Paying for upgrades

Although the process may seem overwhelming at first, we’ll be here to support you every step of the way.

Recipient Kenny and his wife

What you will find on this page

  • Three ways to pay for an upgrade
  • Navigating insurance

Did you know many insurers may cover 70-80% of the cost of a replacement sound processor?  While costs and coverage vary by health plan, on average you may pay $1,800-$3,000 for an upgrade.1 And, the best part is, our Reimbursement and Insurance Services team will work directly with your insurance provider so you don’t have to.

"...if you're dealing with Cochlear Americas, they will help you and make the process a lot easier."

- Donna - Mother of a Nucleus® 7 Upgrade Recipient

Navigating your insurance

Cochlear provides direct insurance billing on your behalf when you are insured by private insurance, Medicare, many state Medicaid plans (including HMOs), and TRICARE. The Cochlear Reimbursement and Insurance Services team navigates the insurance process for you by seeking prior authorization from these plans.1

Then, Cochlear will work to verify your insurance benefits, gather supporting documentation from your clinician, and determine your estimated out-of-pocket costs.

If you are interested in accessing our latest technology and you are not yet eligible to use your insurance benefits, we have programs to help you access a new sound processor.

 

1. 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. Coverage determinations and out-of-pocket costs may vary for individuals with private insurance.

2. You may trade-in one (1) non-obsolete Nucleus Sound Processor when you choose to self-pay. This offer excludes upgrade orders placed through Reimbursement & Insurance Services. Limit 1 trade-in per order.

3. This price does not apply when placing an upgrade order through Cochlear’s Reimbursement & Insurance Services. The Reimbursement & Insurance Service is a Premium Service. Upgrade will be billed to your insurance at the existing list price for the upgrade. Coverage and out-of-pocket expenses will vary depending on your insurance benefit coverage. Please make your selections on colors, sizes, and other options prior to placing your upgrade order. Pricing subject to change at any time. The following states require that sales tax be charged on upgrade orders: Alabama, South Carolina, Illinois, and Delaware. Note: This price does not include any additional fees that may be incurred during the programming of the processor with your hearing healthcare provider. Products can be returned or exchanged within 90 days of your upgrade shipment date at no charge.

4. 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 & Insurance Services.

The Nucleus 7 and Kanso Sound Processors are compatible with the Nucleus Profile Series, CI500 Series, CI24RE (Freedom) Series, CI24R and CI24M implants. The timeframe for Nucleus 7 Sound Processor compatibility for other implants depends on research and development timelines, manufacturing processes and regulatory approvals.The Kanso Sound Processor will not be compatible with the Nucleus® 22 (N22) Implant due to the Kanso Sound Processor's size and coil type. The Nucleus 6 Sound Processor is compatible with all implant models.

Cochlear is currently contracted with the following Medicaid states: AZ, CA, CO, CT, DC, FL, GA, IA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MN, MS, MT, NC, NE, NJ, NM, NV, NY, OH, OK, OR, PA, SD, TN, TX, UT, VA, VT, WA, WI, WV, and WY. The Reimbursement and Insurance Services is a Premium Service. Billable pricing, coverage and out-of-pocket expenses will vary depending on your insurance benefit coverage.