When it comes to understanding important information or enjoying conversations with family and friends, hearing is an important part of daily living. Statistics show that only one-fifth of the patients diagnosed with hearing loss receive the help they need from hearing aids. Medical Xpress notes that one of the most common factors contributing to this statistic has to do with cost. Adding to the problem is the uncertainty of whether hearing aids are covered by the patient’s medical insurance.
When the patients at my Lake Charles clinic discover that they require the auditory assistance of hearing aids to correct hearing loss, they’re often taken aback by the price tag attached to them. Because many of my patients carry Louisiana Healthcare Connections insurance, a common question I hear is, “Does Louisiana Healthcare Connections insurance cover hearing aids?” Several variables like plan type, age, and other factors make a direct answer to their question difficult. An additional consideration is the amount or percentage of coverage that is included in their plan.
The National Institute of Deafness and Other Communication Disorders (NIDCD) estimates 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.” Though most of the patients within these age ranges are Medicare eligible, Medicare does not cover hearing aids. To overcome this issue, a number of insurance companies offer supplemental plans to cover them.
Allwell Medicare (HMO)
The Allwell HMO plan allows members to choose providers from a select network of doctors, specialists, and facilities to tend to their health care needs. Members who choose to go outside the network of approved providers neither Medicare nor Allwell will be responsible for payment. Allwell does provide coverage under this plan, including:
• Medicare-covered Hearing Exam with a $40 Copay
• Annual, Routine Hearing Exam with $0 Copay
• Up to 2 Hearing Aids Annually with a $0-$1,580 Copay
Allwell Dual Medicare and Essentials (HMO SNP)
Similar to the Allwell Medicare (HMO) plan above, this plan includes a list of preferred care providers (PCPs) from which you can choose. This plan also restricts choosing your care provider to network members only. Coverage for hearing aids with this plan include:
• Medicare-Covered Hearing Exams with 0% or 20% Coinsurance per Visit
• Annual, Routine Hearing Exams with $0 Copay
• 2 Hearing Aids Annually with $0 Copay
Because of strict network provider restrictions with these plans, you will need to be sure of your coverage options before seeking a care provider.
Most individuals affected by hearing loss fit into the class of those with Medicare eligibility. Healthy Hearing advises that most private insurance plans do not cover hearing aids for a variety of reasons, but that does not rule out the possibility that coverage or benefits for hearing aids might be available on non-Medicare plans.
Family, individual, and group plans not part of Medicare coverage under Louisiana Healthcare Connections are also subject to the same network provider restrictions as their Medicare supplement plans. Though coinsurance, copayment and out-of-pocket expenses will vary among different plan types, there are benefits provided for auditory health needs, including:
• Hearing Exams, Treatment, Hearing Aids, and Related Supplies (including earpieces and batteries)
• Members 21 and Older Limited to One Annual Hearing Exam
• Members 21 and Older Limited to One Hearing Aid Every Two Years
Acadian Hearing Service Solutions
We know that many of our patients with hearing loss cannot afford hearing aids without some form of financial assistance. We are also aware that determining that the level of coverage you have with Louisiana Healthcare Connections insurance can cause a lot of confusion, especially for our non-Medicare plan patients. Acadian Hearing Services can help you determine whether your insurance coverage includes hearing tests, premium technology, or complete hearing care. Our team can also find out which Louisiana Healthcare Connections copayment, deductible, or coinsurance levels apply to you along with any applicable PPO network discounts or restrictions.
Whether my Lake Charles patients are sure or unsure of the level of coverage they have through Louisiana Healthcare Connections and the benefits for which they are eligible, I advise them to fill out Acadian Hearing Service’s online insurance coverage form here. By doing so, we can provide answers to all of the questions they might have related to their insurance coverage for hearing aids.
Contact us for more information about the various hearing assessment, balance, and best-in-class hearing technology solutions in the Lake Charles, LA area provided by Acadian Hearing Services.
Dr. Heidi J. Sorrells obtained her doctorate degree from Salus University in Elkins Park, Pennsylvania and master’s and bachelor’s degrees from Minot State University in Minot, North Dakota. She is a certified Audiologist by the American Speech-Language-Hearing Association (ASHA) and she holds a Louisiana and a Texas Audiology License. Dr. Sorrells enjoys all aspects of working in a private practice audiology clinic but especially loves the challenges of vestibular (balance) assessment and rehabilitation.