Here’s an update on my hearing-aid insurance situation.
Short version: It turns out that my insurance fully covers the expensive hearing aids that I want to get (yay!), so my last couple days of intermittently fretting about this were unnecessary.
(As usual, of course, this situation underscores some of the problems with our healthcare system. Why should I get to have better hearing aids, and better hearing, than people who don’t have as-good insurance?)
On Monday, I had a hearing-aid consultation, which resulted in my choosing a pair of “premium” hearing aids that were much more expensive than what I had been expecting.
On Tuesday, I called my insurance company to make sure that the hearing aids I’m getting would be covered by insurance. (I had previously been told by my insurance people that the insurance does cover hearing aids; but that had been a very vague/broad statement, and I wanted to be certain about these particular hearing aids, because I didn’t want to end up with an unexpected bill after the fact.)
But the insurance person I spoke with (who clearly didn’t know anything about the topic, was just reading me information) said that my insurance only covers “standard” hearing aids, not “upgraded” ones.
I asked them what counted as upgraded. They said I would have to ask my doctor about that.
So yesterday I talked with someone at my doctor’s office (henceforth “PAMF”), and they said they had no idea what my insurance considered to be standard and what they considered to be upgraded, so I would have to ask my insurance.
So I called my insurance again, and said is there some way that you can look at this specific order/prescription and tell me how much of it the insurance will cover? And they said they would file a ticket and have someone call me back.
So this morning someone from the insurance company called me back (which was nice; the insurance company used to say they would call me back about things but then not do so), and they said that they had talked with PAMF and had been told that I have a consultation appointment in November at which I would be told all about my options for what hearing aids I can get and what the prices would be.
I said (politely, but a little frustrated) that no, that wasn’t true, I already had that appointment. The insurance person brought me into their call with PAMF, and told the PAMF person that I had said that I don’t have a hearing aid appointment in November. I said wait, let me explain. The PAMF person said something, I forget what. I again said let me explain. The PAMF person said “Let me connect you to someone who can help you.” I thought to myself, Yes, that would be very nice, maybe you should have done that sooner. But out loud, I just said thank you.
And then while we were on hold, I switched to my headphones—and accidentally pressed a button that hung up the call, sigh.
A while later, the insurance person called me back and said they had talked with another PAMF person and gotten the information they needed. It turns out that regardless of which hearing aid I order, PAMF will file with the insurance under the same “procedure code.” And the insurance person had looked up that procedure code, and found that it’s fully covered regardless of what the specific hearing aids are. So the ones that I want don’t count as “upgraded.”
(And as a nice bonus, since I’ve already used up my out-of-pocket maximum payment this year, the insurance coverage will be 100%.)