My Anthem Blue Cross Blue Shield insurance covers 80% of the cost of hearing aids after I meet my deductible with no limits (confirmed that there are no limits with Anthem reps today). I went to a provider today and they told me that no limits is deceiving because when they submit a claim to Anthem for code V5261 (digital binaural) that Anthem will only pay them up to some preset amount (pre-negotiated rate?) that is well below what the hearing aids cost, and I would be responsible for the difference. The providers prices seemed fairly reasonable, but the preset insurance amount would end up barely covering half the total cost.
I tried to get the insurance company to tell me what the maximum allowable payout is for V5261 (or if there was a limit at all) but they wouldn’t tell me. My previous hearing aids were billed to the same code 5 years ago and there was no limit. Have any providers run into a limit on what Anthem BCBS considers an acceptable cost for hearing aids?