Hearing Aid Insurance Benefits

Always call the number on the back of your insurance card to see of you have hearing aid insurance benefits.  Ask if there is a special rate for in network providers.  If there’s no difference between in and out of network, then you can go to any hearing aid provider.  Also, ask about deductibles and how often they provide that hearing aid benefit.  Regardless of my status with an insurance company, I’m happy to submit claims electronically and that speeds up the process of considerably.  I’m in the process of applying to insurance companies.  Here is my current status.

 

In-Network

  • Blue Shield
  • MediCal/CenCal
  • The Department of Rehabilitation

 

Waiting to be In-Network

  • EPIC (Applied this month)
  • Aetna (Applied 2 months ago)
  • Cigna (Applied 3 months ago)
  • Anthem Blue Cross (Applied 8 months ago)

Medicare

Medicare does not cover hearing aids, but a lot of secondary insurances require the claim to go to Medicare first.  Once it gets rejected, Medicare forwards it to the secondary insurance.  Everyone who works with hearing aids knows that Medicare only covers an annual hearing test, not hearing aids.  For some reason we have to do the extra paperwork.

 

Credentialing

Because of a process called “credentialing”, becoming a provider takes a long time.  Credentialing is the process of establishing the qualifications of a licensed medical professional and assessing their background and legitimacy.  It takes months to become an in-network provider.  In the case of Anthem Blue Cross, it has taken 8 months so far.  We just signed a contract with them and now we’re waiting for them to sign it.  So far, I’ve been “credentialed” by Sansum Clinic, Blue Shield, Anthem Blue Cross, MediCal, Medicare, and the Department of Rehabilitation.  Maybe some day there will be a standard process where they just accept a diploma from a reputable university and call your last few employers.

 

Claims

It takes a lot of work to submit and process claims.  I usually spend a good portion of my Fridays working on insurance claims and it grows every year.  I anticipate there will be times when I will have to wait a month before I can see a new patient with insurance so that I have time to process the claim in a reasonable amount of time.  Maybe some day anyone with a hearing loss will have access to at least a good basic hearing aid, without lots of paperwork, regardless of income.