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Cookie Bite Hearing Loss - Hearing Aids & Insurance

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Edited

UPDATE 5/21/26
*UPDATE*
After a lot of rigamarole and hours on the phone with Tricare - it turns out that the audiology office had incorrect NPI codes in the Tricare/TriWest system. The actual audiologist’s NPI is in and says covered, but from a previous office he worked for. The NPI connected to the office is actually the NPI for a totally different company.
So, while I was fully approved for my hearing aids and appointments, Tricare paid the original office visit and testing claim, the audiology office took the stance of “see, we’re not under contract, so we are not moving forward,” and at this point, that is fine with me. It is a bummer since the actual was great. I will now have to start this entire process over again and find a new office.

At least I do know that my hearing aids and all associated visits will be 100% covered, and I will owe $0 out of pocket. Just a real PIA.

UPDATE 5/5/26
Apparently the audiologist submitted a pre-auth to Tricare and I found out today EVERYTHING was approved! The actual and all associated visits. I am now waiting on next steps.

Hi! Totally new here!

I’ve gone my whole life thinking “I’m a little hard of hearing” and would fail my hearing test in elementary school, but I guess not enough to warrant follow up by my parents? I’ve also had tinnitus for as long as I can remember. (39 now) I didn’t even realize I had tinnitus until my active duty husband was being treated for his. :woman_shrugging: It’s just normal to me? I’ve been reading lips & using captions forever.

At the behest of my husband and teens I finally saw an audiologist.

I have cookie bite hearing loss both ears, + two tones of tinnitus.

Two questions:

1. The Oticon Intent 1s were recommend for my type of loss + tinnitus… at the tune of $7k. :flushed_face: (I’ve since learned an immense amount about the audiology field + hearing aid sales).

-Is this a good fit for someone with my issues?

2. My husband is active duty army (US) and our insurance covers HAs + all visits/care 100%, but I’m getting push back from the audiologist saying that it isn’t covered.

I’m now feeling like I’m being ghosted by the office.

- Does anyone have Tricare Prime Active Duty and gotten hearing aids??

Thank you so much y’all!

I’m a little overwhelmed. Lots of health issues here already and audiology seems like a whole other world!

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Definitely get a second opinion, your insurance covers 100% so you just need to find an audiologist clinic that accepts it, is the of any use here?

Unfortunately, no. I’m the spouse, so it’s 100% covered by an network audiologist. This is an in network audiologist (all confirmed before the initial appt).

They just kept saying no insurance covers and they cant go through insurance and I have to pay out of pocket.

(which i know is wrong)

Report this back to your tricare representative. Your audiologist is wanting you to pay for it as tricare will never pay the full $7000. You will have to force the issue. Your other choice is to have tricare to recommend a different audiologist.

Edited
@cvkemp said:

tricare to recommend a different audiologist.

@MrsRalph, Ask for a second opinion. I found this (below) on this.webpage3

criteria:
Adults with: Hearing threshold of at least 40 in one or both ears when tested at 500, 1,000, 1,500, 2,000, 3,000, or 4,000Hz; or hearing threshold of at least 26 dB HL in one or both ears at any three or more of those frequencies; or speech recognition score less than 94%. Children with: hearing threshold level of at least 26dB in one or both ears when tested at 500, 1,000, 2,000, 3,000, or 4,000Hz.

Best wishes,
WH (USAF vet from long ago)

In reply to @WhiteHat

Yes. I meet all of this and actually sent a screen shot of the tricare.mil webpage to the audiologist. I’ve had zero communication from them since.

I’ve been on the phone with Tricare a lot, I’ll have to call again.

Edited

In reply to @MrsRalph

I fully understand I am a Navy veteran with service related hearing loss on top of a cookie bite hearing loss. I get my aids from the . I live in an area with many retired veterans and hear the experiences of the veterans and their spouses. Tricare is good but yes all doctors and hearing care etc seem strapped for money and it is the needy patients that are getting screwed.

Hi. Performing musician (piano, studio, live) and I have similar loss as you described. I ended up with Widex Allure aids. I use them in the “music” mode which removes extra processing. I’m very happy with them. Very gentle on my ears too. I use vented cones to maintain some acoustic orientation and I’ve recently started mixing again with really good success and confidence. Being a musician and having hearing loss along with learning to use hearing aids was a difficult process as I’m sure many can relate to who are reading this. Best wishes, good luck.

Oticon Intent 1’s are solid. We do real ear speechmapping with everyone, and I have found them to be the most reliably able to meet prescriptive targets. You would probably do well enough with non-custom , but custom earmolds would allow for more customized acoustics and venting.

In reply to @cvkemp

It may be naive, but I have in the past had reached out and be heard by my Governor’s office, Senator and Representative office. There are aids who cover the phones. Your issue should be addressed under the category of military family “in need of support and intervention” but it also falls under the category of insurance denying a covered benefit. Our elected officials are tasked with all of these issues and what you would ask for is that their office intervene. They will likely call Tricare and then call the audiologist. Another outlet for “we the people” of this great land is the local newspaper. Here it would be the Boston Globe, but whatever newspaper covers the city where your Governor’s office is located. There are journalists who track and will intervene or at least hunt down a story such as yours by investigating it further. Just ideas. It cannot hurt to reach out to others. I’ve learned in my own life the best outcomes happen when I reach out despite my cynicism that anyone even cares or will help me. However if I may support your spouse who lovingly steered you toward being tested. There is so much evidence denying ourselves treatment and aids for hearing loss is not just an inconvenience it effects our brain – the brain shrinks – it is not a good investment in the health of your brain and even balance as you age to ignore treating hearing loss sooner than later. I think you are on the way. I hope you keep reaching out but at this point getting your story profiled in a news article or part of a conglomerate of stories captured in one story usually gets the “rats” out from below the floor boards where they hope to hide their practice of obstructing the client from using insurance, for example. And no one wants a call from the Governor or local Senators. You do have them there for you. Please keep us posted. We all care for you!

I am a veteran and when I had issues with my claims I contacted my representative and senator. I also used also contacts in the agency I was assigned to.

Smart! I thought I was on to something. It has taken me half a lifetime to ask for help when I needed it. We deserve to be helped by others as much as they deserve to be helped by us. Life on life’s terms. I always kept things to myself other than family but then joined a group and inside that group learned that it is healthy to ask for help, a form of self care.

I have been wearing aids for 21 years. I never wanted aids that weren’t visible. I wear my hair in a military flattop. So my aids are definitely visible. I always tell people up front that I am hard of hearing. I am rated 50% disabled due to my hearing loss. My audiologist makes sure I have two sets of hearing aids updated and to the latest fittings at all times.

In reply to @RAISSA

Thank you for this! My husband has actually suggested the same, either reaching out to our congressman or to our local news (they have a special segment where they dig in to this type of thing for people).
So right now I am waiting to see if I get my refund they way it should happen. Then I am waiting to see how and/or if they move forward with the hearing aids and insurance. I also have all the information I need to escale this through Tricare so that they can no longer be contracted if they are not honoring the contract.
I’ll definitely update. No matter what, I need hearing aids from somewhere. My primary doc moved me to the on base in the army hospital, I see them next month.

Welcome and thank you for your service to you and your husband.

I have Oticon Intents 1s and don’t think they are worth 7k. I went through Zip Hearing and paid a lot less like 4800ish. I don’t even think they are worth that to be honest. I also have Jabra Enhance 700 that I purchased directly from Jabra for about 1800. I feel these perform equally as well except in really crowded environments. These are considered over the counter so some insurance may not cover it (not sure about military benefits).

My story is similar to yours but I went a lot longer before getting HA which I first got in August so not even a year. You’ll notice you’ll be less exhausted from social interactions once you get used to them and feel more engaged in conversations. We use up a lot of brain energy keeping up with conversations when we can’t hear well and have to lip read and listen very carefully.

It may be an adjustment but totally worth it long term. I wish I had gotten aids sooner. They’ve also helped me not to notice the tinnitus as much. It’s still there but my attention isn’t in it because I can hear so much more now.

Best of luck! This place is great.

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