How much do implants cost?

Hearing implants may be an effective and affordable solution for you or your loved one. We’ll help you navigate the process.

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What you'll find on this page

  • Determine if a hearing implant is covered by private insurance plans, Medicare or Medicaid
  • Get answers to your frequently asked insurance questions
  • Contact our insurance experts for help navigating the process

The first step to knowing how much a hearing implant will cost is to get a hearing evaluation by a hearing health professional which specializes in hearing implant solutions. Other medical evaluations, X-rays or an MRI scan may be needed. It is important to find out if you are eligible for a hearing implant before obtaining insurance approval. After you find out you are a candidate for a hearing implant solution, you should know your health plan coverage and how to request and obtain insurance approval. Your hearing health professional will help you submit the necessary paperwork. Here are some tips and tools to get you started.

Insurance coverage for hearing aids vs. hearing implants

Unlike hearing aids, hearing implants are covered by Medicare.†† They are also covered by most insurance plans and typically Medicaid.* Contact your insurance company or local Hearing Implant Specialist to determine coverage as well as your estimated out-of-pocket expenses. The cost of the implant will vary from person to person based on their specific health plan.

Need help determining if a hearing implant is covered by your insurance plan? Review this chart to see a breakdown of coverage by policy type.

   Private Insurance  Medicare  Medicaid
 Cochlear Implants
(Nucleus® 7, Kanso® 2)
 Covered by most insurance plans*  Covered††  Typically covered**
 Cochlear™ Nucleus® Hybrid Implant  May be covered*  May be covered  May be covered*
Cochlear™ bone conduction solutions  Covered by most insurance plans*  Covered††  Typically covered**
 Hearing Aids  Typically not covered  By law are not covered  Typically covered**

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"The insurance, it was a gift from heaven. Medicare and my insurance, it was easy. There was no negotiating. I didn't have to fight anybody, so that process was minor. You just want to make sure you're covered as you would with any procedure and network provider."

- Tom K. - Kanso® recipient

Frequently asked questions

The cost of a hearing implant may be covered by insurance. Every health insurance plan is different. Coverage varies by insurance company, plan benefits, the type of hearing implant you may need and your hearing loss. Potential out-of-pocket costs associated with receiving a hearing implant will include any coinsurance, copay and deductible according to your insurance plan. You should contact your insurance provider to determine coverage as well as estimated out-of-pocket expenses prior to surgery. Some services that you will want to discuss with your insurance provider are:

  • Hearing evaluation and test costs
  • Implant components costs (hearing implant and sound processor)
  • Implant procedure costs (hospital, physician, surgery, anesthesia)
  • Battery costs
  • Follow-up visits and care
  • Rehabilitation

For private or commercial health insurance plans:

  • Most private insurance plans cover hearing implants.
  • Individual coverage, benefits and out-of-pocket costs will vary.
  • Please contact your insurance provider or clinic for more information.

For Medicare and Medicaid/CHIP plans:

  • Medicare covers hearing implants, both cochlear implants and bone conduction implants.
  • After completing your hearing evaluation, your audiologist will compare your results with the Medicare coverage criteria to determine your eligibility for coverage under Medicare.
  • Medicaid/CHIP covers hearing services for beneficiaries under age 21, and adults may be covered in some states.
  • Please contact your insurance provider or clinic for more information.

Download Medicare Guide

For Tricare plans:

  • Tricare covers hearing implants, both cochlear implants and bone conduction implants.
  • Individual coverage, benefits and out-of-pocket costs will vary.
  • Please contact your insurance provider or clinic for more information.

 

Your coverage and out-of-pocket costs will be determined by your insurance provider and your specific plan benefits. Your insurance provider can give you details specific to your plan. You can contact them by calling the number listed on the back of your insurance member ID card. Download the worksheet below for additional questions and billing code information that you can provide to your insurance provider.

Some common questions you may want to ask your health plan include:

  • Is a referral required?
  • Is my physician and/or hospital in-network?
  • Am I covered for surgery for a hearing implant?
  • Can you provide me with an estimate of out-of-pocket costs including any coinsurance, copay, or deductible costs for all providers related to the hearing implant surgery?
  • Do I need predetermination or precertification?

To see the full list of questions to ask your insurance provider, download the insurance worksheet.

 

Before obtaining insurance approval, you will need to visit a Hearing Implant Specialist to determine if you are a candidate for a hearing implant. It’s important that you find an audiologist who is trained in all hearing loss solutions, including hearing implants, as he or she will be doing a comprehensive evaluation and recommending the best treatment for you. The evaluation, which is covered by most insurance plans, typically consists of medical and audiological assessments, including X-rays and an MRI if needed.

Once it is determined that you are a candidate for a hearing implant, providers will begin to arrange for your surgery. This typically includes verifying your insurance benefits and obtaining any required authorization. Once authorization has been obtained, your provider or insurance company should notify you. You can also call your insurance provider to confirm you have authorization.

If it is necessary for you to obtain authorization, you should:

  • Contact your insurance provider and ask the question noted in the ‘Questions to ask your health plan’ section above.
  • Obtain the following from your hearing implant surgeon or specialist:
    • A written description of the procedure
    • A letter of medical necessity
    • Medical records
  • Submit a predetermination of benefits request to your insurance provider. Insurance companies often provide a predetermination form or request form. This form should be completed and submitted along with the information you have obtained from your hearing implant surgeon or specialist.
  • Follow up with your insurance provider every ten days.
  • If denied, verify the denial reason and your appeal options.
  • Initiate an appeal based on your denial reason.
  • Continue to follow up with the insurance provider until they render a final written decision.

 

To make the process easier, our Pre-surgical Insurance Support Team is available to help you obtain the necessary insurance approval and provide assistance in appealing denied coverage for Cochlear Nucleus Systems and Cochlear Bone Conduction Solutions.

For pre-surgical insurance questions, please contact:

Insurance Support Team
Phone: (800) 633-4667 (Option 4)
Email: OMS@Cochlear.com

 

Review the written response provided by the health plan and consider appealing the denial if:

  • The health plan defines the procedure differently than your physician has defined it.
  • The requested procedure was denied for medical necessity, and your physician has reviewed the medical policy and feels the criteria has been met.

Contact our Insurance Support Department for assistance with the appeal process.

Insurance Support Team
Phone: (800) 633-4667 (Option 4)
Email: OMS@Cochlear.com

 

Occasionally, health plans do not provide coverage for hearing implant solutions. In that instance, we have compiled a list of established funding sources for Cochlear Implants and Bone Conduction Solutions. Other sources of funding or small local programs may be available in your area. We recommend you contact your audiologist or hearing health specialist to find out information regarding current federal and state programs and resources that may be available in your community.

Some options to explore include:

  • Employer-Sponsored Health Plans: Check to see if your employer offers other health insurance plans and if those plans provide you with coverage for your hearing implant. It may be possible to switch during your open enrollment period.
  • State Health Insurance Marketplace: Research and explore the option of purchasing an individual plan that may provide you with hearing implant coverage.
  • Medicaid Coverage: Coverage for hearing implants vary by state and eligibility is subject to change. Some states have expanded eligibility under the Patient Protection and Affordable Care Act. Contact your hearing implant specialist or your state Medicaid program for more details.

Ask your insurance provider if your Heath Savings Account (HSA) or Flexible Spending Account (FSA) can provide you with financial support for your hearing implant.

To see the full list of funding options, download our Alternative Funding Worksheet.

 

Step-by-Step Guide to the Insurance Process

Step-by-Step Guide to the Insurance Process

700KB | PDF

Download now

Costs of your hearing implant and sound processor over time

No matter which Cochlear hearing solution is best for you, they are designed to allow access to sound processor technology upgrades as they become available without the need for additional surgery. The good news is that many health insurance plans will cover a portion of the cost to upgrade in addition to replaceable parts such as cables, coil, magnets and batteries.

Disclaimer

Please seek advice from your medical practitioner or health professional about treatments for hearing loss. They will be able to advise on a suitable solution for the hearing loss condition. All products should be used only as directed by your medical practitioner or health professional. Not all products are available in all countries. Please contact your local Cochlear representative.

Views expressed by Cochlear recipients and hearing health providers are those of the individual. Consult your hearing health provider to determine if you are a candidate for Cochlear technology. Outcomes and results may vary.

ACE, Advance Off-Stylet, AOS, AutoNRT, Autosensitivity, Beam, Button, CareYourWay, Carina, Cochlear, 科利耳, コクレア, Cochlear SoftWear, Codacs, ConnectYourWay, Contour, Contour Advance, Custom Sound, ESPrit, Freedom, Hear now. And always, HearYourWay, Hugfit, Hybrid, Invisible Hearing, Kanso, MET, MicroDrive, MP3000, myCochlear, mySmartSound, NRT, Nucleus, Off-Stylet, Slimline, SmartSound, Softip, SPrint, True Wireless, the elliptical logo, WearYourWay and Whisper are either trademarks or registered trademarks of Cochlear Limited. Ardium, Baha, Baha SoftWear, BCDrive, DermaLock, EveryWear, Vistafix, and WindShield are either trademarks or registered trademarks of Cochlear Bone Anchored Solutions AB.

*Contact your insurance company or local Hearing Implant Specialist to determine your eligibility for coverage.

**Coverage for adult Medicaid recipients varies according to state-specific guidelines.

†May be covered for patients that meet Medicare's current coverage criteria.

††Covered for Medicare beneficiaries who meet CMS criteria for coverage.

‡The Hybrid L24 Implant is approved in the US only for adults 18 and older for unilateral use only. The Cochlear Nucleus Hybrid acoustic component is not compatible with the Kanso or Kanso 2 Sound Processor. The Kanso or Kanso 2 Sound Processor are not intended to be used by Hybrid L24 Cochlear Implant recipients who receive benefit from the acoustic component.