HES Executive Director, Dr. Anne Orsene, Storms Capital Hill!

She is fighting for you! On November 14, 2019 our Executive Director, Dr. Anne Orsene, along with 175 other Audiologists from across the country, stormed Capitol Hill to gain support for the Medicare Audiologist Access and Services Act of 2019 (H.R. 2276, S.2575).

This act, introduced by Rep. Tom Rice, [R-SC-7], would enhance the Medicare benefit by providing beneficiaries critical direct access to both diagnostic and rehabilitative services provided by an Audiologist. It would remove unnecessary barriers, allowing patients to receive appropriate, timely, and cost-effective care. The goal of Lobby Day was to secure co- sponsors to help push this act forward.

Dr. Orsene, along with several other Audiologists from New York, met with five legislators and their staff to educate them on how this act would benefit Medicare recipients. Our NY team was extremely proud to have secured a co-sponsor for the act, Rep.Max Rose ,of StatenIsland.

Passage of the Medicare Audiologist Access and Services Act would dramatically improve audiology care for Medicare recipients.  It would enable them to have their choice of a qualified audiologist and would eliminate the need for a physician order to receive coverage of medically necessary audiology and vestibular services. It would also allow for Medicare coverage of treatment services such as vestibular rehabilitation, cerumen removal, and aural rehabilitation provided by audiologists.

Medicare’s archaic referral requirements must be modernized to allow seniors direct access to efficient, effective care.  All other federal programs as well as Medicare Advantage plans and most private health insurance plans already allow direct access to audiologists without first requiring a physician referral. Medicare patients should have the right to choose among all recognized providers for all Medicare-covered services as this comprises the majority of hearing health issues for the older adult population.

As a result of Lobby Day, 16 new co-sponsors were secured and the act now has 56 co-sponsors and has bipartisan support in the House and Senate.  Rest assured that HES will continue to fight for the rights of Medicare patients until this act is passed and will push forward to ensure that Medicare beneficiaries with a hearing or balance disorder receive timely treatment from an Audiologist.

 

 

Happy Insurance Season!

With insurance renewal season underway, we want to remind you that we have an on-staff Insurance Specialist, Valerie Schmidt, available during office hours to answer any and all questions that you may have about your hearing health coverage. This is yet another unique service offered at Hearing Evaluation Services. Here are a few important reminders to consider when renewing your insurance:

Flex dollars can be used for hearing aids. Whether you have flex dollars to spend before the end of the year, or if you are factoring in flex dollars with your new program…consider using it for better hearing.

Discounted hearing aid programs through your insurance are not the same as an insurance benefit. We also have in-house programs that many find even better than what some third party companies offer.

Your Audiologists will review all of your options at your appointment. Insurance typically covers baseline hearing tests.

The level of coverage or benefits for hearing devices depend on the insurance company, and the specific levels of benefits within that company.

To connect with our Insurance Specialist, Valerie Schmidt, call (716) 544-6210 or visit our “Ask the Insurance Specialist” page through our website at hesofbuffalo.org.

Hearing Insurance Programs – FAQs

There are so many different kinds of insurance programs out there, many of which seem to change year to year.  If you are confused, you’re not alone!  We have asked the HES Insurance Specialist, Valerie Schmidt to share with us some frequently asked questions she receives when it comes to insurance – and some helpful answers:

What does insurance typically cover?

Nearly all insurances cover baseline hearing tests. There is no minimum age requirement.  Other diagnostic tests are typically covered as well.  This would include balance or dizziness tests or more extensive hearing testing, if necessary.  There are also several different ways that insurance companies support hearing aids but there is a wide variety of ways they go about it.  It all depends on your insurance program.

Are Hearing Aids covered by Insurance?

There are a wide variety of programs for hearing aids, depending on the individual insurance company and specific insurance policy. Some companies allocate a certain amount they will contribute towards hearing aids.  Others participate with hearing aid discount programs, but unfortunately these programs can be extremely limiting in the type of device a patient can receive with very limited choices.  Many patients will also use their flex dollars towards their hearing aids or use it to upgrade to a more advanced device than what their insurance covered.

What is the difference between a hearing aid benefit and a hearing aid discount program?

A hearing aid benefit is money paid by the insurance company to pay all or part of the cost of any hearing aid the patient chooses. It is similar to how insurance companies cover costs towards eye glasses. A hearing aid discount program gives the patient access to hearing aids at a reduced price that the patient pays for entirely.  The insurance company pays nothing.  These discount programs often have a very limited selection available with limited services included.

Can I use flex dollars towards hearing aids?

Yes! Flex dollars can be used towards hearing devices and any custom ear mold offered through Hearing Evaluation Services.  Many patients use this as a way to upgrade from their basic insurance contribution to get a hearing device with some of the newest technological features – such as Bluetooth connectivity, functional smart phone apps, and rechargeable batteries.

What’s the biggest misconception when it comes to insurance coverage?

Unfortunately, some people think that access to discounted hearing aids is the same as an insurance benefit. It’s not. Since the insurance company does not actually contribute to the cost of the hearing aids, the patient pays the whole bill.  Additionally, many of these plans try to limit where patients can go to get their hearing aids and they work with high pressure sales companies.  When you come to HES, we will check your insurance and make sure you know all your options, we honor your insurance benefits or discounts, and we never use high pressure tactics.

If you have any questions about your insurance program, we encourage you to call Valerie Schmidt at 716-833-4488, or you can attend one of our upcoming complimentary insurance seminars.

Get to Know: Valerie Schmidt

As a non-profit organization, Hearing Evaluation Services of Buffalo aims to not only provide top-notch hearing healthcare but also to be a valuable resource to all of our patients about the entire process of learning about and treating hearing loss.

Valerie Schmidt is our on-staff Insurance Specialist, and the person who can help you with any and all questions regarding your hearing health benefits through your insurance program.

Valerie joined our team in 2013 with several years of experience in medical billing, consulting and auditing.  She continually grows her knowledge through continuing education as a Certified Medical Billing Specialist.

As the lead presenter of our complimentary insurance seminars, Valerie has been a key resource in helping patients better understand their insurance benefits and navigate the very confusing world of hearing health insurance.  She also handles all messages from our website for our special “Ask the Insurance Specialist” feature found on our home page.

If you have questions about your specific insurance program or would simply like to have a better understanding of hearing health insurance, we invite you to attend one of our complimentary insurance seminars, ask us through our website feature, or call our insurance line!

What is an Insurance Deductible?

Your deductible is the amount you pay for covered healthcare services before your insurance plan starts to pay. For example, with a $2,000 deductible, you pay the first $2,000 of covered services out of pocket, then your insurance begins to pay.

After you meet your deductible, you usually only pay a co-payment or co-insurance for covered services. Your insurance company pays the rest. Hearing aids typically count towards your deductible.

  • Many plans pay for certain services, like a well visit or disease management program, before you’ve met your deductible. Check your plan for details.
  • All “marketplace” health plans pay the full cost of certain preventive benefits, even before you meet your deductible.
  • Some plans have separate deductibles for certain services, such as prescription drugs.
  • Family plans often have both an individual deductible, which applies to each person, and a family deductible, which applies to all family members.

Generally, plans with lower monthly premiums have higher deductibles.  Plans with higher monthly premiums usually have lower deductibles.

This information, plus much more, including a full explanation of your hearing programs and benefits can be answered by our in-house Insurance Specialist.  You can contact her directly by clicking here.