Welcome to episode six of The Flex Audiology Show!
Today, we’re going to cover some details around Humana insurance and whether they cover hearing aids.
Ashley, our front office staff, is asked about Humana insurance daily. Somebody will call and say, “I have Humana, do they cover hearing aids?”
And the short answer is, we don’t know.
How to Determine Your Humana Benefits
Your benefits with Humana depend on the type of policy you took out with them. We usually recommend that patients come and get evaluated at our office, and from there, we will get your insurance information.
If you feel comfortable, we can take this from you over the phone. Otherwise, you are more than welcome to hand it over when you show up for that initial consultation.
From there, we will call Humana to determine your specific hearing aid benefits.
In this part of Southern Indiana, I have seen a range of different benefits. In some cases, there has been little to no benefit.
In other cases, I have found a considerable benefit of $1,000-$1,500. I would take that any day of the week.
Humana Medicare Advantage Plans
Humana offers many different supplemental insurance plans called Medicare Advantage (Medicare Part C) plans, and they are mostly PPO and HMO plans.
If you are covered by any one of Humana’s Medicare Advantage plans and your audiologist, hearing instrument specialist, or physician is in your network of approved providers, then you can claim some or all the following benefits:
- No copayment required for a yearly, standard hearing assessment (but the assessment must be authorized beforehand)
- No copayment required for up to three fittings and assessments for hearing aids per year
- $30 to $50 copayment or 20% coinsurance for benefits covered by Medicare
- Copayment required for your hearing aids – $0 or $199 to $699 per ear for advanced level devices or $0 or $699 to $999 per ear for premium level devices, and an additional $50 copay for rechargeable aids (preapproval required for all hearing aids)
- $1,000 hearing aid allowance – some brands might not be covered, and the limit is for two hearing aids per year
Humana hearing aid benefits are only given once a doctor, hearing aid specialist, or audiologist has determined the level of hearing loss with a hearing evaluation.
You will pay a higher copayment for an out-of-network provider, and there are limits on coverage.
- Hearing exams covered by Medicare require a 20 to 50% coinsurance payment.
- Hearing exams not covered by Medicare require a $0 to $50 copayment.
- Hearing aids not covered by Medicare require a copayment of $0 or $199 to $699.
Humana’s Non-Medicare Plans
It is unusual for most insurance companies to cover the cost of hearing care and treatment in their basic insurance plans, but Humana offers coverage through some of their supplemental plans, called riders. We can let you know if your plan has one of these riders.
Humana also offers certain member discounts and programs that you might be able to take advantage of to lower the cost of treatment. Ask us for more information by calling (812) 532-3011.
What is TruHearing?
Many of the Humana plans have a relationship with a company called TruHearing, which is probably the most common one that we see.
Now, what is TruHearing?
TruHearing is a third-party managed care company that works and has a relationship with multiple insurance companies and specifically Humana.
What we’ve found is that there are three different policies within this.
#1 Discounted Hearing Aids
TruHearing partners with Humana to provide you with discounted hearing aids.
But the key thing to remember here is that they’re discounted premium hearing aids – but it’s not the cost of the hearing aids that is being deducted. They cost you less because they’ve cut out many of the service components that you get when you go direct to a medical provider.
Instead of getting services for a year, or two, or three, you might only get two or three visits in total. This is something that we can sit down and discuss how this works for you long term.
Another policy type that Humana offers with TruHearing is what would be considered a funded benefit, where you will pay a copay and you will get premium hearing devices, and Humana and TruHearing will work out the logistics of your benefits to ensure the coverage works for you.
#3 Humana Medicaid
Humana also offers a program called Humana Medicaid – it’s income based and there’s no out of pocket for that individual.
So again, you will come in and we will be able to work with you to get you hearing successfully.
The first step is to provide your member ID number to us. As mentioned earlier, we can do this at the beginning of the phone call, or you can bring it into your initial appointment so that we will investigate your options for you.
The key piece that I tell people when dealing with a Humana policy that partners with TruHearing for benefits is that the actual devices themselves are being purchased from TruHearing.
So from an insurance standpoint, Flex Audiology isn’t included in that process. Once the benefit is accessed and accepted through Humana, TruHearing will send the devices to Flex Audiology, and then we will be your service provider to make sure that you are fit appropriately.
This way, you’ll know how to take care of your hearing aids and where to get supplies. So, for Southern Indiana patients – we’re usually the local touch point that partners with Humana.
Want Us to Check Your Insurance Benefits for You?
Hopefully, that answers your questions, but considering that insurance coverage is based on a range of unique factors, the best first step is to have your hearing specialist check your benefits for you.
At Flex Audiology, we will work with you to maximize any benefit that you might have.
To check your insurance benefits with us today, simply fill out the form on this page, and our insurance expert will get back to you as soon as possible.