Insurance, Coverage & Financing
An honest look at what insurance does and doesn't cover, the benefits that may be available to you, and how we keep premium hearing care within reach — regardless of if you have insurance coverage or not.
Benefits That May Apply to You
Insurance may help — here's how.
We work with a lot of our patients using Medicare Advantage and most commercial insurance plans on an out-of-network basis. We walk you through the claim submission process so you can take full advantage of any coverage available toward your hearing care. These are the most common pathways our patients use.
Most Commercial Insurance Plans
State-regulated commercial plans subject to Maine's LD 38 mandate may cover up to $3,000 per hearing aid every 36 months. We help confirm whether your plan qualifies and walk you through the claim submission process so you can utilize your coverage.
BCBS FEP Standard Option
Federal employees and retirees may have an out-of-network benefit of up to $2,500 per hearing aid every five years. Requires prior authorization and documentation of hearing loss greater than 26 dB. We assist with the full process.
Workers' Compensation
Workplace noise-induced hearing loss is commonly covered — especially for current and former shipyard, manufacturing, and industrial workers. We work with patients, carriers, and adjusters to support approved claims.
Pre-Tax Health Accounts
Hearing aids, evaluations, and related services are HSA and FSA-eligible. Pre-tax dollars effectively reduce your cost by your marginal tax rate, and combine with reimbursement and financing.
The Reality of Coverage
Most plans don't cover hearing aids the way you'd expect.
Hearing aids are one of the most impactful health investments a person makes — and one of the least well-covered. Maine passed a state mandate requiring coverage, but most plans we see are exempt. Here's where the gaps usually show up.
Original Medicare
Does not cover hearing aids, fittings, or routine fitting exams. This federal exclusion has stood since 1965. Physician-ordered diagnostic exams are covered; the devices are not.
Medicare Advantage
Many plans include a hearing aid "discount" — but it's almost always administered through a third-party managed care discount company that steers patients toward limited device catalogs.
Self-Insured & Federal Plans
Maine's LD 38 mandate doesn't apply to Medicare, Medicare Advantage, self-insured employer plans, or federal employee plans — which together cover most of the patients we see.
How Riverside Hearing Care Works
Direct care. Built around you.
Most hearing practices are tangled up in insurance networks — which means the insurance company has a say in what devices you get, how many follow-up visits you're allowed, and sometimes which provider you see. Riverside Hearing Care was built specifically to avoid that.
Time for the Appointment You Need
No reimbursement schedule dictating how long a fitting can run. Real Ear Measurement and Electroacoustic Analysis are performed at every fitting — not optional, not skipped, not rushed.
The Right Device for Your Hearing
Without network contracts steering us toward specific manufacturers, we recommend the device that's right for your hearing loss and lifestyle — not what's covered.
Follow-Up That's Built In
Our 3-Step Renewal Fitting and Follow-Up Program is structured care from week one through year three — delivered by your licensed provider, not handed off to support staff.
If Your Plan Directs You to a Discount Network
Comparable pricing. No clinical compromise.
A growing number of insurance companies — more commonly Medicare Advantage — refer patients to third-party managed care discount companies instead of paying providers directly. These aren't insurance benefits. They're intermediaries that negotiate volume pricing and contract with provider networks, often with significant tradeoffs in technology access, follow-up care, and provider choice.
The Riverside Hearing Care Managed Care Discount Program
You shouldn't have to choose between a discount and great care.
For patients whose insurance directs them toward a third-party managed care discount company, we offer our own discount program — bringing pricing closer to what those networks offer, often on technology they don't even provide access to, while maintaining the full scope of best-practice care you deserve.
- Real Ear Measurement at every fitting
- Electroacoustic Analysis at every fitting
- Validated Outcome Measures
- Guided Auditory Rehabilitation
- Full Renewal Fitting & Follow-Up Program
- Access to current premium technology
Financing Options
Cost should never be a barrier to better hearing.
Even with insurance benefits or our RHC Managed Care Discount Program, hearing aids are a meaningful financial commitment. We've partnered with Cherry Financing to offer affordable monthly payment options — including 0% interest plans for qualified patients. Use the calculator below to estimate your monthly payment and apply in minutes.
Frequently Asked Questions
Answers to what patients ask most.
Quick answers to the questions we hear most often. Don't see yours? Give us a call — we're happy to walk through your specific situation.
Does Medicare cover hearing aids?
Original Medicare does not cover hearing aids, fittings, or routine exams for fitting purposes. This federal exclusion has been in place since 1965. Diagnostic exams ordered by a physician are covered, but the devices themselves are not.
Does the Maine LD 38 mandate apply to my insurance?
Maine's LD 38 mandate requires state-regulated commercial insurance plans to cover up to $3,000 per hearing aid every 36 months. It does not apply to Medicare, Medicare Advantage, self-insured employer plans, or federal employee plans. We help confirm whether your specific plan qualifies.
Does BCBS FEP Standard Option cover hearing aids?
Yes. Federal employees and retirees enrolled in BCBS FEP Standard Option have an out-of-network hearing aid benefit of up to $2,500 per hearing aid every five years. Prior authorization and documentation of hearing loss greater than 26 dB are required. We assist with the full prior authorization process.
Can I use my HSA or FSA for hearing aids?
Yes. Hearing aids, hearing evaluations, and related services are HSA and FSA-eligible expenses. These pre-tax dollars effectively reduce your out-of-pocket cost by your marginal tax rate. Many patients combine HSA or FSA funds with insurance reimbursement and Cherry Financing.
What is a superbill and how do I submit one?
A superbill is an itemized receipt that includes the diagnosis codes, procedure codes, and clinic information your insurance carrier needs to process out-of-network reimbursement. We provide a complete superbill at the conclusion of services. You submit it directly to your insurance carrier per their out-of-network claim instructions.
Does workers' compensation cover hearing aids?
Hearing loss related to workplace noise exposure is commonly covered under workers' compensation — especially for current and former shipyard, manufacturing, and industrial workers. The federal Longshore and Harbor Workers' Compensation Act covers many maritime workers. We work directly with patients, carriers, and adjusters to support approved claims.
Do you accept TruHearing, HearUSA, or Amplifon?
We do not contract with third-party managed care discount companies. For patients whose plans direct them to these networks, the Riverside Hearing Care Managed Care Discount Program offers comparable pricing on a fuller range of technology while maintaining best-practice care including Real Ear Measurement and Electroacoustic Analysis at every fitting.
What if I have Medicare Advantage with a hearing aid benefit?
Most Medicare Advantage hearing aid benefits are administered through third-party managed care discount companies that limit device selection and required follow-up care. Our in-house discount program brings pricing closer to those networks while preserving full clinical scope. You're welcome to schedule an evaluation to compare options before deciding.
Let's figure out your coverage together.
Every patient's situation is different. Schedule a hearing evaluation and we'll walk through your options — no pressure, no surprises.
Schedule a Hearing Evaluation Call 207-481-3451