Health insurance and hearing aid benefits

Many of the specialty needs of patients, like dentistry, vision, and hearing, are now being assigned to managed care administration companies who have contracted with the main insurance firm.

The managed care of health insurance benefits is not a new concept. A managed care company is a third-party company the insurance company uses to assist patients with specific benefits to keep their (the insurance company’s) costs as low as possible.

Managed care in the hearing aid marketplace has become an enormous factor in ten short years. When I began my business a decade ago, almost no one had hearing aid benefits on their major medical policies, and no one had any benefits through Medicare supplemental coverage.

Today 65 percent of all health insurance policy holders have some hearing aid benefits and 45 percent of Medicare plans offer hearing aid benefits, too. As insurance companies were affected by the growing demand for hearing aid coverage, primarily by the baby boomers getting to the hearing-impaired age bracket, managed care of those benefits has come to be the industry standard.

This means, if your insurance company uses managed care, you cannot go out of network and use a dispenser who is not in that network.

It also means the managed care group will guide you to their dispenser, set the product options, and most importantly the prices for hearing aids. The hearing professional then becomes a “fee for service” participant in the process.

The managed care model rapidly rose in favor with insurance companies because of the reality of very high prices. Right now, there are some very generous hearing aid benefit plans through insurance in our region. Insurance companies change these benefits from year to year so the purpose of this article is to tell you to check your benefits now as they could be less in 2023.

Many of the major insurance plans in our region have great hearing aid benefits. Some with zero copay and many with very reasonable co-pays. I am a provider for most of the insurance plans, but there are other providers in the region. Call the customer service number on the back of your insurance card to find out what benefits you may have.

Some insurance companies are planning changes to coverage next year so now is a great time to check and find out about your benefits. Most of the benefit coverage for hearing aids are found in Medicare.

Advantage supplemental plans: many of these plans are zero premium plans so you should check with your insurance broker to find out which plan has the best coverage.

By the way, beware of the celebrity endorsed ads offering a laundry list of free Medicare supplement benefits. Those 800 numbers simply forward you to out of town brokers who will prospect you for what is best for them and not you.

Use local insurance professionals. Especially if you expect customer service with your plan choices. Some people are hesitant to switch from their present plan because they are satisfied with the “doctoring” or medical side of the coverage.

That is an important factor to consider when talking with your agent about hearing aid benefits.

If you are still working, have a talk with your human resource staff at work to find out what coverage, if any, you may have for hearing aids. Better hearing is always a “sound” investment as my ads say here in The Express, but better hearing also has a price tag.

It would be a very wise move to check your insurance now and be prepared to talk with your insurance agents in the coming open Medicare enrollment season this fall.

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Jeffrey L. Bayliff is owner of Hear the Birds Hearing Aid Center in Lock Haven.


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