the claim or if the patient has to submit for reimbursement themselves.”
What Does Insurance Typically Cover?
Aside from the initial cost of hearing aids, you might need to visit your hearing instrument specialist for follow-ups, repairs, reprogramming, and cleaning. All of these visits have costs associated, which begs the question of what insurance does or doesn’t cover.
According to Garver, it all comes down to that flat amount that your insurance plan covers. “You usually get a flat amount every three years or every year. For example, if you get a big amount of $2,500 every five years, when that’s paid, that’s all you get. So, anything within that time frame that’s over that amount is the responsibility of the patient.”
However, it’s worth noting that your warranty also matters. According to Garver, “I do include services for the same amount of years as the hearing aid has warranty. And that’s usually three years.” She notes that any tweaking or adjustments made beyond that warranty time are the patient’s responsibility.
Is There Any Additional Financial Support?
Unfortunately, it’s unlikely that your insurance will cover the total cost of your hearing health services. Typically, the best option for financial support beyond what your plan covers is financing. “Care Credit is a big one. Some places also take payment plans,” says Garver. Care Credit is a popular credit card designed for health care expenses. It offers flexible financing options and repayment terms to help cover out-of-pocket medical expenses, like hearing health care.
It’s also important to keep state and federal support options in mind. For example, South Dakota’s Department of Human Services has the Hearing Aid Assistance Program (HAAP), which helps cover the cost of hearing aids for eligible children under the age of 19. Medicaid can also help cover the cost of certain prescribed hearing aids for adults in South Dakota, although there is a list of qualifications you must meet.
Ultimately, getting coverage for your hearing health care all comes down to research. Speak with your insurer and provider to ensure you have all the information you need to proceed. Your provider will be happy to help.
For more information on the hearing health services offered by Lifetime Hearing Solutions visit their website at https://lifetimehearingsolutions.com/ or call 605-342-1619.
