Does Insurance Cover Cochlear Implants?
According to the National Institutes of Health (NIH), one in every three people 65 years of age and older has hearing loss.¹ One main barrier that prevents people from getting a cochlear implant is also one of the most common misconceptions: cochlear implants are too expensive, and my insurance probably does not cover the procedure. This is often not the case, as unlike hearing aids, cochlear implants are covered by Medicare, most insurance plans and typically Medicaid*.
The first step to knowing how much a hearing implant will cost is to get a hearing evaluation by a hearing health professional who specializes in advanced hearing solutions, including hearing implant solutions. You will need to find out if you or a loved one are eligible (or medically qualified) for a hearing implant before obtaining insurance approval. After you find out you or a loved one is a candidate for a hearing implant solution, the next step is to learn more about your health plan coverage and how to request and obtain insurance approval. Your hearing health professional will help you submit the necessary paperwork and estimate out-of-pocket-expenses.
Because the cost of the implant will vary based upon each person’s specific health plan, the next steps are decided by you, your insurance provider, and your hearing health professional. Navigating insurance can certainly feel overwhelming, so to make the process easier, Cochlear has a pre-surgical Insurance Support Team to help obtain necessary insurance approval and assist in appealing denied coverage if needed.
The life-changing benefits you can receive from cochlear implants are far too important to let misunderstandings about insurance coverage get in the way. Tom, a Kanso® recipient, can confirm: "The insurance, it was a gift from heaven. Medicare and my insurance, it was easy. There was no negotiating. I didn't have to fight anybody, so that process was minor. You just want to make sure you're covered as you would with any procedure and network provider."
Start your own hearing journey today by learning more about the insurance process using Cochlear’s Step-By-Step Guide and viewing Cochlear’s website for answers to frequently asked questions and more.
If you or a loved one would like to learn more about qualifications, cochlear implants, insurance, and the general process, start here.
1. Hearing Loss and Older Adults [internet]. National Institute on Deafness and Other Communication Disorders; c2017 [cited 19 Sept 2019]. Available from https://www. nidcd.nih.gov/health/hearing-loss-older-adults.
*Covered for Medicare beneficiaries who meet CMS criteria for coverage. Coverage for adult Medicaid recipients varies according to state specific guidelines. Contact your insurance provider or hearing implant specialist to determine your eligibility for coverage.
Please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always read the instructions for use. Not all products are available in all countries. Please contract your local Cochlear representative for product information. Views expressed as those of the individual. Consult your health professional to determine if you are a candidate for Cochlear technology.