Paying for upgrades
Learn about the options to pay for a sound processor upgrade and what services Cochlear has to help you navigate the process.
What you'll find on this page
- Three ways to pay for a sound processor upgrade
- Cochlear Reimbursement and Insurance Services team
- Frequently asked questions
We can help you navigate the insurance system
Nucleus® 8 and Kanso® 2 Sound Processors
To discuss cost options, book an appointment to talk to an upgrade specialist.
Baha® 7 Sound Processor
To discuss cost options, book an appointment to talk to an upgrade specialist.
Upgrading your Nucleus or Baha Sound Processor
At Cochlear, we are here to help you along your entire hearing journey — including making sure you understand your insurance coverage and the various payment options available. Our Reimbursement and Insurance Services team will work directly with your insurance provider so you can avoid the hassle and focus on enhancing your hearing experience. We also have options if you choose to self-pay for your new sound processor. Below, explore payment options for your Cochlear sound processor upgrade.
Three ways to pay for a sound processor
This option applies if you have Medicare, Medicaid, or private health insurance or a combination of those coverages. Our reimbursement specialists can assist you in accessing your benefits and support you through the process.1
What are the benefits of using Cochlear Reimbursement and Insurance Services?
- Experts to help guide you through the process
- We understand navigating insurance may feel overwhelming. Our experts will guide you through every step of the process, keep you updated on your order status and answer any questions you may have.
- You won't have to deal with the insurance company on your own
- When utilizing our Reimbursement and Insurance Services, we work directly with your insurance so you don’t have to. Our experts can navigate the insurance details and streamline the process to make it easier for you.
If you are uninsured or insured but do not have an insurance benefit available and would like to access the latest technology now, you can take advantage of the discounted self-pay price.
For Nucleus Sound Processors, the price is $7,700 USD when you trade-in a non-retired sound processor.2 If you choose to keep your existing processor, the self-pay cost is $10,700 USD.3,4
For Baha Sound Processors, the price is $3,830 USD when you trade-in a non-retired sound processor.2 If you choose to keep your existing processor, the self-pay cost is $4,830 USD.3,4
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Self-paying allows you to access the latest technology sooner, but may cost you a bit more.
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If you do not have health insurance coverage or you have a benefit exclusion on your plan, self-paying may be the best option.
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If you are not yet eligible for a sound processor replacement through your insurance, you may choose to wait until you become eligible in order to take advantage of your benefits. The eligibility for a sound processor replacement varies based on your insurance plan. Contact us to learn about eligibility for your specific insurance plan.
Your upgrade may qualify for reimbursement for the purchase under your insurer’s replacement sound processor benefit.
- Call the Member Service phone number listed on the back of your insurance ID card and provide HCPCS (Healthcare Common Procedure Coding System) code L8619 for Nucleus 8 and Kanso 2, and codes L8691 and L8694 for Baha 6. The codes are used when billing insurance for a replacement sound processor. Before you finalize the order, be sure to confirm your insurer's required procedures. If a pre-authorization step is available, inquire about the steps. Also, request an in-network exception.
- Once you have fulfilled the proper steps, complete your order form and send it, along with your preferred phone number or email address, to recipient@cochlear.com.
- Download a Pre-Authorization/In-Network Request Sample Letter.
- Follow your insurance plan's procedures for seeking reimbursement on your sound processor replacement order.
Frequently Asked Questions
The cost of an upgraded sound processor varies based on if you choose to self-pay or use your insurance. Insurance plans vary widely. To understand your specific out-of-pocket cost, please contact Cochlear or schedule an appointment with a Customer Relationship Specialist.
Insurance typically covers a portion of a medically necessary upgraded sound processor. However, plans vary widely. Contact Cochlear or schedule an appointment with a Customer Relationship Specialist to determine your insurance coverage and understand your out-of-pocket costs.
Cochlear provides direct insurance billing on your behalf when you are insured by private insurance, Medicare (including HMOs), many state Medicaid plans (including HMOs), and TRICARE. The Cochlear Reimbursement and Insurance Services team navigates the insurance process for you, including helping with approvals and paperwork, so you can avoid the hassle of the insurance process.1
Upgrading your Cochlear Sound Processor is an exciting, rewarding and personal choice that deserves a unique and personalized journey. We are here to help you confidently select the best option for you. Contact us at 1-800-790-8737 to get started today.
Disclaimer
Please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always read the instructions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.
Views expressed are those of the individual. Consult your health professional to determine if you are a candidate for Cochlear technology.
For a full list of Cochlear’s trademarks, please visit our Terms of Use page.
The Nucleus 8 Sound Processor is compatible with the Nucleus Profile Plus, Nucleus Profile Series, CI500 Series, CI24RE (Freedom) Series, CI24R and CI24M implants. The Nucleus 8 Sound Processor is not currently compatible with the Nucleus 22 (N22) Implant.
The Kanso 2 Sound Processor is not compatible with N22 Implants.
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, NH, NJ, NM, NV, NY, OH, OK, OR, PA, SC, 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.
‡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.
*This promotional offer is only available to customers who wish to pay out-of-pocket and not seek reimbursement from any third-party payer, such as Medicare, Tricare, or Kaiser nor use Cochlear’s Reimbursement and Insurance Services. If you have active Medicaid coverage and this item is covered by your plan, you are not eligible for this offer as you must use your Medicaid coverage for covered items. This offer is subject to eligibility verification and we may cancel or modify your order if you do not meet the criteria.
**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. Please 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.
^You may trade in one (1) commercially available sound processor when you choose to self-pay. This offer excludes upgrade orders placed through Reimbursement & Insurance Services. Limit 1 trade-in per upgraded device.
1As 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.