Coverage of hearing aids by health insurance companies
Table of Contents
- 1 Coverage of hearing aids by health insurance companies – advice in Freiburg
- 2 The entitlement to benefits for hearing aids
- 3 The Hearing Aid Ordinance
- 4 Health insurance benefit and co-payment
- 5 The assumption of costs by the statutory health insurance companies
- 6 The cost of advice and adjustment
- 7 Conclusion
Coverage of costs for hearing aids by health insurance companies – advice in Freiburg
More than 14 million people in Germany are affected by a reduced ability to hear. become of it hearing aids used at about 20 percent. It is often not known that the health insurance companies if there is a medical necessity, we will cover the costs of what is known as a hearing aid. One assumption of costs must be clarified beforehand.
There are detailed guidelines and requirements for cost coverage and the required co-payment. At a Advice in Freiburg from your hearing care professional Andreas Holz you can obtain detailed and individual information about the respective regulations.
Coverage of health insurance companies – advice here in Freiburg
The right to care for hearing aids
The details of the prescriptions for hearing aids are laid down in the statutory aids guidelines of the joint federal committee. There are precise specifications as to the type of impairment of your hearing Hearing aids the right supply is.
An ENT doctor must clarify whether surgical or drug treatment might make sense for a specific impairment. One Coverage by the health insurance companies always assumes a medical need for a hearing aid.
In order to determine this, an examination by your ENT doctor is a prerequisite. The examination enables a tailor-made treatment, in which the hearing aids are specifically tailored to your impairment. At a Consultation in Fribourg You can find out about the regulations from your hearing care professional for reimbursement by the health insurance companies as well as the co-payment.
The Hearing Aid Ordinance
After a detailed examination of your hearing ability, your ENT doctor will issue you with a corresponding prescription for a hearing aid that is to be precisely fitted. You will need this for your follow-up appointment with hearing care professional.
Without the ordinance, there is no adoption of the Cost of the required hearing aids possible. Medical proof of an existing hearing loss is therefore a prerequisite for such a prescription.
The aid guidelines specify in detail which criteria must be met in order for you to Claim for reimbursement from your health insurance company to have. To this end, specific guidelines have been defined in the area of tone audiometric and speech audiometric hearing loss.
cash register payment and co-payment
Whenever a medical necessity for hearing aids is certified in writing by an ENT doctor and is linked to a corresponding prescription, you are entitled to one Coverage by the health insurance companies. The costs are only paid for the medically required health insurance product.
However, many patients often want a device that has a higher value or performance or a more attractive design. A supply with such an aid is always possible, but will not covered by the cash registers due to the additional costs involved.
In this case, you have to pay the additional costs that go beyond the reimbursement framework of the health insurance companies yourself in the form of an additional co-payment. During a consultation in Freiburg, your hearing care professional will tell you the exact regulations and also inform you about the different device models.
The assumption of costs by the statutory health insurance companies
the assumption of costs consists of various factors.
The cost of the device:
- Contract price per hearing aid up to 685 euros
- Flat rate for the production of individual earpieces over 33.50 euros
- Lump sum for repairs up to about 125 euros
If your hearing loss borders on deafness, you are entitled to higher amounts. In this case, around 840 euros will be paid for your device. For a second device, you can your insurance company will assume the costs apply after a period of six years at the earliest.
If you decide in principle for a so-called cash register model, which is free of own contributions and its costs are fully covered by your health insurance, the co-payment is significantly reduced. In this case, your co-payment is a maximum of ten euros for each hearing aid.
The cost of advice and adjustment
the statutory funds not only cover the cost of your hearing aid. You also pay for a consultation with your hearing care professional in Freiburg. Should you choose one purchase a device free of charge, the health insurance covers the repair costs for six years after purchase. This applies in principle to all repairs that become necessary during this period.
If, on the other hand, you have decided on a hearing aid that is associated with a personal contribution obligation, you must also make the corresponding co-payments yourself in the event of a repair.
Conclusion
A hearing aid provides you with valuable help in everyday life. You have a legal right to have the costs covered if you can present a prescription from an ear doctor. For a hearing aid that is approved as a health insurance model, you do not have to pay any of your own costs, apart from the additional payment of ten euros for the prescription.
Higher quality models are always associated with their own share in the amount that goes beyond the cash benefit.
Andreas Holz Hörakustik will be happy to provide you with information about the respective options and the modalities of cost absorption by health insurance companies as part of a consultation in Freiburg.
Andreas Holz
(hearing acoustics master)