Unlike hearing aids, cochlear implants may be covered by Medicare. They are also covered by many insurance plans and typically Medicaid.*
However, every health insurance plan is different, and we know that the insurance approval process can be confusing and frustrating. Here are the different types of insurance and the guidelines to help you through the process.
Your health plan’s coverage may vary based on:
- The terms of the coverage document in effect on the date of service
- Applicable laws/regulations based on the state you live in
- Medical coverage policies
Commercial health plan coverage varies by the plan you are on. You should work with your surgeon’s office to determine eligibility for coverage and benefits. Ask your health plan if they will provide a voluntary predetermination of benefits review. If yes, ask your doctor’s office to submit a predetermination packet to your health plan. For more information, go to our Insurance Resource Center and download the full guide.
Medicare may cover cochlear implant systems. You should work with your surgeon’s office to determine eligibility for coverage and benefits. Traditional Medicare does not offer an option for predetermination or prior authorization for coverage. For more information, go to our Insurance Resource Center and download the full guide.
Medicaid coverage for cochlear implants varies by state. Prior authorization of a cochlear implant surgery is generally required. You should work with your surgeon’s office to determine eligibility for coverage and benefits. For more information, go to our Insurance Resource Center and download the full guide.
The Cochlear™ Nucleus® Hybrid Implant System** is reviewed by insurance plans differently than a traditional cochlear implant system. Many insurance companies cover the Cochlear Nucleus Hybrid Implant System for patients who qualify as a candidate. Medicare may also cover. Contact your local hearing implant specialist to determine your eligibility for coverage.
Visit our Insurance Resource Center to get answers to your insurance questions related to Cochlear Implants, including the Hybrid Implant System.
*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.
** The Hybrid L24 Implant is approved in the U.S. only for adults 18 and older.
