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Health Insurance Question

Health Insurance Question

Old Jul 17th 2020, 9:22 am
  #1  
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Default Health Insurance Question

Some of you may remember, In August of 2017 I got some new hearing aids on my health insurance. Since then, I moved jobs and got a health plan on a different insurance company. My hearing aids are recommended to be replaced every 3-5 years due to the fast changing technology and my needs as a young person in a busy work environment to keep up with improvements in hearing technology.

My new insurance says I can replace hearing aids every 3 years, so should I wait the exact date of 3 years has passed by, or is it okay to begin the process sooner because it is a different insurance provider than the one I got my current hearing aids on? Also, my current plan has me copay 30% of the cost, after the $1,500 deductible is met. Am I right in thinking this means I pay $1,500 towards the new ones and then the insurance will pay 70% on the remaining balance?

Thanks in advance for any help understanding this. Health insurance in the USA still confuses me!
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Old Jul 17th 2020, 11:08 am
  #2  
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Default Re: Health Insurance Question

My new insurance says I can replace hearing aids every 3 years, so should I wait the exact date of 3 years has passed by, or is it okay to begin the process sooner because it is a different insurance provider than the one I got my current hearing aids on?
Different provider, new timescale. You could get another pair now since you haven't made a claim to this benefit on this plan before (unless of course there is a qualifying period)

Also, my current plan has me copay 30% of the cost, after the $1,500 deductible is met. Am I right in thinking this means I pay $1,500 towards the new ones and then the insurance will pay 70% on the remaining balance?
Right. So if they were $5,000 you would pay the $1,500 deductible and then another $1,050 as the 30% copay on the balance for a total of $2,550. The insurance company would pay 70% of the remainder so would pick up the tab for $2,450 according to the information you have provided.
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Old Jul 17th 2020, 7:34 pm
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Default Re: Health Insurance Question

Originally Posted by civilservant View Post
Different provider, new timescale. You could get another pair now since you haven't made a claim to this benefit on this plan before (unless of course there is a qualifying period)



Right. So if they were $5,000 you would pay the $1,500 deductible and then another $1,050 as the 30% copay on the balance for a total of $2,550. The insurance company would pay 70% of the remainder so would pick up the tab for $2,450 according to the information you have provided.
If your current ones work and assuming your deductible is on a calendar year, if you don’t anticipate any other large expenses on your Insurnace this year you might want to wait till it resets on 01 Jan 2021. And if anything does come up this year you can always get them sooner.
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Old Jul 17th 2020, 8:16 pm
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Default Re: Health Insurance Question

Originally Posted by tht View Post
If your current ones work and assuming your deductible is on a calendar year, if you don’t anticipate any other large expenses on your Insurnace this year you might want to wait till it resets on 01 Jan 2021. And if anything does come up this year you can always get them sooner.
I was thinking something similar. I am not familiar with the life of hearing aids, but given how much of the cost has to come out of your pocket, I would think that waiting until you needed to replace them would be a good strategy, or if hearing aids run the risk of "just stopping working one day", and (presumably) you need them to have a normal life, maybe get new ones and them store them until your current ones stop working (properly).

And to Tht's primary point, stacking multiple major medical expenses into one benefit year is a good strategy to maximize the amount that your insurance will pay out.


Last edited by Pulaski; Jul 17th 2020 at 8:18 pm.
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Old Jul 18th 2020, 1:58 am
  #5  
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Default Re: Health Insurance Question

Also that appears to be an HDHP, if you dont have it already you can use HSA money to pay for this. HSA money rolls over from year to year and is always your money.
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