- In this video, I'm talkin' about the basics of insurance
when it comes to hearing aid coverage.
Comin' up.
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Hi guys, Cliff Olson, Dr. Of Audiology
and founder of Applied Hearing Solutions in Phoenix, Arizona
and on this channel, I cover a bunch
of hearing-related information
to help make you a better informed consumer.
So if you're into that,
make sure you hit that subscribe button.
And don't forget to click the bell
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Contrary to popular belief,
there are insurance plans that do provide coverage
for hearing aids and hearing aid related services.
But not all plans are the same.
Different plans will have different amounts of coverage
for hearing aids and the services
that are associated with those hearing aids.
So I wanna provide you with a little basic understanding
of the different types of insurance
so you can better understand yours.
In general, you have seven different types
of insurance coverage in the United States.
You have commercial or private insurance,
third-party administrators, Medicaid,
vocational rehabilitation, Tricare,
Veteran's Administration, and worker's compensation.
Now I'm gonna provide a brief overview
of each of these in this video,
but I will be making separate
more detailed videos about each,
so make sure that you check out other videos
on my YouTube channel.
When it comes to commercial or private insurance,
this is typically insurance that's provided by an employer
or by retiree benefits.
Now when you're thinking
of how traditional insurance works, this is it.
You will likely have a deductible that needs to be met
and you may have some cost sharing or co-insurance
and coverage limits before any portion of testing
or hearing aids are covered.
Then the insurance company will pay
for a portion of the remaining balance
for the testing and the hearing aids
up to a certain amount, in most cases.
Many commercial or private insurance plans
also have out of network benefits
that you'll find inside of PPO plans, but not HMO plans.
This means that if you know a really good provider
that you wan to go see,
but they are not in network with your insurance plan,
you can still go see that provider
and you can still use your coverage benefits.
When it comes to third-party administrators,
otherwise known as TPAs or third-party networks,
they basically act as a middleman
between the insurance company and your hearing care provider
to control costs for the insurance company.
There are typically no out of network benefits
when it comes to third-party administrators.
So if your hearing care provider
is not inside of their network,
then you will not be able to use
your hearing aid benefits with them.
These third-party administrators
are owned by insurance companies
and hearing aid manufacturers
and they will control the type of products that you can get
and the level of care that you receive
along with the cost and the reimbursement
to your hearing care provider.
Some providers like myself
choose not to participate in third-party networks
because the amount of reimbursement
that we get from these networks
does not cover the cost of doing business
when you provide high-level care.
Medicaid, not Medicare, but Medicaid programs are state-run
and they typically provide hearing aid related services
to individuals who are younger and sometimes adults as well.
The level of technology of hearing aids
that you get from Medicaid is usually predetermined
since the reimbursement rates are so low.
Vocational rehabilitation, otherwise known as voc rehab,
are state-run programs that typically provide assistance
to individuals who are trying to stay in the workforce
or trying to get into the workforce
by providing them with some amount of hearing aid coverage.
Much like Medicaid, these programs typically provide
a low level of hearing aid technology
because again, the reimbursement rates are really low.
Tricare is coverage for active duty military
and may cover hearing aids
and even bone-anchored hearing aids
and hearing aid related services
for service members and beneficiaries
with a profound hearing loss.
Tricare does not provide hearing aid coverage
for retirees or their family members,
nor does it provide coverage for reserve select members
or retired reserve members.
Then you have the Veteran's Administration,
otherwise known as the VA.
Now inside of the VA, you have the VHA,
which is the Veteran's Health Administration,
and the VBA, which is the Veteran's Benefits Administration.
Through the VHA is where you can actually get hearing aids
usually at no cost to you
and you get all of the care and services
provided with that as well.
And typically inside of a VA, they will only dispense
the highest level of technology as well.
And last but not least, you have worker's compensation.
Now worker's compensation is usually tied
to a work-related injury,
and there are usually no out of pocket expenses.
But this really does depend
on the type of plan that you have.
Now it is important for you, if you have insurance,
to understand what type of insurance that you have
or what type of insurance you're gonna be signing up for.
As you can see, not all types of insurance plans are equal
when it comes to hearing aid benefits.
So you need to make sure
that you're doing your due diligence
to find out exactly what type of coverage
your insurance is gonna provide for your hearing aids.
That's it for this video.
Special thanks to Dr. Kim Cavitt
from Audiology Resources, Inc.
who helped provide some research
and fact checking of this video.
If you have any questions,
please leave them in the comments section below.
If you like the video, please share it.
If you wanna see other videos just like this one,
go ahead and hit that subscribe button.
Also feel free to check out my website,
http://www.DrCliffAud.com.
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