Hearing aids: assumption of costs

 People with statutory health insurance who need a hearing aid usually receive a contract price of up to 685 euros per hearing aid. In certain cases, the cost coverage can increase to 840 euros.

The essentials in brief:

• Health insurance companies are legally obliged to pay for hearing aids if they are medically necessary.
• The claim includes adjustment, testing of the devices, maintenance of the devices and repair.
• It is important to find out with the ENT doctor or the hearing aid acoustician exactly which model is best suited for your impairment.
• Fixed rates apply to hearing aids and hearing aids. Fixed amounts are maximum prices up to which the health insurance companies will cover the costs for a prescribed aid.

The problem of hearing loss is widespread. According to the German Association for the Hard of Hearing, 19 percent of the German population is hearing-impaired.

Hearing aids are intended to compensate for hearing deficits. They are intended to alleviate or eliminate communication restrictions in everyday life. On the one hand, by amplifying noises. In addition, hearing aids can also be about:

• Improve speech understanding in ambient noise
• enable spatial hearing
• to reduce the impairment of tinnitus

Hearing aid - who pays for what?

Basically, if an ENT doctor prescribes a hearing aid, the statutory health insurance company will cover the costs. However, only for the medically necessary checkout device. If you want a higher-quality, more visually appealing and more expensive device, you have to pay the additional price yourself .

Whether the basic model paid for by health insurance is sufficient depends on many individual factors and cannot be generalized. What is sufficient for one person is completely insufficient for another.

Statutory health insurance companies usually pay a contract price of €685 per hearing aid , plus a flat rate of €33.50 for individually manufactured earpiecesand a service fee for repair work of approx. 125 € . If the hearing loss is bordering on deafness, the cost of the hearing aid increases to around €840. The second hearing aid can be replaced after six years at the earliest. The specific assumption of costs hardly differs depending on the health insurance company. Insured persons only pay a statutory additional payment of a maximum of 10 euros per device for a hearing aid that is free of charge (health insurance model).

In addition, the health insurance also covers the costs for consultation and adjustment of the device by a hearing aid acoustician. And for repairs: In the case of hearing aids that are free of charge, the repairs are covered for a period of 6 years.

Tip: If you decide against a health insurance device for medical reasons and for a device that is not free of charge, you should always apply to your health insurance company to cover the additional costs .

Hearing aid: When am I entitled to a fitting?

Hearing loss is a limitation of the ability to hear. It ranges from a minor impairment to complete hearing loss. Hearing loss can be temporary or permanent.

The guideline of the Federal Joint Committee on the prescription of aids in contract medical care specifies exactly which hearing impairments can be treated with a hearing aid . For this purpose, the ENT doctor must clarify whether medical or surgical treatment options are also possible.

How does the fitting of a hearing aid work?

When a prescription is made for the first time, the ENT doctor must determine the cause of the hearing loss and the degree of impairment in various tests. In addition, it is checked whether the patient is able to operate the device and wants to wear a device at all.

Depending on the results of the medical history and the associated tests, a hearing aid is prescribed. Air conduction hearing aids are usually considered the standard of care . There are as

1. Behind-the-ear devices or
2. in-the-ear devices.

In medically justified cases, supply with other types of devices is also possible. It is therefore advisable to discuss with your ENT doctor which hearing aid is best suited to your specific situation.

Satisfaction with a hearing aid is significantly influenced by the initial fitting by the acoustician. He or she must adapt the hearing aid to the individual hearing loss pattern of the person concerned based on the doctor's prescription. This fine-tuning is usually not done in a single appointment and takes place several weeks after purchasing the hearing aid. After the fitting, the doctor treating you will carry out a check-up. Here it is tested whether the desired improvement could actually be achieved.

Summary – Your journey to hearing aids

1. Find out from your health insurance company about the benefits they provide . The Hörakustik specialist company will take care of the correspondence with the health insurance company for you. The specialist staff will obtain the approval there and settle accounts with the health insurance company.
2. Visit your ENT doctor, who will determine your degree of hearing loss and issue the prescription for a hearing aid.
3. Then consult a hearing aid acoustician. Get detailed advice on the quality of hearing aids that are fully paid for by health insurance and those that require you to pay extra. Let us explain: What are the differences?
4. Test: Do you even notice the differences? And ask yourself: would the improvement be worth paying for? Make sure they don't sell you a more expensive device than what you want. Take enough time to adjust the device and visit the acoustician as often as necessary until everything fits.

Tip: All hearing aid acousticians are obliged to provide you with "insured information on hearing aid supply". In this you will find all the essential information easily presented. Have this information for insured persons handed to you.

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