We’re more than halfway through 2024, and it’s a great time to consider how to make the most of your insurance benefits before the end of the year. One option that might be available to you, is to upgrade your Cochlear™ sound processor if deemed medically necessary.
As you look to maximize your 2024 insurance benefits, Cochlear is here to help you navigate the process. If you’re ready to place your sound processor order, you can go to the online Cochlear Store or call Customer Service at 1-800-523-5798. If you would like to speak with an upgrade expert for help in the process or to learn about the benefits of new technology, you can book a virtual appointment here.
Cochlear can work with your insurance provider and clinician on your behalf. This includes collecting the necessary documentation to determine coverage and billing your insurance directly – even if Cochlear is not in-network with your insurance provider. Cochlear can also bill your insurance directly for covered parts and accessories, such as cables, coils, and rechargeable batteries if we are contracted with your provider.1234
Upgrade today to maximize your 2024 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 2024. Please note that the last day Cochlear will be shipping orders is December 27, 2024. 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 31, 2024, if you plan to use your benefits in 2024.5
Hear from an expert
We spoke with Brayden, an Upgrade Solution Specialist (USS), here at Cochlear. Brayden is an expert at helping recipients understand the benefits of upgrading to new technology and guiding them through the process.
“As a bilateral recipient who has gone through the upgrade process before being employed by Cochlear, I understand how cumbersome the upgrade process can be.
It has been a pleasure getting to assist recipients through the upgrade process and helping them understand what their insurance will cover and options to manage the associated out-of-pocket cost. Most people do not understand their insurance when it comes to sound processor upgrades.”
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 plan, once your deductible is met, your insurance will pay for a higher percentage of your covered services. This typically means lower costs to you.
If you’ve met your deductible, your insurance may cover a higher portion of the cost of a new sound processor. If you haven’t met your deductible, the costs from a new sound processor may help you reach your deductible. This could lower your out-of-pocket costs for the rest of the year.
Many 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.
In most cases, insurance will also cover medically necessary parts and accessories. This can include cables, coils, and rechargeable batteries. It’s worth checking if insurance will cover the cost of necessary parts or upgrades. A lot of people just assume insurance won’t cover anything. Cochlear’s Reimbursement and Insurance Services team are experts in the insurance process. You may be surprised!
Recipients save time and energy by having Cochlear work with insurance on their behalf. An insurance claim isn’t as simple as calling to be authorized or denied. The process can be frustrating and confusing. There is a fair amount of documentation, reviewing, and communication back and forth with the insurer. Reimbursement and Insurance Services is a great resource. Cochlear can help by taking on some of the heavy lifting off of your plate.
There are benefits of receiving an upgraded sound processor by the end of the year. It’s close to multiple holidays, and it’s special to hear about recipients hearing their relatives better at celebrations.
Want to learn more about our latest technology?
As part of our lifetime commitment to you, Cochlear is constantly innovating to improve comfort and performance. Our latest sound processors are designed to help you hear your best. Learn more about our next-generation Cochlear™ Nucleus® Sound Processor and Baha® Sound Processor technology.
To connect with a specialized upgrade expert, like Brayden, to better understand the upgrade process or the benefits of new technology, book a virtual appointment.
- 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 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: AL, AZ, CA, CO, CT, DC, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MN, MS, MT, NC, ND, NE, 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 31, 2024 are not guaranteed to be approved by your insurer or shipped on or before December 27, 2024, 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.
