A critical part of independent living and a better quality of life comes from your capacity to hear conversations, especially those relating important information or staying up-to-date on what’s going on with loved ones. Medical Xpress notes a sad statistic, relating that only one in five individuals diagnosed with a hearing loss receives the much-needed help provided by hearing aids. Among the factors cited for this failure to reap the benefits of hearing assistance is the lack of or uncertainty of whether or not their insurance policy covers hearing aids and hearing care expenses.
Along with the bewilderment of learning that they have a hearing loss and need the auditory assistance provided by hearing aids, many of my Houston area patients have a concern about covering the costs. Since many of my patients have BlueCross BlueShield policies, a common question I have to answer is, “Does BlueCross BlueShield insurance cover hearing aids?” Because the answer depends upon various conditions like plan type, age, and other factors, I can’t provide an instant response. To help alleviate concerns and answer insurance coverage questions related to BCBS and hearing aid coverage, I have compiled some useful general information.
Medicare Plans from BCBS
The National Institute of Deafness and Other Communication Disorders (NIDCD) reports that “approximately one in three people in the United States between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing.” Although all of the individuals within these age ranges are Medicare eligible, Medicare does not provide coverage for hearing aids. Fortunately, insurance companies, such as BCBS, have developed insurance plans, policies, and supplements to accommodate this lack of coverage.
BlueEssential or BlueCare Plus (HMO SNP)
Both BlueEssential and BlueCare Plus include the health maintenance organization (HMO) option, which allows members to choose doctors, specialists, and facilities from within a select network. The two differ in that BlueEssential plans do not specify coverage benefits for hearing aids, while BlueCare Plus plans do provide routine hearing care coverage. Still, you will need to obtain clarification of precise benefits related to hearing aids. Also, members who choose a provider outside the approved HMO network will have further restricted coverage.
Blue Advantage (PPO)
The Blue Advantage plan is a less-restrictive preferred provider organization (PPO) type insurance package, which allows members to choose outside the BCBS network with fewer restrictions. However, the Blue Advantage Medicare supplement insurance does provide hearing aid coverage, including:
• Two hearing aids annually (one per ear) if purchased through TruHearing
• Two models available:
o Premium models with 48 channels, six programs in 10 styles
o Advanced models with 32 channels, six programs in 10 styles
• Three follow-up visits (in-network for fitting and adjustment)
• 45-day trial period
• 3-year manufacturer warranty
• 48 batteries each unit (non-rechargeable models)
Blue Elite (Medicare Supplement)
Blue Elite Medicare supplement plans eliminate the restrictions of PPO or HMO type insurance plans, allowing you to see any doctor, specialist, or service provider without referrals, including seeing a hearing specialist. Hearing aids and hearing care coverage are added options rather than a part of basic coverage.
Healthy Hearing notes that most private insurance plans do not cover hearing aids for a variety of reasons. Among them is the fact that most individuals in the age group affected by hearing loss are Medicare eligible. This complicates the issue related to determining whether your non-Medicare plan covers hearing aids, and does not rule out the possibility that some hearing aid coverage or benefits are available.
Family, individual, and group plans not included with Medicare coverage provide a variety of add-on options for hearing aids and hearing care with the inclusion of various copayment, deductible, and coinsurance options. In some instances, there are also member discounts and specialized programs within and outside the BCBS network, which can assist with covering costs.
Clarity Hearing Service Solutions
I understand that the majority of individuals with a hearing loss need help to pay for hearing aids. Knowing whether and at what level BlueCross BlueShield insurance covers hearing aids and hearing care can be confusing. Our team at Clarity Hearing is eager to assist you in determining whether your coverage only includes hearing tests, premium technology, or complete hearing care.
Filling out our online form starts the process of determining which BCBS copayment, deductible, or coinsurance levels apply to you along with any available PPO network discounts and restrictions. Keep in mind that the best level of hearing care available with or without insurance coverage is the primary focus of my associates, Clarity Hearing, and me.
Scott Marquardt is the owner of Clarity Hearing and a highly skilled audiologist who has been in practice for over 20 years. Dr. Marquardt earned a master’s degree in audiology from Lamar University in Beaumont, Texas, and a doctorate from A.T. Still University. He is a member of the American Speech Language Hearing Association and a fellow of the American Academy of Audiology. He and the team offer comprehensive hearing healthcare services and specialize in the care of tinnitus, imbalance, and auditory processing disorders.