What’s included in your cover?
If you’re covered for Implantation of hearing devices and have served the 12-month waiting period, we’ll pay benefits for:
- Initial cochlear implant and sound processor
- Medically required sound processor replacement outside the warranty period.
We won’t pay benefits if:
- You’re replacing the sound processor solely due to the warranty period expiring
- You’re upgrading to improved technology (e.g. newer models with enhanced features)
- You’re claiming for complementary products or accessories (e.g. TV streamers, microphones)
- Implantation of hearing devices is excluded or restricted on your Hospital cover
- You’re claiming an initial sound processor but haven’t served the relevant waiting period
- You’re replacing the sound processor and haven’t been with TUH for at least 12 months.
Sound processor replacement guidelines
| SERVICE | ELIGIBILITY | CLAIMING INFO | WHAT WE PAY |
|---|---|---|---|
| Initial cochlear implant & sound processor (inpatient service) | 12-month waiting period on hospital cover that includes Implantation of hearing devices | • 100% of cochlear implant and sound processor cost • Hospital and specialist doctor fees (as per your hospital cover) | |
| Replacement sound processor – within manufacturer warranty period (outpatient service) | Contact your service provider. Replacement will be covered under manufacturer warranty. | • No benefit payable | |
| Replacement sound processor – within 12 months of manufacturer warranty period expiring (outpatient service) | Has had relevant Hospital cover with TUH for a minimum of 12 months before claiming replacement sound processor | Ask your service provider to: • Complete an AHSA Sound Processor Replacement Application Form • Provide documentation/letter from treating audiologist/consultant • Submit form and documents to us via secure link | • Benefits are pro-rated to reflect the age of the current sound processor and the member will pay a portion of the cost. • TUH will calculate the benefit and any out-of-pocket costs after a request has been received from the manufacturer or supplier. • No benefits are payable for facility or doctor’s fees. |
| Replacement sound processor – more than 12 months after manufacturer warranty period expiring (outpatient service) | Has had relevant Hospital cover with TUH for a minimum of 12 months before claiming replacement sound processor | Ask your service provider to: • Complete an AHSA Sound Processor Replacement Application Form • Provide documentation/letter from treating audiologist/consultant • Submit form and documents to us via secure link | • 100% of sound processor cost • No benefits payable for facility or doctor’s fees (outpatient services aren’t covered) |
These guidelines are current as at 16 October 2026 and subject to change. Please contact us to discuss your specific circumstances.
Your questions answered
What’s a cochlear implant?
A cochlear implant is a medical device that helps people with severe to profound hearing loss. Unlike hearing aids, which amplify sound, cochlear implants bypass damaged parts of the inner ear and send electrical signals to the brain, where they are interpreted as sound.
What’s a sound processor?
A sound processor is the external part of the cochlear implant. It’s a small device that’s worn on or near the ear to capture sounds, process them and send them to the cochlear implant. They usually last 5-7 years, based on the use, care and advancements in technology. Newer upgraded models that enhance sound quality, noise filtering and wireless connectivity, are released regularly. Warranty periods for sound processors can vary between 2 to 10 years.
I’m about to get a cochlear implant – can I claim for this?
Yes, if you’ve had Ultimate Choice, Easy Choice, Top Hospital Gold, Silver+ Family Hospital, Silver+ Hospital, Silver+ No Pregnancy Hospital, Silver+ Active Choice, Bronze+ Young Choice for at least 12 months (or previously had an equivalent level of cover with another fund) you can claim for the initial cochlear implant and sound processor.
If you have Basic+ Hospital and Bronze+ Hospital, your cover is restricted and out of pocket costs will apply.
Can I claim for a sound processor replacement?
Yes, if you’ve had Ultimate Choice, Easy Choice, Top Hospital Gold, Silver+ Family Hospital, Silver+ Hospital, Silver+ No Pregnancy Hospital, Silver+ Active Choice, Bronze+ Young Choice for at least 12 months with TUH. Please see the guidelines summary for more details on whether you can claim.
How do I claim for a sound processor replacement?
It will depend on a few things like whether the sound processor is still under warranty. In most cases, the service provider has to complete an application form and send it to us with the required supporting documents.
We’ll then review the claim and notify the service provider of the outcome within 10 business days via email. For a step-by-step guide on how to claim, please see the guidelines summary.
How will you pay my benefit?
We’ll pay your service provider directly, after confirming the replacement sound processor has been fitted.
