We’ve made it halfway through 2021, and now is a great time to start considering how to make the most of your insurance benefits before the end of the year by upgrading your Cochlear sound processor.
As you look to maximize your insurance benefits before the end of 2021, Cochlear is here to help you navigate the insurance process. For upgrade orders, we’ll work with your insurance provider and clinician on your behalf, which includes collecting all the necessary documentation to determine coverage and billing your insurance directly – even if Cochlear is not commercially contracted with your insurance plan. In addition, Cochlear provides direct insurance billing for covered parts and accessories, such as cables, coils, and rechargeable batteries if we are contracted with your provider. 1234
Hear from a peer
Hear directly from Cochlear recipient Jack about his experience with Cochlear’s Reimbursement and Insurance Services.
Hear from an expert
To learn more about how to maximize your insurance benefits before the end of the year, we spoke with Lauren Klein, a Customer Relationship Specialist (CRS), here at Cochlear. As a member of the CRS team, Lauren is an expert at helping recipients understand the benefits of upgrading to new technology and guiding them through the upgrade process. “How deductibles work and why it’s important to use your insurance benefits before year end are some of the more common questions I receive,” Lauren says.
Maximizing your deductible
Your deductible is the specified amount of money that you must pay out-of-pocket before your insurance will pay toward your services. Depending on your specific plan, once you’ve satisfied your deductible your insurance will cover a higher percentage of your covered services, which typically means lower costs to you.
If you’ve already met your deductible, your insurance may cover a higher percentage of the cost of a new sound processor. If you haven’t yet reached your deductible, the costs associated with a new sound processor may help you reach your deductible and lower your out-of-pocket costs for the remainder of the year—including any orders for medically necessary parts and accessories. Either way, you could maximize your insurance benefits for the remainder of 2021 and lower your out-of-pocket costs.
“A lot of recipients don’t realize that upgrades are often covered in full or in part by insurance if their healthcare provider deems it to be medically necessary,” Lauren says. “It’s always exciting when I get to tell the recipient that the upgrade is more affordable than they think.”
In most cases, insurance will also cover orders for medically necessary parts and accessories like cables, coils, and rechargeable batteries. “When it comes to using your insurance benefits to upgrade or purchase necessary accessories, it’s always worth trying to see if your insurance will cover the cost or not. I speak with a lot of recipients that just assume their insurance won’t cover anything. Cochlear’s Reimbursement and Insurance Services team are experts in assisting recipients with the insurance process and obtaining reimbursement approval where possible. You may be surprised!”
To Lauren, “The biggest benefit for our recipients is the ability to save them time and energy by working with insurance on their behalf. I always try to remind recipients that a claim isn’t as simple as calling and getting authorized or denied. There is a fair amount of documentation, reviewing, and communication back and forth with the insurer during the authorization process. Reimbursement and Insurance Services is a great resource to help our recipients feel more empowered and help them focus more on their day to day life. The insurance process can be frustrating and confusing, so it is great that Cochlear can take on the heavy lifting for the recipient.”
Upgrade today to maximize your 2021 insurance benefits
It is important to keep in mind that benefit qualification by your insurance company is dependent on when your order is shipped from Cochlear, not when the order is placed. Insurance companies require replacement order claim submissions to have a ship date within the calendar year of 2021. Please note that the last day Cochlear will be shipping orders is December 30, 2021. Since the average processing time for a replacement sound processor order is approximately 6-8 weeks, we recommend that you plan ahead and place your replacement sound processor order no later than October 29, 2021 if you plan to use your benefits in 20215. Lauren recognizes the added benefit of being able to help recipients maximize their insurance benefits just before the end of the year. “Since it’s so close to the holidays, it’s great to hear stories of recipients being able to hear their relatives better at holiday celebrations or being able to open their sound processors as holiday gifts. This brings so much joy to my heart.”
Interested in learning more about our latest technology?
As part of our lifetime commitment to you, Cochlear is constantly innovating our hearing technology to improve your comfort, performance and usability. Our latest sound processors are designed to help you hear your best with more wearing options, wireless connections and new features. Learn more about our next-generation Cochlear™ Nucleus® Sound Processor and Baha® Sound Processor technology.
Contact us to make the most out of your 2021 insurance benefits and get started with your sound processor upgrade order today.
- Information provided by Cochlear Americas regarding insurance coverage or reimbursement is provided as guidance only and is not intended as reimbursement or legal advice. Cochlear Americas makes no representation or warranty regarding such information or its completeness, accuracy, fitness for a particular purpose, or that following such guidance will result in any form of coverage or reimbursement from any insurer. Information presented is subject to change at any time. To be sure that you have the most current and applicable information available for your unique circumstances, please consult your own experts and seek your own legal advice regarding your reimbursement needs. In all cases, products or services billed must be medically necessary, actually performed and appropriately documented in the medical record. You will be responsible for paying any applicable coinsurance, deductible, or amounts not covered by your insurance to Cochlear. Coverage determinations and out-of-pocket costs may vary for individuals with private insurance.
- As of Feb 1, 2018, Cochlear provides direct insurance billing support for many major private insurance plans, Medicare, Medicaid‡ (including HMOs) and Tricare for repairs, parts and accessories. Cochlear’s full-service billing support is available for recipients who are covered under one of the plans with whom Cochlear is contracted. If you would like to place an order for a replacement part or accessory, please keep in mind orders may take up to 2 weeks to process and ship, so please plan ahead.
- Please keep in mind, if you choose to self-pay today, you may not be able to submit a claim to your insurance on your own if Cochlear is contracted with your private insurance provider. Visit http://www.Cochlear.com/US/insurancelist to see if Cochlear is contracted with your insurance provider. If Cochlear is contracted with your insurance provider, we suggest placing your order through Cochlear’s Reimbursement and Insurance Services.
- ‡Cochlear is currently enrolled with Medicaid programs in the following states: AZ, CA, CO, CT, DC, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MN, MS, MT, NC, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, and WY.
- Orders placed on or before October 29, 2021 are not guaranteed to be approved by your insurer or shipped on or before December 30, 2021, 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 your insurance carrier.