How does your insurance work?
Most insurance plans include a deductible and an out‑of‑pocket maximum. As you pay for care throughout the year, you move closer to meeting those amounts.
Once your deductible is met, your plan may cover up to 80% of eligible costs. After you reach your out-of-pocket maximum, covered costs are often paid in full for the rest of the year.
At the start of each plan year, your totals reset, and the process starts over. For most plans, this happens on January 1st.
If you have already met, or are close to meeting, either limit, this may be a good time to explore upgrading to the latest sound processor technology with a reduced out‑of‑pocket cost.
How do you know if insurance is likely to cover the cost of an upgrade?
Insurance requirements vary by plan, but in most cases, a sound processor may be eligible for an upgrade when it is out of warranty and supported by current medical needs. These needs can include:
- A documented improvement in hearing performance with next-generation technology
- The device no longer meets the recipient’s activities of daily living
- The device has been lost or stolen
- The device has reached the payer’s required timeframe for replacement, often 3 to 5+ years, depending on the plan
You’ll need to have seen your clinician in person or virtually within the last 24 months. Your clinician will also need to document your current need for an upgrade or replacement, which can be done through a portal message, email, phone call, or in-person visit depending on clinic and insurance requirements.
Note: Contact your insurer or Cochlear to understand the specific details of your plan.
What if you haven’t been to your clinic in the last 24 months?
If you haven’t been to your clinic in the last 24 months, even a short check-in or virtual visit can help make your records current and make the process easier when you start your upgrade. Insurance plans generally need to see notes from a clinician as to why an upgrade is necessary.
Where can you see if your warranty is active?
Log into your Cochlear Family Account, or check in the Smart App for your equipment. There you should see information on whether your warranty is currently active.
Alternatively, if you don’t have a Cochlear Family Account or the Smart App, you can call our customer service support line at 1-800-483-3123
Why should you upgrade now?
Insurance benefits generally reset every January. If you’ve already paid for care this year, your upgrade could cost significantly less right now than if you wait until next year.
To have your upgrade count toward your 2026 insurance benefits, your device must ship before the end of the year.
Please place your order and provide the required documentation by September 30th1 so we have time to verify your benefits, work with your insurance provider, and ensure your device is delivered to you in time.
How can you start an order?
If you are eligible and interested in upgrading, click the button below and fill out the form.
Please have your name, date of birth, clinic, and insurance information ready. Our team will walk you through the next steps and work directly with your insurance on your behalf.
Call: 1-844-671-6164
Email: upgrade@cochlear.com
Start the Order Online: Cochlear Store Home
What if you’re unsure if this new technology is right for you?
Cochlear offers a 90 day no questions asked money back guarantee on your device. If you try the new device out and it doesn’t deliver what you are expecting, you can return it to us, and we will provide you with a refund. Our goal is to make sure that your hearing system works for you.
What if you have cost concerns?
Through our partner CareCredit®, we offer financing options to help make your upgrade more manageable by spreading out-of-pocket costs over time. If this would be helpful for you, just ask about financing when you begin your upgrade.
You are not alone in this process. We are here to support you as you continue your hearing journey, today and into the future.
2- Orders placed on or before September 30, 2026, are not guaranteed to be approved by an insurer or shipped before December 31, 2026, the last available shipping date to meet the insurance deadline. Placing an order through Cochlear’s Reimbursement and Insurance Services does not imply approval from an insurance carrier.
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