New Fee Policy
Beginning January 1, 2026 our fee policy will change. Due to widespread changes in reimbursement and administrative practices across many insurance companies and third-party hearing benefit administrators, we will be implementing a new service fee structure for hearing-aid–related care.
Why this change is necessary?
Over the past several years, many insurers and Third-Party Administrators (often referred to as TPAs)—including TruHearing, NationsHearing, Hearing Care Solutions (HCS), UnitedHealthcare Hearing, and various Medicare Advantage plans—have made significant changes to their hearing aid benefits. These changes include:
- Reduced or eliminated reimbursement for follow-up care such as cleanings, adjustments, and troubleshooting.
- Unbundled benefits, meaning device cost may be covered, but the ongoing professional care required to maintain and program the devices often is not.
- Restricted covered services under TPA contracts (e.g., limited or no payment for in-office repairs, dome/receiver replacements, or routine maintenance).
- Increased administrative burden, including additional authorizations, documentation, and claim requirements.
- Reimbursement well below the cost of providing comprehensive care, especially through third-party benefit programs.
While we strive to absorb these changes whenever possible, the ongoing reductions now make it necessary to adjust our service model to maintain the high standard of care our patients expect and deserve.
For Insurance Patients (including TPA-administered plans)
Beginning January 1, 2026, certain in-office services that were previously included or billed to insurance will now incur a service fee, which may include:
- In-office visits (scheduled and walk-ins)
- Hearing aid cleanings and maintenance
- In-office repairs and troubleshooting
- Hearing aid reprogramming and adjustments
- Supply replacement (domes, wax guards, receivers, batteries)
- Extended or complex follow-up visits
We will always inform you when a fee applies and provide cost information upfront. We will continue to submit claims for any services that are still billable under your specific plan.
For Private/Direct-Pay Patients
This change will have minimal impact on our private-pay patients. However, to maintain consistency across all service types and compensate for rising operational costs, certain follow-up and maintenance services will also fall under the new fee schedule.
Unlike insurance/TPA patients, your service fees are not dictated by external reimbursement cuts—but the updated structure ensures that all patients receive the same high-quality care and access to appointments while keeping our services sustainable.
We are here to help
We recognize that insurance benefit changes can be confusing and sometimes frustrating. Our team is happy to:
- Review your insurance or TPA benefits
- Explain which services may involve out-of-pocket costs
- Provide estimates for upcoming visits
- Help you understand alternative care options if applicable
Your hearing health remains our top priority, and we are committed to continuing to provide comprehensive, personalized care.
Thank you for your understanding and for trusting us with your hearing needs.
Warm regards,
James “Randy” Whitlow, HIS