Insurance plans and policies differ in their coverage for hearing aids. We're connected with all major insurance carriers to optimize your in-network hearing care savings. Our skilled team is ready to confirm your hearing aid insurance benefits. Contact us now for assistance!

In many instances, an in-network hearing aid provider can provide more significant discounts than out-of-network options. At Stanford Hearing, with three locations in Sioux Falls, Buffalo, and Madison, we are proud to be a leading hearing aid provider in-network with all major insurance plans.

Our accepted insurance plans include:

• AARP
• Aetna
• Blue Cross Blue Shield
• Cigna
• Humana
• TriCare
• United Healthcare
• Medicare Advantage
• Nations Hearing
• TruHearing
• UnitedHealthcare Hearing

To discover if your insurance covers hearing aids, reach out to your nearest Stanford Hearing location! Our insurance experts will coordinate with your insurer to confirm your hearing aid benefits.

Additionally, as in-network providers for all major insurers, we frequently assist patients in obtaining premium hearing aids with minimal to no out-of-pocket expense. We simplify maximizing your hearing aid insurance benefits.

The need for a referral from your primary care physician varies with your insurance plan. Typically, most commercial PPO plans don't need a referral to see our in-network providers. However, some policies, such as Medicare, might need a referral for coverage of testing and treatment. So, our team will gather your insurance details and help you get the required referral or documentation to guarantee coverage of your services.

Yes, the cost of hearing aids will likely count towards your deductible, based on your insurance plan. Thus, your payment for the hearing aids may contribute to your annual deductible, the amount you must pay before insurance begins to cover some healthcare costs.

Let Us Help

Our team at Stanford Hearing can assist you in comprehensively understanding your insurance coverage, deductible requirements, and any possible out-of-pocket expenses related to acquiring hearing aids through us.

Choosing an in-network hearing care provider like Stanford Hearing can significantly reduce your hearing healthcare costs. In-network hearing care specialists adhere to the negotiated rates set by your insurance company, which typically lowers your out-of-pocket expenses for appointments, tests, and necessary hearing aids or accessories.

Key benefits of selecting an in-network hearing specialist and audiologist include:

• Reduced Costs: In-network audiologists accept lower service rates, a benefit of being part of the insurance network. This results in lower costs for your appointments and other hearing healthcare services.
• More Affordable Hearing Aids: With an in-network audiologist, your insurance is likely to cover a larger portion of your care costs. This leads to greater coverage and potentially less personal expense.
• Predictable Expenses: In-network audiologists mean fewer unexpected costs or denied claims. They follow the insurance company's rules and regulations, offering more predictable costs and coverage.

In Summary

Overall, an in-network hearing care center like Stanford Hearing helps you save on hearing healthcare costs and ensures top care within your insurance plan's guidelines.

In the hearing care sector, third-party hearing aid benefit administrators are entities distinct from patients and healthcare providers tasked with reimbursing or paying for services provided. These third parties can be insurance companies, government programs, employers, or other health coverage providers.

Agreements

Hearing care providers, like Stanford Hearing, typically need to form agreements with these administrators to be recognized as in-network and receive service reimbursements. We have undergone this process, becoming an in-network provider for all major insurance carriers and their associated hearing aid benefit administrators.

Contracts

Provider Contracting: These administrators often contract with hearing care providers to form a network of in-network services. These contracts outline reimbursement terms, including rates, billing procedures, and network participation requirements. Providers adhering to these terms join the administrator's network and may appear in provider directories.

Claims

Claims Submission and Reimbursement: Providers submit claims to administrators for services to covered patients. Administrators review these claims for accuracy and compliance with plan guidelines. Approved claims result in reimbursements to providers based on pre-agreed rates and schedules.

The coverage offered by Hearing Aid Benefit Administrators, also known as Third-Party Administrators (TPAs), can differ based on the specific TPA and the insurance plan they manage.

It Depends

Insurance plans under TPAs may cover various hearing aids, depending on the plan terms and choices made by the employer or organizing body. This coverage can span different hearing aid styles, technologies, and brands. Some plans might set criteria for coverage, like the level of hearing loss, requirements for medical necessity proof, or the use of preferred (in-network) providers.

Do You Work with TPAs?

At Stanford Hearing, we work with major TPAs, including United Healthcare Hearing, Nations Hearing, and TruHearing, among others. Our experts are adept at maximizing your savings while offering top-notch hearing care.

The interval for obtaining new hearing aids under insurance varies by plan or policy, typically ranging from 1 to 3 years. This regular reset allows patients to take advantage of the latest hearing aid advancements. New features are frequently introduced as technology evolves. While some individuals may find their current hearing aids adequate for over four years, newer models could offer more benefits. As hearing aid technology progresses, so do the ways these devices enhance users' lives, a benefit worth exploring.

Maximize Your Benefits

At Stanford Hearing, our team assists patients in maximizing their benefits. We verify the frequency at which you're eligible for new technology and remind you when your benefits renew, enabling you to access the latest technology often at little to no additional cost. For any inquiries, please contact us!

While Traditional Medicare usually doesn't offer hearing aid benefits, Medicare Advantage now provides benefits that can equip you with advanced hearing aids at minimal to no out-of-pocket cost. So, if you're covered by Medicare Advantage and need hearing loss treatment, contact your nearest Stanford Hearing location today!

Medicare and Medicare Advantage are both U.S. healthcare programs, but they differ in structure and benefits. Here's a breakdown:

• Medicare: A federal health insurance program mainly for those 65 and older and certain younger people with disabilities. It includes:
• Part A: Covers hospital insurance, including inpatient stays, skilled nursing facility care, hospice care, and some home health services. Most people don't pay a premium for Part A if they or their spouse have paid Medicare taxes while working.
• Part B: Covers medical insurance, including doctor visits, outpatient care, preventive services, and medical supplies. Part B requires a monthly premium based on income.
• Part D: Offers prescription drug coverage through standalone Part D plans or Medicare Advantage plans with drug coverage. Part D plans, provided by private insurers, vary in premiums and coverage.
• Medicare Advantage (Part C): An alternative to receiving Medicare benefits offered by private insurance companies approved by Medicare. These plans must cover at least what Original Medicare (Parts A and B) covers but can include additional benefits like dental, vision, hearing, and fitness programs. They typically use a network of healthcare providers. Stanford Hearing is part of these networks.

Key Points

In summary, Medicare provides coverage through Parts A, B, and D, while Medicare Advantage, offered by private insurers, includes the same coverage plus potentially more benefits.

Many don't, but Stanford Hearing does! We work with every insurance plan in our area, including Medicare Advantage, where other hearing practices might be out of network. Choose Stanford Hearing as your go-to for in-network hearing aid benefits!

If a hearing center can't confirm their in-network status with Medicare Advantage, your potential savings may be significantly less. Not all hearing centers are in-network with Medicare Advantage plans. The network of healthcare providers, including hearing centers, varies with each Medicare Advantage plan, but Stanford Hearing ensures coverage for all participants.

How Medicare Advantage Plans Work

Medicare Advantage plans usually have a network of healthcare providers who have agreed-upon rates with the insurance company, often leading to lower out-of-pocket costs for plan members. Using an out-of-network hearing center might be more costly, with different coverage rules like higher copayments or coinsurance.

For hearing services coverage, including hearing aids and tests, review your Medicare Advantage plan's hearing care details. Coverage levels vary; some plans offer comprehensive hearing services, while others have limited coverage. Note that Medicare itself offers limited hearing aid coverage, so a Medicare Advantage plan might be more beneficial for hearing-related needs.

In short, if a hearing center isn't confirmed as in-network with Medicare Advantage plans—and many aren't—you might not save as much. To avoid uncertainty, contact your nearest Stanford Hearing Aids hearing center. Our providers are assuredly in-network with Medicare Advantage.

The hearing care industry has transformed significantly over the past five years. Traditionally, patients and insurance companies paid a higher "bundled price" for hearing aids. This price included ongoing service and support for 3 to 5 years or more. As of 2017, we estimated that only 20-35% of patients had insurance benefits covering part of their hearing aid costs.

Things Are Improving

Now, the model has evolved. The good news is that we estimate 60-75% of patients with hearing loss now have some hearing aid benefit. This increase is largely due to the inclusion of hearing aid benefits in most Medicare Advantage insurance plans. However, the nature of these benefits has changed. Today, they typically cover the electronics, a hearing test, programming, delivery of the hearing aids, and a limited number of follow-up appointments. What they don't cover is the ongoing service and support necessary to maintain hearing aids and ensure optimal hearing (like professional cleaning and routine adjustments). To learn how you can continue saving on additional follow-up appointments and more, click below.