Doctor examining ear
July 10, 2017 | by The Polyclinic

We’ve teamed up with Connexion Insurance Solutions to provide you answers to some of the frequently-asked-questions patients ask about Medicare. Each month we’ll publish an article or series of questions that are commonly asked about Medicare.

Q. My plan includes hearing coverage. What’s the difference between an audiologist and a hearing aid specialist? What questions should I ask about a hearing benefit when evaluating a plan?

A. An audiologist is someone who diagnoses and treats a patient's hearing and balance problems. The majority of audiologists work in healthcare facilities, such as hospitals, physicians' offices, audiology clinics, and some work in schools. The primary differences between an audiologist and a hearing instrument specialist (or "dispensers") is their level of training and scope of practice. Audiologists hold a master’s degree or doctorate in audiology, with six to eight years of higher education with extensive training in hearing.

A hearing instrument specialist also known as a hearing aid specialist, is a professional who evaluates a patient’s hearing problems and chooses the best hearing aid to improve the patient’s condition. Hearing instrument specialists typically have on-the-job training in a less formal manner.

What to Ask When Evaluating Hearing Benefits

  • Does a deductible apply?
  • Is the benefit for exams only or for exams and hardware?
  • How much does the plan pay toward the cost of hearing aids?
  • How often can you get new hearing aids?
  • Can you go to any service provider or are you limited to a network of providers?

Q. If my primary care doctor is on vacation, and I am on a Medicare Advantage plan and I see another doctor, is the visit still covered?

A. It depends on your Medicare Advantage Plan.

Some plans contract with and pay only the individual’s assigned primary care doctor, in which case you’d need to wait to see your own doctor upon return or pay the cost out of pocket. Other plans contract and pay the organization that the doctor works with such as The Polyclinic. In this case, you can see another doctor in the organization and the plan will cover the cost of the visit. To find out whether you can or cannot see a substitute primary care doctor, call the customer service number on your plan ID card.

The Polyclinic and Connexion Insurance Solutions

Connect with a Medicare Specialist

Call 1-877-217-3279 or email to speak with a Medicare specialist (Monday-Friday; 8 a.m. - 5 p.m.) at Connexion Insurance Solutions.

Attend a Free Medicare Class

For more information about Medicare at The Polyclinic, attend The Polyclinic, Medicare and You. Free and open to all. Find a class and RSVP.