The number of individuals with some form of hearing loss is expected to rise from 44.6 million to 74.8 million in the next 40 years, according to a Johns Hopkins University study.
The greater tragedy is that most of them wait until their hearing loss becomes a significant issue before they seek help.
Due to the stigma of hearing loss, the fact that it comes on slowly, and its seeming insignificance to overall health, hearing healthcare is typically far down the list of health priorities.
Consequently, when hearing loss becomes a reality, many people are not financially prepared to take advantage of the hearing aids and hearing care that would allow them to continue living their active and independent lifestyles.
Let’s face it—paying for hearing aids out of pocket is a challenge for Abilene area patients. If you’re like most of them, your immediate concern when it comes to paying for hearing aids and hearing care is whether you’ll be covered by your health insurance policy.
With this article, we’re going to answer some general questions you might have concerning hearing aid coverage as well as the more specific question:
Does UnitedHealthcare (UHC) cover hearing aids?
Let’s address your general insurance questions first.
Is There Coverage for Hearing Aids Through Medicare and Medicaid?
The first consideration for most individuals over the age of 65 is Medicare, which covers those receiving Social Security benefits due to age or disability. Let’s get right to the point.
Medicare only covers hearing exams and does not cover hearing aids. However, if you are eligible for Medicaid, you may receive partial or full coverage for hearing aids depending on your state.
Services covered by Medicaid Texas for adults include:
- Audiology and audiometry evaluation and diagnostic services
- Hearing aids
- Hearing aid accessories
- Hearing aid repairs
- Ear impressions and earmolds
- Hearing aid batteries as often as medically necessary
- Cochlear implants, auditory brainstem implants (ABI), and bone-anchored hearing devices
The limitations associated with these coverages are as follows:
- Hearing aids, one per ear every five years and replacement hearing aids within the same five-year period
- Hearing aid repairs are not allowable during the warranty period
- For ear impressions and earmolds, one is covered per hearing aid, whether monaural or binaural
Note that coverage for hearing aids for adults is for one hearing aid if there is hearing loss in both ears. Those with hearing loss in one ear do not qualify for coverage.
Due to these limitations, most people have to turn to their private health insurance policies to receive the financial assistance they need.
Determining Whether Your Private Health Insurance Policy Covers Hearing Aids
Although about two dozen states (Texas included) currently mandate health insurance companies to provide full or partial hearing aid coverage for children, only six (Texas not included) extend this mandate for adults.
Unfortunately, without a mandate, most private insurance companies don’t provide coverage for hearing aids in their plans. In order to find out if your private health insurance covers you for hearing aids, you’ll have to contact them and ask them questions about your coverage, like:
- What is your current health plan benefit for hearing aids?
- Do you have to use specific providers and, if so, who is on the list of providers in your area?
- If your coverage includes a benefit, do you have to pay out of pocket and then submit paperwork to get
- reimbursed, or can the provider bill the health plan directly?
- Is your benefit limited to specific hearing aid models or technology? Ask them to define terms such
- as “routine” hearing aids.
- Are there any criteria or stipulations for coverage? Some plans require that your hearing loss be at a certain
- level in order to qualify for their benefit.
UnitedHealthcare Hearing Aids Coverage
Now to answer your more specific question:
Does UHC cover hearing aids?
If you have UnitedHealthcare insurance, then you’re in luck. UnitedHealth Group is one of the few companies that do offer coverage for hearing care and hearing aid treatment. It is available in all 50 states as well as 130 countries around the world.
Various United Healthcare insurance plans provide different levels of benefits in association with the American Association of Retired Persons (AARP) with their Medicare Advantage (Part C) plans.
AARP MedicareComplete Plan 1 (HMO)
Included benefits from this plan include a $20 co-pay for hearing exams, a $380 co-pay for inner-ear hearing aids, and a $330 co-pay for outer-ear hearing aids. Patients may schedule appointments with their preferred doctors and have a $0 monthly premium.
AARP MedicareComplete Plan 2 (HMO)
Similar to Plan 1, the main difference is a $5 hearing exam co-pay, but you can expect to pay a monthly premium of $36. The co-pay of $375 to $2,075 for both inner-ear and outer-ear hearing aids is the same with this plan.
AARP MedicareComplete Plan 3 (HMO)
A third alternative from UnitedHealthcare allows for a $0 co-pay for hearing exams with a monthly premium of $81. As with Plan 2, the co-pay for both types of hearing aids is between $375 and $2,075, depending on the technology level.
Our Insurance Experts Can Help
Better hearing not only means better communication, but it also means a higher quality of living and better overall health.
An investment in hearing aids provides the best treatment option for those with a hearing loss, but paying for them can be challenging.
Even if you’re not eligible for Medicaid coverage, individuals with UnitedHealthcare hearing aids coverage can expect some level of much-needed help toward the purchase of their hearing aids.
Our insurance experts at Holland Hearing Center can help to determine the amount of benefit you will receive for hearing aids and hearing care.