Hearing the hum of traffic, the buzzing of lights, and the low rumble of conversation within a crowd might not attract your attention as sounds you listen for. However, if those sounds, along with the sounds of rain on the roof, birds singing in the garden, a trickling stream, or conversations with your loved ones become dim or go away, those grab your attention. Hearing loss is one of the most commonly diagnosed physical conditions behind arthritis and heart disease, according to the Hearing Loss Association of America, and it affects about 48 million Americans, nearly 20% of the population.
Though hearing aids provide a valuable solution in the correction of the condition, Medical Xpress notes that only one in five individuals diagnosed with hearing loss bother to get the help they need from hearing aids. Among the reasons behind this aversion to receiving treatment is uncertainty or lack of understanding related to insurance coverage for hearing aids.
When my Houston area patients learn that they will benefit from auditory assistance from hearing aids, one of their first concerns is whether their Cigna Insurance policy will cover the costs. There is no simple answer to that question because coverage will depend upon the type of plan, coverage riders, and other issues. I have compiled some general information related to hearing aid coverage under a few of Cigna’s policies to help answer some of your coverage questions.
Medicare Coverage Issues
Statistics provided by the National Institute on Deafness and Other Communication Disorders (NIDCD) indicate that one in three people between 65-74 and half of the 75+ population has hearing loss conditions that can benefit from hearing aids. All of the individuals within this category are Medicare eligible, but basic Medicare coverage does not provide for the cost of fitting hearing aids or the hearing aids themselves. Fortunately, other insurance companies have various types of coverage available to address this problem.
Cigna-HealthSpring Advantage (HMO)
Cigna’s health maintenance organization (HMO) option allows plan members to choose doctors, specialists, and facilities from a network of providers. Within the HealthSpring Advantage network, coverage includes $700 per ear every three years and a free routine hearing exam every year. Under the HMO plan, you can choose to see a provider outside of that network but with limitations to your coverage.
Cigna-HealthSpring Preferred (PPO)
An alternative provided by Cigna is their HealthSpring Preferred plan, which is a preferred provider organization (PPO) insurance plan. This plan offers the same $700 per ear every three years and a free annual routine hearing exam coverage. The difference between the HMO and PPO options is that the PPO plan is less restrictive about choosing doctors, specialists, and facilities. However, there are still out-of-network costs associated with going outside of the network for care.
Exclusive Provider Network (EPOs)
Exclusive provider network (EPO) plans are also available from Cigna. Plans in this category are something of an HMO and PPO hybrid with slightly more flexibility than the HMO plans but include uncovered out-of-pocket expenses if you seek care outside the plan’s network. Hearing aid coverage is included in Cigna’s EPO plans, but coverage varies with respect to location and whether hearing care and hearing aids were options added to your plan.
Allow Clarity Hearing Services to Help You
Determining whether your policy covers hearing aids is not always easy to ascertain. The fact that only 23 states require insurance carriers to cover hearing aids, most often explicitly addressing children under 18 years-of-age complicates the issue further. The American Speech-Language-Hearing Association (ASHA) also notes that only a small percentage of the above mentioned 23 states include provisions also to cover adults. Consequently, extensive research is necessary to determine the extent of hearing aid coverage provided by your Cigna Insurance policy.
The Clarity Hearing team has the right amount of experience and expertise to obtain the facts related to your insurance coverage, taking away your stress. We can check on your Cigna policy and determine the level of coverage you can expect for hearing aids and overall hearing health care. Fill out our online insurance coverage check form to start the process. Also, rest assured that my Clarity Hearing associates and I are here to work with you every step of the way to provide the very best hearing health care available to you.
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.