So this is just amusing
The billing code shows up as "hearing aids and accessories". But, Connor is not using his FM system as an accessory (many kids get FM systems with their hearing aids) He is getting an FM system because he isn't a good candidate for a hearing aid.
So it should be Durable Medical Equipment. But the code is hearing aids.
Hearing Aids are covered at 100% (no copay, no deductible, no coinsurance) up to $1400 per ear every 36 months. I'm getting conflicting information on whether we're responsible for any amount over the $1400 per ear, or whether that is the contracted amount.
DME is covered at 90%, plus copay, plus deductible. No cap.
Every person I've talked to says that they see no reason why it wouldn't be covered, regardless of whether it processes as hearing aid accessories or DME. But the Audiologist is cautioning me that they've had these denied many times before.
I don't know what to think now!
We were going to get him only one receiver this year, and the second receiver next year, but if insurance is going to pay for it, then we're going to get him two receivers right away. I wish I knew so I could order the dang things!! I'm going to call the insurance company one more time, talk to a different person, and see if I get a different answer. Then just bite the bullet and have the audiologist order it I guess.