Imagine a world without bird songs, gurgling streams, and rainfall on the roof. Although the absence of these sounds might not cause you concern, a decreased capacity to understand the conversations of family and friends or to hear important information disrupts your quality of life. Statistically, one in five individuals with a hearing loss that can benefit from the use of hearing aids never receives the needed help they provide, reports Medical Xpress. Among the factors contributing to this statistic is a lack of or uncertainty associated with insurance coverage of hearing aids and hearing care expenses.
I have noted the reaction of my patients to a diagnosis of hearing loss and the recommendation for auditory assistance provided by hearing aids over the years. Among the questions that often follow, many of my Houston area patients ask about covering the costs. A common question I hear is, “Does my Humana insurance policy pay for hearing aids?” The answer to that question is more complicated than you might think because it depends on several variables that might include plan type, age, and other factors. To provide some answers to questions about Humana insurance coverage of hearing aids, I have put together some general coverage information.
Medicare Plan Coverages
Most hearing-loss patients fall within the age range of Medicare coverage eligibility, because “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,” according to National Institute of Deafness and Other Communication Disorders (NIDCD) statistics. The problem that arises in relation to this statistic relates to the fact that Medicare does not provide coverage for hearing aids. On the other hand, most insurance companies offer Medicare supplement options to help cover these expenses.
All three different levels of HumanaChoice Medicare Advanced plans come as preferred provider organization (PPO) insurance types. The benefits related to in-network hearing care services and hearing aids are the same in all plans, including:
• $45 copayment for Medicare cover benefits
• No copayment for routine exams (one annually)
• No copayment for hearing aid fitting and evaluation (3 visits per year)
• Authorization required for hearing exams
• Hearing aids copayments $399 (advanced level instruments) or $699 (premium level instruments) maximum of 2 per year
Out-of-Network Coverage on all plans remains unchanged concerning non-Medicare covered hearing care and hearing aids. Still, there is a 40% coinsurance payment for hearing exams covered by Medicare.
Hearing aid coverage from most private insurance companies is a problem. Healthy Hearing notes that most private insurance plans do not cover hearing aids for a variety of reasons; one of the main ones is that Medicare-eligible individuals are the main age-class of patients who require hearing aids. Though this complicates finding coverage for those not eligible for Medicare, it does not rule out the availability of partial coverage, discounts, or benefits to help pay for your hearing aids.
Humana’s insurance plans do comply with the Texas mandate requiring insurance policies to provide hearing aids and hearing care coverage for children under the age of 18 in all of its available packages. Coverage variables associated with different plans usually include copayment, deductible, and coinsurance for the coverage of children and optional riders that provide benefits for adults. If your Humana policy does not cover hearing aids, member discounts and specialized programs might still be available for helping to cover costs within and outside their membership network.
Clarity Hearing Service Solutions
There is enough confusion when it comes to the process of selection, fitting, and adjusting to hearing aids, so I do all that I can to help alleviate patient stress over insurance coverage. Our team at Clarity Hearing has the necessary expertise and experience to help determine the level of copayment, deductible, or coinsurance benefits associated with your specific Humana policy along with any network discounts or restrictions that might apply.
To be sure about their coverage, I advise my patients to take advantage of our online insurance coverage form, which starts the process of finding out all you need to know about hearing aids and hearing care coverage. My Clarity Hearing associates and I apply our broad range of experience and skills to provide you with the peace of mind that comes with excellent hearing health care.
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.