It’s estimated that over 28 million people in the U.S. are in need of hearing aids. Of all these people, though, only a fraction have hearing aids. This disparity is largely due to insurance companies’ failure to adequately cover hearing aids and other hearing health resources. If you’re dealing with this problem or shopping for insurance to cover hearing health, you need to know a few important things. Finding health insurance that covers all of your needs shouldn’t be a hassle, and with this guide, you’ll know what questions to ask when you’re shopping for a policy.

Understanding Your Hearing Aid Coverage

If you’re shopping for insurance for hearing aids in Houston, TX, you should first assess your policy and determine whether it offers hearing aid coverage. Coverage various across policies, with some offering partial or full coverage and others offering little to no coverage. Memorial Hearing works with clients to consider all available insurance options and find the best solution for your hearing health needs, including routine hearing exams and, if necessary, hearing aids. Read on for more information on whether or not your insurance is likely to cover a hearing aid and exam.

Does Medicare Cover Hearing Aids?

Over 62 million people are enrolled in Medicare, and if you’re one of them, you’re likely wondering whether or not your coverage includes hearing aids. The answer depends on what type of Medicare plan you have. Unfortunately, the original Medicare parts A and B do not cover hearing aids, exams, or fittings. Medicare Advantage plans, such as part C, might, though. It’s important to note that although an original Medicare plan does not cover specific hearing health resources, your primary care doctor may include a routine hearing exam as part of your annual check-up — ask them if your insurance covers this service, and if so, take advantage of it.

Does Health Insurance Cover Hearing Aids?

Original Medicare plans don’t cover hearing health services, but what about other insurance providers? Do they cover hearing aids and exams? According to the American Speech-Language-Hearing Association, the answer varies by state. In Texas, health benefit plans are required to cover hearing aids for children, but are not required to cover them for adults.

Even with insurance coverage, you may be subject to a deductible or benefit cap that necessitates out-of-pocket payment. Still, it’s worth checking with your insurance provider to see whether they cover hearing aids, and if so, what portion of the cost you may be liable for.

Ask These Questions When You Call Your Insurance Company About Hearing Aids

If you’ve decided to reach out to your insurance company to determine whether hearing aids are included in your coverage, it’s important to ask the right questions throughout the conversation. Understanding your insurance policy can be challenging, but you can get the information you need to make an informed decision about your hearing if you ask these questions.

Are Medical Hearing Exams Covered in My Plan?

One of the first questions you should ask an insurance representative is whether or not medical hearing exams are covered in your policy. A representative will provide details about what your policy does and does not cover, including hearing health exams and resources. Listen carefully to the way that your question is answered. A medical hearing exam — also called an audiometry exam — is different than a routine hearing check performed at an annual check-up. These exams are specifically intended to assess whether a person needs a hearing aid, and the exam typically entails the following:

  • The patient enters a sound-treated room
  • Headphones connected to an audiometer are worn
  • Noises at different pitches and volumes are played
  • Patient responds based on hearing capability
  • A patient’s ability to hear speech may also be tested

This exam is a painless and simple way to diagnose any hearing problems you may have, and results are typically available immediately after completion.

What Is the Maximum Payment for Hearing Aids Covered in My Plan?

If hearing health visits are covered, you should get specific information about how much your policy pays and whether you will be liable for any portion of your care. You should ask, too, what the maximum payment for hearing aids is per your insurance policy. You can get this information by asking the following questions:

  • What is the cap on hearing aid exam and device benefits?
  • What sum or percentage of my hearing care am I liable for?
  • Will my payments go towards a deductible or out-of-pocket max?

These questions will help you determine whether your plan adequately covers hearing health, and if you are partially responsible for the cost, how much that will be.

Are Hearing Aid Benefits In or Out-of-Network?

Finally, you should reach out to your insurer to see whether the benefits you’re offered are on an in- or out-of-network basis. In some cases, your policy may include hearing health benefits, but those benefits may only be covered if they are accessed through an in-network provider. If you access benefits through an out-of-network provider, you may be liable for the entire cost of your care. It’s important to verify the status of a provider before proceeding with any care.

Get the Hearing Health Care That You Need

Finding care for your hearing can be difficult and expensive if you don’t have adequate insurance coverage. Even with insurance, it can still be a stressful endeavor. Luckily, there are resources available to help you navigate the system and get the care you need. Memorial Hearing serves clients throughout the Houston, TX area by diagnosing and treating a range of hearing health issues. We partner with each of our patients to help them find an insurance option that works and ensure that care is affordable and accessible. Call (832) 981-5062 or reach out online for more information.

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