Age-related hearing loss is a common problem among people over 65, but many aren’t getting the help they deserve. Roughly two out of three seniors who could benefit from hearing aids aren’t using them, according to the National Institute on Deafness and Other Communication Disorders (NIDCD).
One reason is the high cost of hearing aids. Many can’t pay for these helpful devices out of pocket, and hearing aid coverage is commonly missing from insurance plans. Many seniors buy Medicare Advantage plans from the Blue Cross Blue Shield Association, but does this popular provider cover hearing aids? We’ll answer this question and more.
Does Blue Cross Blue Shield Cover Hearing Aids?
Some Blue Cross Blue Shield insurance plans include hearing aid coverage. These fall under supplemental plans that provide Medicare coverage for dental, vision, and hearing services. In addition to the cost of the devices themselves, they cover hearing aid fitting and routine hearing exams to check for signs of hearing loss.
Blue Cross Blue Shield Medicare Plans
While hearing care isn’t included in all BCBS plans, the association offers supplemental plans under Medicare Part C that provide additional coverage for hearing services, including routine hearing exams and hearing aids.
Here are the different Blue Cross Blue Shield Medicare Plans that cover hearing aids and hearing care.
Blue Care Network (BCN) offers two Medicare Advantage plans: BCN Advantage HMO and BCN Advantage HMO-POS.
HMO stands for Health Maintenance Organization and POS stands for Point of Service.
BCN HMO and BCN HMO-POS do not cover hearing aids. However, they provide coverage for some routine services, such as:
- Dental exams
- Dental cleanings
- Cataract surgery
To get coverage for routine ear exams and hearing products, you may need to buy a supplemental plan along with any of the two BCN plans.
Services in the supplemental plan include:
- One routine hearing exam every year with 50% coinsurance
- Free hearing aid fitting every three years
- New hearing aids every three years with 50 percent coinsurance (up to $1,250 per hearing aid)
To buy the supplemental plan, add it to the BCN HMO or BCN HMO-POS plan during enrollment. Another way is to submit a paper application form available for download from the forms page.
Medicare Plus Blue
The Medicare Plus Blue is a Preferred Provider Organization (PPO) plan offered by Blue Cross Blue Shield. It covers in-network and out-of-network services, and you don’t need a referral from your primary care physician to consult a specialist.
Coverage for routine hearing exams as well as hearing aid fitting and purchase is available through the Medicare Plus Blue plan. You may need to pay part of the costs in coinsurance.
PPO plans that entitle you to two hearing aids every three years are:
- PPO Assure
- PPO Signature
- PPO Vitality
PPO Essential does not cover routine hearing exams or hearing aids.
Unlike PPO and HMO plans, Legacy Medigap provides insurance coverage for any service provider you choose. You also don’t need a referral from your primary care physician to see a specialist.
However, Legacy Medigap doesn’t include hearing care. To get coverage for these services, you need to purchase a Dental Vision Hearing Package package.
This supplemental package costs $15.25 per month.
The additional services that come with this plan are annual hearing tests, one hearing aid, and dental and vision benefits.
How Does Medical Insurance Work?
Like all forms of insurance, medical insurance is based on the idea of pooling risks.
Various people regularly pay an amount into the pooled funds with the understanding that they’ll get help when they need to cover a considerable, unexpected expense, like a medical emergency or a necessary surgery.
The risks are absorbed and distributed within the pool, making high-cost medical expenses more manageable. Here are some of the basic features of a health insurance plan:
They are also adjusted based on age and pre-existing conditions. The average monthly premium ranges from $340 to $525. A high premium typically means more coverage and services.
A deductible is the amount you have to pay out of your pocket before your insurance starts covering costs. Most health insurance plans have a deductible.
Once you meet your deductible and the insurance starts, you begin to share the medical costs with your insurer. The percentage of expenses you have to contribute is called coinsurance. For example, if your coinsurance is 15 percent, your provider will cover 85 percent of your medical expenses after the deductible is met.
Most health insurance plans include 100 percent coverage for preventive care.
- Wellness screenings
- Annual check-ups
- Flu shots
Some plans may require a copay for these services
Copay is a small fee you pay at the doctor’s office or the pharmacy.
For example, if the copay is $20 for doctor visits, you have to pay this much every time you visit a doctor. If the copay is $10 for monthly prescription drugs, you will need to pay $10 every month at the drug store when you pick up your prescription.
Every plan sets an upper limit on the amount you have to pay. This is called out-of-pocket maximum. Once you reach this limit, the insurance will cover all remaining expenses.
Every insurance company has a set of service providers, including doctors, hospitals and outpatient treatment centers. Only the providers listed on your insurance plan will accept your insurance when you pay for services. They are called network providers.
Read Also: Does United HealthCare cover hearing aids?
While hearing care isn’t one of the benefits of standard Blue Cross Blue Shield insurance plans, the association does offer supplemental packages that cover hearing aids and routine hearing exams. You may need to pay coinsurance for hearing aid fitting and purchase. If you’re still unsure about your coverage, contact your provider directly.
You can also consult with your audiologist about hearing aid discounts and low-cost alternatives, like personal sound amplification devices and other hearing products that might work fine for your level of hearing loss.