Hearing Aids are not "medically necessary"? Thus, no insurance benefits?

I’m about to spend $7k on a new pair of hearing aids. I am in the “profound” loss range (was born this way) and have finally took the initiative to get the best aids I can purchase.

I just talked to my insurance company (Blue Cross) and they said they pay up to $1k per ear IF the aids are deemed as “medically necessary”. Since my loss range is like 80db (high frequencies) I’d imagine they would be “Medically necessary”…but Blue Cross told me they will have their doctor look at it and determine this.

Well, I’m bracing for the worse. I am trying to get the Otolens (invisible in ear aids) and I just KNOW that BC is gonna say that there are cheaper BTE versions to buy…

Does anyone have any experience with this? Thanks.

With my previous employer, my medical insurance covered hearing aids up to $6000 up to 90% every 5 years, but it was always a fight to get them to pay.

With my current employer I can get aids at a reduced price through HearPO, and the medical coverage pays up to $300 every 2 years, or the full amount if it’s due to accident or congenital defect. Listening to too loud rock music in my youth wasn’t considered congenital or an accident. :stuck_out_tongue:

All insurance is different. Some will pay more then others. Some will insist that you see a particular audiologist or they won’t pay anything. “Medically necessary” is a pretty loose term, which means that you need to find out exactly what that means. One thing you can be sure of is that the insurance company will try to pay the least amount of money possible. You need to better educate yourself and to better understand your insurer’s responsibilities, otherwise they will do whatever they want and you probably won’t be happy.
But then again they may surprise you and just cover you in full, no questions asked.:D:eek:

My insurance offers no coverage at all. I would be happy with anything.

You never know what your insurance company is going to do, even when they say they will cover hearing aids. For instance, we received notice that our company was going to cover aids up to $5000 per ear, for total of $10,000. Wow, right?! Oh, received this notice in early May and it was retroactive to Jan 1, 2010. I had gotten new aids in March, so I was thrilled. I called to clarify, the details were confirmed, so off I sent my claim form. Heh, just got a denial due to no precertification/preauthorization. Righhtt, like I knew this was going to be covered 2 months ahead of time. Oh brother. I’m appealing of course but not holding my breath.